Human Adenovirus Associated with Severe Respiratory Infection, Oregon, USA, 2013–2014

Scott, Magdalena Kendall; Chommanard, Christina; Lu, Xiaoyan; Appelgate, Dianna; Grenz, LaDonna; Schneider, Eileen; Gerber, Susan I.; Erdman, Dean D.; Thomas, Anne

doi:10.3201/eid2206.151898

Cited by 138 publications

(153 citation statements)

References 37 publications

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“…In recent years, concerns regarding the highly virulent serotype have increased and studies have reported fatal cases caused by specific AdV serotypes such as AdV-3, -7, -11, -14, and -55 (10111314161719), especially in relatively vulnerable populations such as military personnel. Among Korean military personnel, 6 patients with severe AdV pneumonia caused by AdV-55 were first identified between 2012 and 2014 (16); other severe pneumonia cases associated with AdV-55 have been identified.…”

Section: Discussionmentioning

confidence: 99%

“…Since the fatal case of AdV pneumonia in a healthy adult was described in the 1960s (5), severe disease caused by AdV has been reported among non-immunocompromised adults, especially in vulnerable populations, such as military recruits and residents of health care facilities (6789). Recent studies have also described fatal cases of severe AdV pneumonia caused by particular serotypes, which provide insight into emerging, highly virulent serotypes, even in non-immunocompromised patients (1011121314). …”

Section: Introductionmentioning

confidence: 99%

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Characteristics of Adenovirus Pneumonia in Korean Military Personnel, 2012–2016

et al. 2017

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Adenovirus (AdV) can cause severe pneumonia in non-immunocompromised host, but limited data exist on the distinctive characteristics of AdV pneumonia in non-immunocompromised patients. We evaluated distinctive clinico-laboratory and radiological characteristics and outcomes of AdV pneumonia (n = 179), compared with non-AdV pneumonia (n = 188) in Korean military personnel between 2012 and 2016. AdV pneumonia patients had a higher rate of consolidation with ground-glass opacity (101/152) in lobar distribution (89/152) on computed tomography (CT) (P < 0.001). Laboratory findings showed a higher incidence of unusual blood profiles such as leukopenia (55/179, P < 0.001) or thrombocytopenia (100/179, P < 0.001). The patients had more systemic symptoms such as myalgia (82/179, P = 0.001) or diarrhea (23/179, P < 0.001), compared with non-AdV pneumonia patients. Bacterial co-infection was identified in 28.5% of AdV pneumonia. Most of the AdV isolates typed (69/72, 95.8%) were AdV-55. Patients with a pneumonia severity index ≥ class III were more commonly observed in AdV pneumonia patients compared with non-AdV pneumonia patients (11.2% vs. 2.1%, P < 0.001), and time to clinical stabilization from admission was longer in the AdV pneumonia patients compared with the non-AdV pneumonia patients (3.8 vs. 2.6 days, P < 0.001). Mechanical ventilation (n = 6) was only required in AdV pneumonia patients, one of whom died due to AdV-55. Our data showed that AdV pneumonia in non-immunocompromised patients had distinct characteristics and most of the isolates typed in our study were AdV-55. It is suggested that AdV-55 is an important pathogen of pneumonia in Korean military personnel.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Characteristics of Adenovirus Pneumonia in Korean Military Personnel, 2012–2016

et al. 2017

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“…It was also the prevalent genome type in Japan during 1987 to 199246 and in Korea during two outbreaks in 1995–1996 and 2001–200247, with a high fatality rate (18%) in children48. Recently, it emerged to cause adult severe CAP in the USA during 2013–20142732. In our study, HAdV-7d caused more severe clinical manifestations and adverse consequences than other types, particularly HAdV-3 and HAdV-2 (61 and 12 cases, respectively), with longer duration of fever, higher morbidity of tachypnea/dyspnea, pleural effusion, diarrhea, hepatosplenomegaly, and consciousness alteration, as well as with higher rates of pneumonia, mechanical ventilation and death.…”

