Large Epidemic of Respiratory Illness Due to Adenovirus Types 7 and 3 in Healthy Young Adults

Ryan, Margaret A. K.; Gray, Gregory C.; Smith, Besa; McKeehan, Jamie A.; Hawksworth, Anthony W.; Malasig, Marietta D.

doi:10.1086/338471

Cited by 119 publications

(86 citation statements)

References 64 publications

(47 reference statements)

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“…These distinctions correlate strongly with antigenicity, clinical presentation, and epidemiological character (30), and the same groups are similarly clustered on the basis of genetic homology (11). Under most circumstances, the clinically important Ad species are those associated with febrile respiratory disease (AdB1, AdC, and AdE) since these can cause widespread outbreaks with severe clinical presentations, including viral pneumonia and death (17,20,25,29).…”

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confidence: 99%

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PCR Analysis of Egyptian Respiratory Adenovirus Isolates, Including Identification of Species, Serotypes, and Coinfections

et al. 2005

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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.

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“…Ad3 and Ad7 (both species B1 serotypes) can cause large disseminated outbreaks that affect both adults and children and can cocirculate in a given geographic area (18,29). These two serotypes are often responsible for the most severe respiratory symptomologies associated with adenoviral infection (12,16).…”

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PCR Analysis of Egyptian Respiratory Adenovirus Isolates, Including Identification of Species, Serotypes, and Coinfections

et al. 2005

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“…The surveillance program was originally established at four recruit training camps in the United States to define the burden of adenoviruses (10) but was later expanded to eight sites and included testing for other viral agents (24). This surveillance documented large increases in adenovirus morbidity and several fatal cases after the vaccine was exhausted (2,10,25), suggesting that the initial vaccine was efficacious for the majority of circulating pathogenic strains. However, several cases of Ad4 and Ad7 infection were discovered among previously vaccinated individuals, raising the possibility that newly emergent strains of adenovirus had appeared.…”

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Molecular Analysis of Adenovirus Isolates from Vaccinated and Unvaccinated Young Adults

Blasiole

Metzgar

Daum³

et al. 2004

J Clin Microbiol

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Infections of adenovirus type 4 (Ad4) and Ad7 were discovered among previously vaccinated individuals through febrile respiratory illness surveillance at military recruit camps. Genetic analysis was performed on these isolates and a sample of adenovirus isolates from unvaccinated patients. Antigenic regions of the adenovirus hexon gene from 21 vaccinated and 31 unvaccinated patients were sequenced and compared to homologous regions of Ad4 and Ad7 vaccine strains and of other representative hexon sequences archived in GenBank. The phylogenetic distribution of sequences from vaccinated individuals closely resembled those from unvaccinated individuals. The most common Ad7 strain was the Ad7d2 hexon genotype, and the most common Ad4 strain was a genotype nearly identical to the recently discovered Z-G 95-873 Ad4 variant. Near exclusive isolation of Ad4 since 1999 indicates that the Ad4 variant is currently responsible for the vast majority of adenovirus morbidity in military recruit camps. Different ratios of nonsynonymous to synonymous nucleotide substitution rates in known antigenic regions compared to nonantigenic regions indicated positive selection for diversity in the antigenic regions and purifying selection in the nonantigenic regions.

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“…Since then, disease outbreaks among trainee populations have recurred, including several deaths. (123,(125)(126)(127)(128) A replacement manufacturing line for adenovirus type 4 and type 7 vaccines will be submitted for …”

Section: Influenzamentioning

confidence: 99%

Immunization to Protect the U.S. Armed Forces: Heritage, Current Practice, Prospects

Greenwood¹,

Grabenstein²,

Pittman³

2005

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Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Prescribed by ANSI Std Z39-18 Immunization to Protect the U.S. Armed Forces 2 REPORT DATE Immunization to Protect the U.S. Armed Forces:Heritage, Current Practice, ProspectsImmunization protects the personal health of United States military personnel and maintains their mission readiness. The immunization program of the U.S. Department of Defense (DoD) is broad-ranging, protecting the forces from an array of pathogenic threats. Because the active and reserve components of the U.S. DoD consist of over 2.2 million people at any given time, the program immunizes a significant percentage of the U.S. adult population.This article updates and expounds on previous reviews of the U.S. military immunization program, (1-7) discussing historical perspectives, the rationale for current immunization policies, and future prospects. Military immunization requirements often exceed those provided to civilian adults, because of the travel and other occupational hazards confronted by soldiers, marines, sailors, airmen, and coast guardsmen. Military immunization requirements are quite similar for each of the five Armed Forces (i.e., Army, Marine Corps, Navy, Air Force, Coast Guard). The requirements and recommendations are described in a joint immunization regulation, (8) summarized in table 1.Immunizations have both direct benefit to the recipient and indirect benefit to the people in the community the vaccinee resides in or works with (i.e., "herd immunity"). "Herd immunity" or "community immunity" results when a decreased number of susceptible people and the decreased excretion of infectious particles impairs disease transmission. In military settings, the indirect benefit takes on an additional dimension, insofar as an immunized service member is less likely to succumb to a disease that threatens his or her team's mission. By staying healthy, the immunized service member helps other team members accomplish their mission and return home safely. Due to both direct and indirect benefits, most U.S. military immunizations are required, rather than voluntary. Figures 1 and 2 illustrate records used to document immunizations of troops during World War II.Senior preventive-medicine officers from the five Armed Services develo...

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Large Epidemic of Respiratory Illness Due to Adenovirus Types 7 and 3 in Healthy Young Adults

Cited by 119 publications

References 64 publications

PCR Analysis of Egyptian Respiratory Adenovirus Isolates, Including Identification of Species, Serotypes, and Coinfections

PCR Analysis of Egyptian Respiratory Adenovirus Isolates, Including Identification of Species, Serotypes, and Coinfections

Molecular Analysis of Adenovirus Isolates from Vaccinated and Unvaccinated Young Adults

Immunization to Protect the U.S. Armed Forces: Heritage, Current Practice, Prospects

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