An article appearing in The Journal of Allergy and Clinical Immunology (JACI) examines the first reported case of persistent shedding of the rotavirus vaccine in a patient with severe combined immune deficiency (SCID).

The authors report a case of a 9-month-old infant girl who was examined in the hospital after a history of faltering growth and chronic diarrhea. She had received immunizations according to the recommended schedule, including a rotavirus vaccine administered at two, four and six months.

Following the vaccine at four months, the patient developed persistent diarrhea and vomiting with poor weight gain that became worse at six months. Tests of her stool samples showed the presence of a rotavirus strain that matched that of the vaccine she had received. After a thorough assessment of her case, the patient was diagnosed with SCID. She was given a successful transplantation of cord blood at age 11 months and two and a half months later, there were no further traces of rotavirus in her stool.

The rotavirus is the most common cause of acute gastroenteritis, which is commonly referred to as "stomach flu" in young children. Gastroenteritis affects the stomach and intestines and is characterized by vomiting and diarrhea.

Since vaccines can present problems for immunosuppressed patients due to potential morbidity and mortality, some are not recommended for these individuals. The fundamental deciding factor is whether the vaccine is believed to carry less risk than exposure to natural infection, as is the case with the rotavirus.

Primary immunodeficiencies, such as SCID, are usually diagnosed within the first year of life. Thus, the authors concluded that in this new era of universal rotavirus vaccination, it is important to consider this diagnosis when managing patients with faltering growth and chronic diarrhea.

The Journal of Allergy and Clinical Immunology is the official scientific journal of the American Academy of Allergy, Asthma & Immunology (AAAAI).

Source
AAAAI