The relationship between wild-type rotavirus and intussusception is also of interest because of a slightly increased risk of intussusception detected following vaccination with 3 different rotavirus vaccines based on different rotavirus strains: Rotarix (GlaxoSmithKline Biologicals), RotaTeq (Merck & Co.), and RotaShield (Wyeth). No causative association has been found between intussusception and certain other viruses including astrovirus, sapovirus, and echovirus. However, findings for these viruses are sparse. Enterovirus, norovirus, and human herpesvirus 6 (HHV-6) have been shown to have statistically significant relationships with intussusception in some studies. Adenovirus, in particular type C, has been consistently associated with intussusception in infants and young children. Because some studies have reported a seasonality to intussusception cases, several viral pathogens have been considered as possible etiologies. Some cases of naturally occurring intussusception are caused by anatomical lead points however, in most cases the cause is unknown. Other differences between populations have also been noted in the age distribution, clinical management, and outcomes of intussusception in infants and young children. However, the incidence of intussusception varies by country: rates have been documented as high as 300 per 100 000 infants in Korea and Vietnam and as low as 9 per 100 000 infants in Bangladesh. Worldwide, an estimated 74 intussusceptions per 100 000 infants occur annually. Some intussusception cases may resolve spontaneously. Intussusception, an invagination of the intestine, is the leading cause of bowel obstruction in infants and can lead to vascular compromise, necrosis of the intestine, and death when not reduced by enema or during surgery. Adenovirus, rotavirus, intussusception, intestinal obstruction, viral pathogens
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