Outbreak of acute febrile respiratory illness caused by human adenovirus B P14H11F14 in a military training camp in Shandong China

Abstract

This study reports an outbreak of acute febrile respiratory illness caused by human adenovirus B [P14H11F14] in a military training center in China between May and June 2014. In total, 164 military personnel were affected, and two patients were admitted into the intensive care unit of the military regional central hospital. A HAdV-B [P14H11F14] virus was confirmed as the etiological pathogen of this acute outbreak of febrile respiratory illness based on clinical manifestations, epidemiological characteristics, specific molecular detection results, phylogenetic analysis, and serological assays. The virus was isolated by the rhabdomyosarcoma cell culture method, and the complete sequences of the E1A, penton base, hexon, and fiber genes were determined and deposited in the GenBank database. Phylogenetic and sequence homology analyses indicated that the isolated strain is most closely related to some HAdV-55 strains from mainland China. However, this strain appeared to be less virulent than former HAdV-55 strains. According to the chest X-ray results of 31 affected patients, there was no radiological evidence of pneumonia. The most frequent symptoms in these patients were sore throat (95.12 %, 156/164) and tonsillitis (93.29 %, 153/164). During the course of the outbreak, incorrect response measures and some potential risk factors, such as fire training and marching training, may have exacerbated the spread of the infection. This outbreak illustrates the urgent need to improve the epidemiological and etiological surveillance of HAdV infections and to improve the ability of doctors and health officials in basic units of the Chinese army to respond effectively to febrile respiratory illness.

Epidemiologic analysis of respiratory viral infections among Singapore military servicemen in 2016

“…More recently, HDAdV-55 was found to be responsible for an outbreak among Korean military personnel with 1 case of fatality [ 11 ]. Adenovirus B was also found to be responsible for febrile respiratory illness in a military training camp in China [ 14 ]. Serological surveillance on US military basic trainees showed that 66% and 73% of trainees were susceptible to Adenovirus Type 4 and 7 [ 15 ].…”

Molecular Typing and Rapid Identification of Human Adenoviruses Associated With Respiratory Diseases Using Universal PCR and Sequencing Primers for the Three Major Capsid Genes: Penton Base, Hexon, and Fiber

“…As a result, it is important to type HAdVs accurately and rapidly for clinical diagnoses and epidemiological investigations in order to provide information on the pathogen, including the distribution of infections by individual and specific types, as well as to detect and characterize emergent strains in the context of outbreaks ( Xie et al, 2013 ; Li et al, 2014 ; Dongliu et al, 2016 ; Tan et al, 2016 ; Yi et al, 2017 ). As recombination is recognized as a significant evolutionary pathway for the emergence of novel HAdV pathogens, rapid characterization is important ( Walsh et al, 2009 , 2010 ; Zhou et al, 2012 ; Dehghan et al, 2013a , 2019 ; Robinson et al, 2013a , b ).…”

“…A striking example is HAdV-B55. This is a “Trojan horse,” as it is a highly contagious human respiratory pathogen that is a recombinant of HAdV-B11 and HAdV-B14 parentals ( Yang et al, 2009 ; Zhang et al, 2012a ; Dongliu et al, 2016 ; Cheng et al, 2018 ). It has a HAdV-14 genome chassis, including the HAdV-14 penton base gene and fiber gene, which encodes cell tropism ( Pan et al, 2018 ), but a partial HAdV-11 hexon gene, which encodes the antigenic epitopes of the virus denoting it as a renal pathogen.…”

Human Adenovirus Type 55 Distribution, Regional Persistence, and Genetic Variability

“…Recent reports describing large numbers of HAdV-55-associated ARD cases in both China and South Korea, including outbreaks and some deaths in both civilian and military communities, have raised concerns about the possibility of global transmission events, similar to those described for severe acute respiratory syndrome or Middle East respiratory syndrome (21,(37)(38)(39)(40)(41)(42)(43). Outbreaks and isolated cases of HAdV-55-associated ARD have been reported in the literature in other countries, such as Turkey (44), Israel (45), and France (46) since 2005.…”