H Pylori Link To SIDS Challenged By SIDS Medical Experts

TO: Affiliate Presidents and Executive Directors
FROM: Phipps Cohe, SIDS Alliance National Public Affairs Director
DATE: 10/25/00

RE: H Pylori Link To SIDS Challenged By SIDS Medical Experts

A new study has been published in the Archives of Diseases in Childhood
titled, "An Association Between Sudden Infant Death Syndrome (SIDS) and
Helicobacter Pylori Infection," led by J.R. Kerr of the Infectious Diseases
Research Group at the University of Manchester (U.K.). The study suggests
that H Pylori, a common bacterium or "stomach bug" usually linked to ulcers,
may be deadly when transmitted through saliva passed from an infected parent
or other care giver to an infant via kissing, testing of feeding bottles or
cleaning of pacifiers in the adult's mouth.

The prime purpose of the study was "to determine the presence of visible
bacteria" through the examination of tissue samples. However, according to
the report, "bacteria were not observed in any section of the stomach,
trachea, or lung from the cases or controls." Extracted DNA from the
tissues were then tested for H Pylori ureC and cagA, two genes that have
been linked to the bacterium. Of the 32 SIDS cases involved in the study,
28 tested positive for one or both of these genes, compared with only 1 of
the 8 controls. Based on this result, the authors proceeded to speculate
that "H Pylori occurs in a higher than expected incidence in cases of SIDS."

Despite the use of some highly sensitive tests, the current study fails to
establish the proposed pathophysiologic link between H Pylori and SIDS.
This may be due to the non-specific nature of mild infections; and to flaws
in the control population against which the SIDS results were measured.

The vast majority of babies with mild infections, such as those caused by H
Pylori bacterium, merely get sick and do not die. The study's authors do
not come up with a plausible explanation as to how a mild infection can
cause SIDS or sudden death. They conclude that H Pylori infections increase
SIDS risk, but it is unclear from this study as to how or whether they
really do.

In order to advance the H Pylori/SIDS theory, attempts would have to be made
to associate the high frequency of H Pylori the authors have seen in their
SIDS study population with similar results as viewed against a more adequate
control group. The controls utilized by the current study included infants
who had died of prematurity, serious diseases, and a number of other
conditions that suggest the sterile environment of hospitalization and
antibiotics use that would preclude the possibility of infection. This may
explain the virtual absence of H Pylori in the control group, which puts a
completely different spin on the results. Clearly, controls drawn from
among accident victims, and others subject to environmental contaminants
would provide a fairer comparison.

While it is not a good idea for parents or care givers to transfer feeding
bottles and other objects from their own mouths to those of their babies for
sanitary reasons, the SIDS Alliance believes that alarming the public
prematurely about any perceived relationship between H Pylori and SIDS is
unwarranted at this time. In interviews, the authors, themselves emphasize
the need for independent confirmation of their findings.

The SIDS Alliance is a national, not-for-profit, voluntary health
organization dedicated to the support of SIDS families, public education,
and medical research. For the latest, quality-assured information about
Sudden Infant Death Syndrome and ways to reduce SIDS risk, call the SIDS
Alliance toll-free at 1 (800) 221-SIDS (7437) or visit the SIDS Alliance
Online at www.sidsalliance.org.