title: Vaccine-acquired rotavirus in infants with severe combined immunodeficiency.
abstract: Live pentavalent human-bovine reassortant rotavirus vaccine is recommended in the United States for routine immunization of infants. We describe three infants, two with failure to thrive, who had dehydration and diarrhea within 1 month after their first or second rotavirus immunization and subsequently received a diagnosis of severe combined immunodeficiency. Rotavirus was detected, by means of reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay, in stool specimens obtained from all three infants, and gene-sequence analysis revealed the presence of vaccine rotavirus. These infections raise concerns regarding the safety of rotavirus vaccine in severely immunocompromised patients.
authors.affiliation: Department of Pediatrics, Section of Allergy and Immunology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.
authors.forename: Niraj C
authors.initials: NC
authors.lastname: Patel
authors.forename: Paula M
authors.initials: PM
authors.lastname: Hertel
authors.forename: Mary K
authors.initials: MK
authors.lastname: Estes
authors.forename: Maite
authors.initials: M
authors.lastname: de la Morena
authors.forename: Ann M
authors.initials: AM
authors.lastname: Petru
authors.forename: Lenora M
authors.initials: LM
authors.lastname: Noroski
authors.forename: Paula A
authors.initials: PA
authors.lastname: Revell
authors.forename: I Celine
authors.initials: IC
authors.lastname: Hanson
authors.forename: Mary E
authors.initials: ME
authors.lastname: Paul
authors.forename: Howard M
authors.initials: HM
authors.lastname: Rosenblatt
authors.forename: Stuart L
authors.initials: SL
authors.lastname: Abramson
mesh_terms: D004279:DNA, Viral / Q000032:analysis; D003681:Dehydration / Q000209:etiology; D003968:Diarrhea, Infantile / Q000209:etiology; D005183:Failure to Thrive / Q000209:etiology; D005243:Feces / Q000821:virology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012367:RNA, Viral / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012401:Rotavirus / Q000235:genetics / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000209:etiology* / Q000821:virology; D022243:Rotavirus Vaccines / Q000009:adverse effects*; D016415:Sequence Alignment; D017422:Sequence Analysis, DNA; D016511:Severe Combined Immunodeficiency / Q000150:complications* / Q000628:therapy; D033581:Stem Cell Transplantation; D017201:Virus Shedding
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral; D022243:Rotavirus Vaccines