Adenovirus 7a: a community-acquired outbreak in a children???s hospital

Mitchell, Lauren; Taylor, Brenda; Reimels, William; Barrett, Fred F.; DeVincenzo, John P.

doi:10.1097/00006454-200010000-00011

Cited by 46 publications

(55 citation statements)

References 18 publications

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“…The prevalence of AdV infections is high, as revealed by serological studies (27). The most common sites of infection in immunocompetent individuals include the gastrointestinal tract, the upper respiratory tract, and the eyes (1,9,22). In the presence of a functional immune system, AdV infections are not associated with life-threatening disease, but latent infections with persistence of the viral genome, involving particularly species C, have been found in about 80% of the individuals investigated (12).…”

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confidence: 99%

Comparative Sequence Analysis of the Hexon Gene in the Entire Spectrum of Human Adenovirus Serotypes: Phylogenetic, Taxonomic, and Clinical Implications

Ebner

Pinsker

Lion

2005

J Virol

127

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The adenovirus (AdV) hexon constitutes the major virus capsid protein. The epitopes located on the hexon protein are targets of neutralizing antibodies in vivo, serve in the recognition by cytotoxic T cells, and provide the basis for the classification of adenoviruses into the 51 serotypes known to date. We have sequenced the entire hexon gene from human serotypes with incomplete or no sequence information available (n ‫؍‬ 34) and performed a comparative analysis of all sequences. The overall sequence divergence between the 51 human serotypes ranged from 0.7 to 25.4% at the protein level. The sequence information has been exploited to assess the phylogeny of the adenovirus family, and protein distances between the six AdV species (A to F) and among individual serotypes within each species were calculated. The analysis revealed that the differences among serotypes within individual species range from 0.3 to 5.4% in the conserved regions (765 amino acids [aa]) and from 1.5 to 59.6% in the variable regions (154 to 221 aa). Serotypes of different species showed an expectedly greater divergence both in the conserved (5.9 to 12.3%) and variable (49.0 to 74.7%) regions. Construction of a phylogenetic tree revealed three major clades comprising the species B؉D؉E, A؉F, and C, respectively. For serotypes 50 and 51, the original assignment to species B and D, respectively, is not in accordance with the hexon DNA and protein sequence data, which placed serotype 50 within species D and serotype 51 within species B. Moreover, the hexon gene of serotype 16, a member of species B, was identified as the product of recombination between sequences of species B and E. In addition to providing a basis for improved molecular diagnostics and classification, the elucidation of the complete hexon gene sequence in all AdV serotypes yields information on putative epitopes for virus recognition, which may have important implications for future treatment strategies permitting efficient targeting of any AdV serotype.Human adenoviruses (AdV) represent a large family, currently comprising 51 different serotypes, which are divided into six species (designated A to F) based on different oncogenic, hemagglutinating, morphological, and DNA sequence properties. The prevalence of AdV infections is high, as revealed by serological studies (27). The most common sites of infection in immunocompetent individuals include the gastrointestinal tract, the upper respiratory tract, and the eyes (1, 9, 22). In the presence of a functional immune system, AdV infections are not associated with life-threatening disease, but latent infections with persistence of the viral genome, involving particularly species C, have been found in about 80% of the individuals investigated (12). Adenoviruses were described to enter human cells either by the coxsackievirus and adenovirus receptor CAR (3) or by the cell surface protein CD46 (11), which are present on most human cell types (23). Since adenovirusbased vectors are not regarded as harmful to healthy individuals, they ar...

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confidence: 99%

Comparative Sequence Analysis of the Hexon Gene in the Entire Spectrum of Human Adenovirus Serotypes: Phylogenetic, Taxonomic, and Clinical Implications

Ebner

Pinsker

Lion

2005

J Virol

127

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“…Updates on the vaccine are available at the website of the Centers for Disease Control and Prevention (www.cdc.gov/vaccines). Most HAdV epidemics in immunocompetent individuals are observed in winter and early spring, but infections in immunocompromised patients occur throughout the year (96,97). Epidemiological data indicate that the majority of primary HAdV infections occur during the first 5 years of life, due to the lack of humoral immunity.…”

Section: Primary Infection and Persistencementioning

confidence: 99%

Adenovirus Infections in Immunocompetent and Immunocompromised Patients

2014

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SUMMARY Human adenoviruses (HAdVs) are an important cause of infections in both immunocompetent and immunocompromised individuals, and they continue to provide clinical challenges pertaining to diagnostics and treatment. The growing number of HAdV types identified by genomic analysis, as well as the improved understanding of the sites of viral persistence and reactivation, requires continuous adaptions of diagnostic approaches to facilitate timely detection and monitoring of HAdV infections. In view of the clinical relevance of life-threatening HAdV diseases in the immunocompromised setting, there is an urgent need for highly effective treatment modalities lacking major side effects. The present review summarizes the recent progress in the understanding and management of HAdV infections.

