Subspecies B2 Ads have rarely been associated with ARD, and only in Eurasia. This survey represents the first report of AdB2-associated ARD in the Western Hemisphere. The simultaneous emergence of several species B Ads suggests a common external source (the civilian population) and a decrease in preexisting immunity to species B Ads.

Potential sources of adenovirus transmission among US military recruits included the presence of adenovirus on surfaces in living quarters and extended pharyngeal viral shedding over the course of several days. The introduction of new recruits, who were still shedding adenovirus, into new training groups was documented. Serological screening could identify susceptible recruits for the optimal use of available vaccines. New high-throughput technologies show promise in providing valuable data for clinical and research applications.

Eighty-eight adenovirus (Ad) isolates and associated clinical data were collected from walk-in patients with influenza-like illness in Egypt during routine influenza surveillance from 1999 through 2002. Respiratory Ad distributions are geographically variable, and serotype prevalence has not been previously characterized in this region. Serotype identity is clinically relevant because it predicts vaccine efficacy and correlates strongly with both clinical presentation and epidemiological pattern. Species and serotype identities were determined using several well-validated multiplex PCR protocols culled from the literature and supplemented with a few novel primer sets designed to identify rare types. The isolates included common species B1 serotypes (Ad3 and Ad7), common species C serotypes (Ad1, Ad2, and Ad5), the less common species B2 serotype Ad11, and three isolates of the rare species B1 serotype Ad16. Two isolates that appear to be variant Ad16 were also identified. Fifteen coinfections of multiple adenoviral types, primarily AdB/AdC and Ad3/Ad7 dual infections, were detected. The majority of these were verified using redundant PCR tests targeted at multiple genes. PCR is able to resolve coinfections, in contrast to traditional serum neutralization tests. PCR is also comparatively rapid and requires very little equipment. Application of the method allowed an inclusive determination of the serotypes found in the Egyptian respiratory sample set and demonstrated that coinfections are common and may play a previously unrecognized role in adenovirus pathogenesis, evolution, and epidemiology. In particular, coinfections may influence adenoviral evolution, as interserotypic recombination has been identified as a source of emerging strains.

We have developed a PCR/electrospray ionization mass spectrometry (PCR/ESI-MS) assay for the rapid detection, identification, and serotyping of human adenoviruses. The assay employs a high-performance mass spectrometer to "weigh" the amplicons obtained from PCR using primers designed to amplify known human adenoviruses. Masses are converted to base compositions and, by comparison against a database of the genetic sequences, the serotype present in a sample is determined. The performance of the assay was demonstrated with quantified viral standards and environmental and human clinical samples collected from a military training facility. Over 500 samples per day can be analyzed with sensitivities greater than 100 genomes per reaction. This approach can be applied to many other families of infectious agents for rapid and sensitive analysis.Human adenoviruses cause a variety of diseases in humans (13,14); the types of illness may include gastroenteritis, cystitis, and respiratory disease (pneumonia and respiratory tract infections) (3,34). In some cases, including closed environments such as schools and military facilities, these diseases can become epidemic (6, 32). The impact on military facilities has been particularly important because the infections have a tremendous negative effect on both the readiness and training schedules of the military personnel. The use of live oral vaccines against serotypes 4 and 7, two of the most common serotypes found in infected military personnel, prevented large epidemic outbreaks until production was discontinued in 1996 (15). Following the cessation of vaccine administration, these outbreaks resumed (16).Adenoviruses show a high degree of variation. Over 50 serotypes have now been identified based on the use of serotypespecific neutralization assays (5). These serotypes are grouped into six species (A to F) according to a number of criteria, including nucleic acid sequence and agglutination properties (2). Although serotypes 4 and 7 are the most prevalent strains associated with adult respiratory infections, other serotypes are also detected in these populations. Many studies have shown that there is genetic diversity within these serotypes (1,(19)(20)(21)33) and that genome typing of individual serotypes can be used to study the biogeographical origin of outbreak strains and can assist in unraveling the epidemiology of an outbreak (19a).The ability to rapidly detect and serotype adenovirus is crucial for (i) recognizing that an outbreak is occurring, (ii) prescribing appropriate supportive care, (iii) ruling out other disease etiologies, (iv) making decisions regarding quarantining individuals to reduce the spread of the outbreak, (v) following the epidemiology of the outbreak in real time across multiple sites, and (vi) predicting vaccine effectiveness. The conventional methods used for the detection and serotyping of adenovirus include culture and immunofluorescence to identify adenovirus generically, followed by serotype-discriminating microneutralization assays using sero...

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