Background.Recently, epidemiological and clinical data have revealed important changes with regard to clinical adenovirus infection, including alterations in antigenic presentation, geographical distribution, and virulence of the virus.Methods. In an effort to better understand the epidemiology of clinical adenovirus infection in the United States, we adopted a new molecular adenovirus typing technique to study clinical adenovirus isolates collected from 22 medical facilities over a 25-month period during [2004][2005][2006]. A hexon gene sequence typing method was used to characterize 2237 clinical adenovirus-positive specimens, comparing their sequences with those of the 51 currently recognized prototype human adenovirus strains. In a blinded comparison, this method performed well and was much faster than the classic serologic typing method.Results. Among civilians, the most prevalent adenovirus types were types 3 (prevalence, 34.6%), 2 (24.3%), 1 (17.7%), and 5 (5.3%). Among military trainees, the most prevalent types were types 4 (prevalence, 92.8%), 3 (2.6%), and 21 (2.4%).Conclusions. For both populations, we observed a statistically significant increasing trend of adenovirus type 21 detection over time. Among adenovirus isolates recovered from specimens from civilians, 50% were associated with hospitalization, 19.6% with a chronic disease condition, 11% with a bone marrow or solid organ transplantation, 7.4% with intensive care unit stay, and 4.2% with a cancer diagnosis. Multivariable risk factor modeling for adenovirus disease severity found that age !7 years (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.4-7.4), chronic disease (OR, 3.6; 95% CI, 2.6-5.1), recent transplantation (OR, 2.7; 95% CI, 1.3-5.2), and adenovirus type 5 (OR, 2.7; 95% CI, 1.5-4.7) or type 21 infection (OR, 7.6; 95% CI, 2.6-22.3) increased the risk of severe disease.

Swine workers and their spouses are at markedly increased risk of acquiring swine influenza virus infections.

Background  Identifying risk factors for zoonotic influenza transmission may aid public health officials in pandemic influenza planning. Objectives  We sought to evaluate rural Iowan agriculture workers exposed to poultry for previous evidence of avian influenza virus infection. Methods  In 2004, we enrolled 803 rural adult Iowans in a 2‐year prospective study of zoonotic influenza transmission. Their enrollment data and sera were compared with those of 66 adult controls enrolled at the University of Iowa in 2006 by using proportional odds modeling. Results  Of the 803 participants 58·8% were male with a mean age of 55·6 years. Forty‐eight percent reported previous poultry exposure. Sera were studied by microneutralization techniques for antibodies against avian H4, H5, H6, H7 and H9 viruses. Touching live birds was associated (OR 1·2; 95% CI 1·02–1·8) with increased antibody titer against H5 virus. Similarly, participants who reported hunting wild birds had increased antibody titers against H7 virus (OR 2·8; 95%CI 1·2–6·5) and subjects who reported recent exposure to poultry had increased antibody titers against H6 (OR 3·4; 95% CI 1·4–8·5) and H7 viruses (OR 2·5, 95% CI 1·1–5·7). There was no evidence of elevated antibody against avian H4 or H9 viruses. Conclusions  These data suggest that hunting and exposure to poultry may be important risk factors for avian influenza virus infection among rural US populations. Agriculture workers should be included in influenza pandemic plans.

Background-Epidemiological data suggest that clinical outcomes of human adenovirus (HAdV) infection may be influenced by virus serotype, coinfection with multiple strains, or infection with novel intermediate strains. In this report, we propose a clinical algorithm for detecting HAdV coinfection and intermediate strains.

Background The clinical impact of polymicrobial respiratory infections remains uncertain. Previous reports are contradictory regarding an association with severe disease. Methods Three hundred and forty-six specimens from children with acute respiratory illness identified at the University of Iowa Hospitals and Clinics Clinical Microbiology Laboratory (CML) were evaluated by DFA, and/or viral culture by CML and later by molecular study for the presence of influenza, parainfluenza (HPIV), respiratory syncytial virus (HRSV), adenovirus (HAdV), human metapneumovirus (HMPV), rhinovirus (HRV), and human bocavirus (HBoV). Demographic and clinical data were abstracted from medical records. Results Multiple viruses were detected in 46 (21.7%) of 212 virus-positive specimens with the most frequent virus-virus combinations being HRV-HRSV (n=12), HRV-HBoV (n=6), and HRV-HPIV 3 (n=4). Risk factors for coinfection included: male gender (OR 1.70, 95% CI 0.83–3.46), 6 mos-1 yr age (OR 2.15, 95% CI 0.75–6.19), and history of immunosuppression (OR 2.05, 95% CI 0.99–4.23). Children with viral coinfections were less likely than children with single virus infections to be admitted to an intensive care unit (OR 0.32, 95% CI 1.12–9.17), however, this may be explained by undetected viral-bacterial coinfections. Conclusions HRV, HRSV, HBoV and polymicrobial infections were prevalent in this study. While the cross-sectional design could not easily examine polymicrobial infection and disease severity, prospective, population-based research regarding the clinical impact of such infections is warranted.

We retrospectively studied 420 pharyngeal swab specimens collected from Peruvian and Argentinean patients with influenzalike illness in 2002 and 2003 for evidence of human metapneumovirus (HMPV). Twelve specimens (2.3%) were positive by multiple assays. Six specimens yielded HMPV isolates. Four of the 6 isolates were of the uncommon B1 genotype.

Background-Adenovirus type 3 (HAdV3) is one of the most prevalent serotypes detected globally. Variants of HAdV3 have been associated with outbreaks of severe disease.

11-␤ hydroxysteroid dehydrogenase type 2 (HSD2) oxidizes the biologically active glucocorticoid (GC), cortisol, to inactive cortisone. We characterized HSD2 gene expression and activity in human adult and fetal lung tissues and in cultured fetal lung explants, and examined the potential regulation of HSD2 in the fetal lung by sex steroids. Human adult lung, fetal lung, and cultured fetal lung explant tissues contained similar amounts of HSD2 mRNA. However, higher levels of HSD2 protein were detected in human fetal lung tissue than in adult lung, with expression being restricted to a subset of epithelial cells in the fetal lung tissue. Differentiated fetal lung explants maintained in culture expressed higher levels of HSD2 protein and enzymatic activity than undifferentiated fetal lung tissues. Finally, HSD2 protein levels were decreased in male, but not female, fetal lung explants treated with 17-␤ estradiol. In contrast, 5-␣ dihydrotestosterone did not significantly affect HSD2 levels. These data indicate that HSD2 protein and activity levels increase in parallel with the differentiation of alveolar type II epithelial cells in vitro, and that HSD2 protein levels are regulated by 17-␤ estradiol in male fetal lung tissue. (Pediatr Res 62: 26-31, 2007)