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Intussusception incidence among infants in the UK and Republic of Ireland: a pre-rotavirus vaccine prospective surveillance study

Samad, L; Cortina-Borja, M; Bashir, HE; Sutcliffe, AG; Marven, S; Cameron, JC; Lynn, R; (2013) Intussusception incidence among infants in the UK and Republic of Ireland: a pre-rotavirus vaccine prospective surveillance study. Vaccine , 31 (38) pp. 4098-4102. 10.1016/j.vaccine.2013.06.084. Green open access

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Abstract

INTRODUCTION: Intussusception, an abdominal emergency in young children, has been linked to a previous vaccine used to prevent rotavirus gastroenteritis. Although this vaccine was withdrawn, recent studies have suggested a potential, very small increased risk of intussusception following the administration of newly developed rotavirus vaccines. We aimed to determine the baseline incidence of intussusception among infants in the UK and Republic of Ireland - prior to the imminent introduction of the rotavirus vaccine into the UK schedule this year. METHODS: Prospective, active surveillance via the established British Paediatric Surveillance Unit (BPSU) was carried out from March 2008 to March 2009. Clinicians across 101 National Health Service (and equivalent) hospitals, including 27 paediatric surgical centres, reported cases admitted for intussusception in the UK and Republic of Ireland. The standard Brighton Collaboration case definition was used with only definite cases included for incidence estimation. RESULTS: The study response rate was 94.5% (379 questionnaires received out of 401 case notifications). A total of 250 definite cases of intussusception were identified. The annual incidence among infants in the UK and Republic of Ireland was 24.8 (95% CI: 21.7-28.2) and 24.2 (95% CI: 15.0-37.0) per 100,000 live births. In the UK, the highest incidence occurred in Northern Ireland (40.6, 95% CI: 21.0-70.8), followed by Scotland (28.7, 95% CI: 17.5-44.3), England (24.2, 95% CI: 20.9-27.9), then Wales (16.9, 95% CI: 6.8-34.8). In England, regional incidence was highest in London and lowest in the West Midlands. By age, the highest incidence (50.3/100,000 live births, 95% CI: 33.4-72.7) occurred in the fifth month of life (for England). A seasonal trend in the presentation of intussusception was observed with the incidence significantly (p=0.001) increased during winter and spring. CONCLUSION: The baseline rates obtained in this study will inform rotavirus vaccine-safety policy by enabling comparison with post-introduction incidence.

Type: Article
Title: Intussusception incidence among infants in the UK and Republic of Ireland: a pre-rotavirus vaccine prospective surveillance study
Location: Netherlands
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.vaccine.2013.06.084
Publisher version: http://dx.doi.org/10.1016/j.vaccine.2013.06.084
Language: English
Additional information: Copyright © 2013 Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/3.0/). This document was posted here by permission of the publisher. At the time of the deposit, it included all changes made during peer review, copy editing, and publishing. The U. S. National Library of Medicine is responsible for all links within the document and for incorporating any publisher-supplied amendments or retractions issued subsequently. The published journal article, guaranteed to be such by Elsevier, is available for free, on ScienceDirect, at: http://dx.doi.org/10.1016/j.vaccine.2013.06.084
Keywords: BPSU, British Paediatric Surveillance Unit, Incidence, Intussusception, NHS, National Health Service, ONS, Office for National Statistics, Surveillance, Vaccine safety, Female, Great Britain, Humans, Infant, Infant, Newborn, Intussusception, Ireland, Male, Prospective Studies, Rotavirus Infections, Rotavirus Vaccines, Seasons
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1400450
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