A swimming pool-associated outbreak of pharyngoconjunctival fever caused by human adenovirus type 4 in Beijing, China

Abstract

Patients with swimming pool-acquired human adenovirus (HAdV) infections usually manifest characteristic clinical features that include fever, pharyngitis, and conjunctival inflammation, syndromically referred to as pharyngoconjunctival fever (PCF). HAdV types 3, 4, and 7 are most commonly associated with PCF. This article reports an outbreak of PCF that involved 55 students and staff at a university in Beijing, China. Fifty patients had used the same swimming pool 2 weeks before the onset of symptoms. HAdV type 4 was identified from patient eye and throat swabs and concentrated swimming pool water samples. Partial hexon gene sequences obtained from the water samples were 100% identical to the sequences obtained from the swab samples, which clustered with HAdV-4 within species E. Swimming pool water contaminated with HAdV-4 was the most likely source of infection, although one instance of likely person-to-person transmission was noted.

Seroprevalence of Neutralizing Antibodies against Six Human Adenovirus Types Indicates the Low Level of Herd Immunity in Young Children from Guangzhou, China

“…Many HAdV types are relevant to ARD, including HAdV species B (type 3, 7, 14, 55, 11, 16, 21, 50), species C (type 1, 2, 5, 6, 57), and species E (type 4) (Lynch and Kajon 2016 ). Of these HAdVs, HAdV3, -4, -7, -14, and -55 have been reported to be associated with severe ARD outbreaks in military and civilian populations, and have caused severe and even fatal infections in both children and adults (Chen et al 2015 ; Lin et al 2017 ; Kajon et al 2018 ; Li et al 2018 ; Yao et al 2019 ; Bautista-Gogel et al 2020 ). HAdV-3 and -7 are the most common types in pediatric patients with ARD, and HAdV-7 is more likely to cause life-threatening pneumonia (Deng et al 2013 ; Lin et al 2017 ; Fu et al 2019 ).…”

Prevalence of Common Respiratory Viral Infections and Identification of Adenovirus in Hospitalized Adults in Harbin, China 2014 to 2017

“…Phylogenetic history of several respiratory viruses isolated from China in recent years have been well established, including the influenza virus ( Wang et al, 2018 ; Yang et al, 2018 ), the PIV ( Pan et al, 2017 ) and the RSV ( Liu et al, 2014 ; Zou et al, 2016 ). The information about adenoviral evolutionary history in China was limited to outbreak reports and novel strains identification ( Lu et al, 2014 ; Li et al, 2018 ), leaving a gap for circulating stains among adult patients.…”

Adenoviral Infections in Singapore: Should New Antiviral Therapies and Vaccines Be Adopted?

“…Upon its discovery in the 1950s [15], HAdV-E4 was largely considered restricted to and controlled by vaccine in the US military population, with rare detections among civilians, such as school children in the Netherlands in 1958 [16], users of a private swimming pool in the USA in 1977 [17], and conjunctivitis patients in Japan in 1979 [18]. More recently, surveillance for HAdV has improved, and evidence of HAdV-E4 infections among civilian populations in the USA, Italy, West Africa, China, Hong Kong, Taiwan, India, Malaysia, and Singapore have been increasingly reported [8,[19][20][21][22][23][24][25][26][27][28]. Due to the historical lack of HAdV genotyping surveillance, it is unknown whether HAdV-E4 is a new or re-emerging pathogen in SEA.…”