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“…According to the last global survey, approximately one-fifth of all HAdV infections reported to the World Health Organization (WHO) were attributed to HAdV7 (5). HAdV7 outbreaks generally occur in settings with close living conditions, such as military barracks, hospital wards, and chronic care facilities (1,(6)(7)(8). In hospitals, HAdV has emerged as a nosocomial pathogen, and nosocomial outbreaks caused by HAdV7 with fatal cases have been reported worldwide (8-10).…”

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“…HAdV7 outbreaks generally occur in settings with close living conditions, such as military barracks, hospital wards, and chronic care facilities (1,(6)(7)(8). In hospitals, HAdV has emerged as a nosocomial pathogen, and nosocomial outbreaks caused by HAdV7 with fatal cases have been reported worldwide (8)(9)(10). Although some prevention measurements have been carried out to control nosocomial transmission, questions regarding the efficacy of these programs persist, and the contribution of HAdV7 (and adenoviruses in general) to nosocomial infection is likely to be underestimated.…”

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Human Adenovirus Type 7 Infection Associated with Severe and Fatal Acute Lower Respiratory Illness and Nosocomial Transmission

Cui

Wen

et al. 2015

J Clin Microbiol

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A 23-year-old male died of severe pneumonia and respiratory failure in a tertiary hospital in Beijing, and 4 out of 55 close contacts developed fever. Molecular analysis confirmed human adenovirus type 7 (HAdV7) as the causative agent. We highlight the importance of early diagnosis and treatment and proper transmission control of HAdV7. CASE REPORT Human adenovirus type 7 (HAdV7) infection is associated with acute respiratory disease syndrome, pharyngoconjunctival fever, pneumonia, and central nervous system disease (1-4). According to the last global survey, approximately one-fifth of all HAdV infections reported to the World Health Organization (WHO) were attributed to HAdV7 (5). HAdV7 outbreaks generally occur in settings with close living conditions, such as military barracks, hospital wards, and chronic care facilities (1,(6)(7)(8). In hospitals, HAdV has emerged as a nosocomial pathogen, and nosocomial outbreaks caused by HAdV7 with fatal cases have been reported worldwide (8-10). Although some prevention measurements have been carried out to control nosocomial transmission, questions regarding the efficacy of these programs persist, and the contribution of HAdV7 (and adenoviruses in general) to nosocomial infection is likely to be underestimated. Here, we report a case of HAdV7 infection associated with severe pneumonia and fatal acute lower respiratory disease and nosocomial transmission.The index case, a 23-year-old male in Wuhan City, Hubei Province, China, presented with a fever of approximately 39°C on 18 January 2014, but discontinuous treatment did not alleviate his symptoms. On 26 January, he was admitted to the emergency department of a tertiary hospital in Beijing. A routine blood test showed high neutrophil levels (71.4%) and elevated plasma C reactive protein (19 mg/ml), and chest radiographs revealed an increase of right lung markings. However, the use of cefoxitin sodium by injection did not prevent his condition from worsening, with symptoms including severe fever, cough, and phlegm. He was diagnosed with pneumonia and transferred to the respiratory department on 28 January. Six days later, he was transferred to an intensive care unit (ICU) because of lung consolidation, and he passed away on 5 February 2014.During his hospitalization, 4 of 55 close contacts developed fevers higher than 38.0°C, including a family member, a bedside clinician, and two patients in the same ward (Table 1 and Fig. 1). The initial secondary case (patient 1) was his cousin, a 19-year-old girl who visited the index case on 26 January for 30 min in the emergency department and on 2 February for 5 min in the respiration department. The distance between them was more than 2 meters, but neither wore a mask. She experienced a fever of 38.5°C on 3 February. Patient 2, a 29-year-old male with acute pancreatitis and a fatty liver, was admitted to the same ward of the emergency department on 27 January. He developed a fever on 3 February, and a chest X-ray showed pulmonary shadows. Patient 3, a bedside clinician of the inde...

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Adenovirus 7a: a community-acquired outbreak in a children???s hospital

Abstract: Adenovirus 7a can cause large community epidemics affecting children. The disease produced by adenovirus 7a in children is almost exclusively of the respiratory tract, and in some individuals it may be very severe and possibly fatal.

Cited by 46 publications

References 18 publications

Comparative Sequence Analysis of the Hexon Gene in the Entire Spectrum of Human Adenovirus Serotypes: Phylogenetic, Taxonomic, and Clinical Implications

Comparative Sequence Analysis of the Hexon Gene in the Entire Spectrum of Human Adenovirus Serotypes: Phylogenetic, Taxonomic, and Clinical Implications

Adenovirus Infections in Immunocompetent and Immunocompromised Patients

Human Adenovirus Type 7 Infection Associated with Severe and Fatal Acute Lower Respiratory Illness and Nosocomial Transmission

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