Section: Discussionmentioning

confidence: 99%

“…The three recent isolates circulating in Southern China (DG01; 2011), Southwestern China (CQ1198; 2010), and Northwestern China (0901HZ/ShX; 2009) were identified as a re-emergent genome type 7d (HAdV-7d) after approximately 20-year absence in China1. In the United States, the recent emergence of HAdV-7d during 2013–2014 caused many hospitalizations and fatal CAP in adult civilians2732. These emergent or re-emergent HAdV-7d variants may have powerful potential to cause more outbreaks, not only in Asia with its dense population centers, but also in Americas.…”

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confidence: 99%

Fatal Community-acquired Pneumonia in Children Caused by Re-emergent Human Adenovirus 7d Associated with Higher Severity of Illness and Fatality Rate

Zeng

Zhang

et al. 2016

Sci Rep

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Human adenoviruses (HAdVs) are highly contagious pathogens causing acute respiratory disease (ARD), such as community-acquired pneumonia. HAdV-7d, a re-emergent genomic variant, has been recently reported in Asia and the United States after a several-decade absence. However, whether HAdV-7d is associated with higher severity than other types is currently unclear. In this study, the clinical and epidemiological investigation showed that fever, cough, and sore throat were the three most common respiratory symptoms of HAdV infections. HAdV-7 caused longer duration of fever, higher morbidity of tachypnea/dyspnea, pleural effusion, diarrhea, hepatosplenomegaly, consciousness alteration, as well as higher rates of pneumonia, mechanical ventilation and higher fatality rate (28.6%) than other types, particularly HAdV-3 and HAdV-2. The genomes of seven HAdV-7d isolates from mild, severe, and fatal cases were sequenced and highly similar with each other. Surprisingly, two isolates (2011, 2012) had 100% identical genomes with an earlier strain from a fatal ARD outbreak in China (2009), which elucidates the virus origin and confirms the unexpected HAdV genomic conservation and stability. Phylogenetic analysis indicated that L1 52/55-kDa DNA packaging protein may be associated with the higher severity of illness and fatality rate of HAdV-7. Clinicians need to be aware of HAdVs in children with ARD.

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“…Recently there have been small, localised outbreaks of pulmonary adenovirus infections described in Oregon and Illinois further highlighting the need to consider the pathogen in clinical practice 13 14…”

Section: Discussionmentioning

confidence: 99%

Disseminated adenovirus infection causing severe ARDS

2017

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A previously healthy young man with a rare genetic condition presented with severe acute respiratory distress syndrome secondary to pneumonia with septic shock. He did not improve with conventional therapy for his known causal organism thus prompting further workup. He was found to be profoundly immunosuppressed raising our suspicion for atypical organisms. A bronchoalveolar lavage sample was positive via PCR for adenovirus which we suspect exacerbated a pre-existing bacterial pneumonia and led to a severe and non-responsive respiratory failure. His serum adenovirus load was markedly elevated. Treatment was started once the diagnosis of disseminated adenovirus infection was made; however, at that time patient was suffering from refractory hypoxaemia, respiratory acidosis, right heart failure and septic shock. Despite maximal supportive measures our patient ultimately expired over the course of 6 days.

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Human Adenovirus Associated with Severe Respiratory Infection, Oregon, USA, 2013–2014

Abstract: HAdV-B7 might be reemerging in the United States.

Cited by 138 publications

References 37 publications

Characteristics of Adenovirus Pneumonia in Korean Military Personnel, 2012–2016

Characteristics of Adenovirus Pneumonia in Korean Military Personnel, 2012–2016

Fatal Community-acquired Pneumonia in Children Caused by Re-emergent Human Adenovirus 7d Associated with Higher Severity of Illness and Fatality Rate

Disseminated adenovirus infection causing severe ARDS

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