{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T09:48:24Z","timestamp":1761126504605,"version":"3.40.5"},"reference-count":23,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,5,1]]},"abstract":"<jats:p>OBJECTIVES. The rhesus tetravalent rotavirus vaccine (RRV) was withdrawn from the routine program for childhood immunization in the United States because of the rare and unexpected occurrence of intussusception in the 2-week period after administration of the first dose.<\/jats:p>\n               <jats:p>METHODS. To search for the pathogenesis of this association, we compared the pathology of surgical specimens from infants who had surgical reduction of their intussusceptions within 2 weeks of receiving the vaccine (case patients; n = 8) with the pathology of specimens from children who had surgery &amp;gt;2 weeks after immunization (n = 6) or who had never been immunized (n = 26). Tissue was examined for evidence of the vaccine strain of rotavirus by reverse transcriptase-polymerase chain reaction (RT-PCR), in situ hybridization, and immunohistochemical staining.<\/jats:p>\n               <jats:p>RESULTS. RRV was identified by RT-PCR in tissue samples from 7 of the 8 case patients and in 2 of the 6 children who received the vaccine at a more distant time (29 and 58 days before surgery), but it was not identified in samples from any of the nonvaccinated children. No evidence of rotavirus tissue involvement was detected in any of the children by in situ hybridization or immunohistochemical staining. Pathologic evidence (for example, inclusion bodies, smudge cells) of adenovirus infection was present in 35% of the 37 specimens examined by routine staining and immunohistochemistry.<\/jats:p>\n               <jats:p>CONCLUSIONS. The fact that RRV was detected by RT-PCR but not by either of the other assays could be explained by RRV being present in the lumen of the gut but not in the tissues of appendix, ileum, or Peyer's patches. The Peyer's patches were not hyperplastic, and we could not establish the pathogenic mechanism for this association.<\/jats:p>","DOI":"10.1542\/peds.2005-1556","type":"journal-article","created":{"date-parts":[[2006,5,1]],"date-time":"2006-05-01T17:22:05Z","timestamp":1146504125000},"page":"e827-e832","source":"Crossref","is-referenced-by-count":21,"title":["Intussusception After Administration of the Rhesus Tetravalent Rotavirus Vaccine (Rotashield): The Search for a Pathogenic Mechanism"],"prefix":"10.1542","volume":"117","author":[{"given":"Maureen","family":"Lynch","sequence":"first","affiliation":[{"name":"Viral Gastroenteritis Section, Division of Viral and Rickettsial Diseases"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wun-Ju","family":"Shieh","sequence":"additional","affiliation":[{"name":"Infectious Disease Pathology Activity, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph S.","family":"Bresee","sequence":"additional","affiliation":[{"name":"Viral Gastroenteritis Section, Division of Viral and Rickettsial Diseases"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen M.","family":"Tatti","sequence":"additional","affiliation":[{"name":"Infectious Disease Pathology Activity, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon R.","family":"Gentsch","sequence":"additional","affiliation":[{"name":"Viral Gastroenteritis Section, Division of Viral and Rickettsial Diseases"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara","family":"Jones","sequence":"additional","affiliation":[{"name":"Infectious Disease Pathology Activity, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baoming","family":"Jiang","sequence":"additional","affiliation":[{"name":"Viral Gastroenteritis Section, Division of Viral and Rickettsial Diseases"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Hummelman","sequence":"additional","affiliation":[{"name":"Viral Gastroenteritis Section, Division of Viral and Rickettsial Diseases"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher M.","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"Viral Gastroenteritis Section, Division of Viral and Rickettsial Diseases"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherif R.","family":"Zaki","sequence":"additional","affiliation":[{"name":"Infectious Disease Pathology Activity, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger I.","family":"Glass","sequence":"additional","affiliation":[{"name":"Viral Gastroenteritis Section, Division of Viral and Rickettsial Diseases"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2006,5,1]]},"reference":[{"key":"2021120823270638800_R1","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Committee on Infectious Diseases. Prevention of rotavirus disease: guidelines for the use of rotavirus vaccine. Pediatrics.\u20081998;102:483\u2013491","DOI":"10.1542\/peds.102.6.1483"},{"key":"2021120823270638800_R2","unstructured":"Centers for Disease Control and Prevention. Rotavirus vaccine for the prevention of rotavirus gastroenteritis among children: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep.\u20081999;48(RR-2):1\u201320"},{"key":"2021120823270638800_R3","doi-asserted-by":"crossref","unstructured":"Zanardi LR, Haber P, Mootrey GT, Niu MT, Wharton M. Intussusception among recipients of rotavirus vaccine: reports to the vaccine adverse event reporting system. Pediatrics.\u20082001;107(6). Available at: www.pediatrics.org\/cgi\/content\/full\/107\/6\/e97","DOI":"10.1542\/peds.107.6.e97"},{"key":"2021120823270638800_R4","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Committee on Infectious Diseases. 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