octors no longer are administering the RotaShield anti-diarrhea vaccine after reports that it may increase infants’ risk of bowel obstruction.

RotaShield was the world’s first vaccine to prevent diarrhea caused by rotavirus in infants and young children. But after reports of a possible increase in the rate of intussusception (a type of bowel obstruction that occurs when part of the bowel folds onto itself), the Centers for Disease Control and Prevention and the American Academy of Pediatrics recommended last summer that health-care providers temporarily suspend using RotaShield until further studies could be performed. A careful statistical analysis showed the rate of intussusception was about one in every 5,000 recipients of RotaShield; the majority of cases occurred three to seven days after the first dose of the vaccine.

In October, American Home Products, which produced the rotavirus vaccine, withdrew RotaShield from the market. Observers say it could be years before another rotavirus vaccine is approved.

“A year ago, it was hoped we could depend on this vaccine,” says Dr. Jane Siegel, chairwoman of the infection control committee at Children’s Medical Center of Dallas. “But now, it’s back to the drawing board. There are a lot more questions that need to be answered.”

One of the best ways to help prevent the spread of rotavirus is by washing hands with soaps and cleansers after having contact with infants and toddlers who have diarrhea and after changing diapers of all infants and toddlers. The virus often is transmitted from one infected child to another by contaminated hands or objects. Signs of the illness typically include a fever, upset stomach, vomiting and diarrhea. In the United States, about 55,000 infants are hospitalized each year for rotavirus, which is a highly contagious disease. About 40 deaths in the United States each year are attributed to the disease. Worldwide, rotavirus kills about 900,000 infants each year.

The Food and Drug Administration was expected to recommend approval of the pneumococcal vaccine, called Prevenar, by the end of 1999. The vaccine, which has been called one of the decade’s most important health advances for children, protects against deadly infections such as meningitis as well as recurrent ear infections. If approved, it is anticipated that the vaccine will be recommended for all children 2–59 months of age, with priority given to those groups of children at greatest risk for serious disease, such as infants 2–23 months of age, children 24–59 months of age with sickle cell disease, HIV infection or who do not have a normally functioning spleen, as well as Alaska natives or American Indians.