Outbreak of Acute Respiratory Disease in China Caused by B2 Species of Adenovirus Type 11

Abstract

An outbreak of acute respiratory tract infection occurred in Shanxi Province, China, from March to April 2006. Of the 254 patients affected by this outbreak, 247 patients were students of a senior high school; 1 of these patients died during the outbreak. Serological tests and blood culture revealed no evidence of bacterial infection. The results of direct reverse transcription-PCR or PCR performed with clinical specimens collected from the patients, including the sole patient who died, were positive for human adenoviruses (HAdVs) but negative for influenza virus, measles virus, rubella virus, mumps virus, parainfluenza virus, respiratory syncytial virus, and human enteroviruses. These findings were confirmed by enzyme-linked immunosorbent assay for HAdV immunoglobulin A, the conventional neutralization test, and viral isolation and identification. Sequencing of the entire hexon gene revealed that HdAV type 11a (HAdV-11a) belonging to the B2 species of HAdV was the etiological agent responsible for the outbreak. However, both the analysis of the phylogenetic relationship and the similarity plot indicated that the sequence of the 3 end of the hexon gene outside the hypervariable regions the HAdV-11a strain isolated in this outbreak may be a recombinant with the sequence of the HAdV-14 strain of species B2. Although isolates of HAdV species B2 seldom cause respiratory infections, they may pose a new global challenge with regard to acute respiratory diseases; this possibility cannot be overlooked and should be carefully considered. Hence, the need to establish and improve both epidemiological and virological surveillance of HAdV infections in China should be emphasized.

Computational Analysis of Human Adenovirus Type 22 Provides Evidence for Recombination among Species D Human Adenoviruses in the Penton Base Gene

“…Simultaneous infection by more than a single HAdV type is possible because of conserved host receptor affinity, common tissue tropisms, and an absence of immunity across serotypes. Our data, along with evidence from previous studies (22,23,37,43), identified recombination events among viruses with similar tissue tropisms, providing evidence that the restriction of tissue tropism might determine in part the observed recombination within adenoviruses of the same species. Recently, a novel HAdV, HAdV-D53, was isolated from an outbreak of keratoconjunctivitis.…”

Avidity Binding of Human Adenovirus Serotypes 3 and 7 to the Membrane Cofactor CD46 Triggers Infection

“…The B1 viruses adenovirus type 3 (Ad3), Ad7, Ad16, Ad21, and Ad50 (Ad3/7/16/21/50) predominantly infect the upper respiratory tract, whereas the B2 viruses Ad11/14/34/35 are associated with kidney and urinary tract infections with fatal outcomes in immunocompromised patients (30,54,68). Recent epidemiological reports described the reemergence of several of these virus types associated with outbreaks of respiratory disease (7,32,39,77). The tropism of species B viruses is broader than that of the C species and includes cancer cells, dendritic cells, and hematopoietic stem cells.…”

Genome Sequence of the First Human Adenovirus Type 14 Isolated in China

“…Fifty-one years later, a re-emerging variant, HAdV-14p1, was associated with several highly contagious outbreaks of acute respiratory disease (ARD), including fatalities, in the United States (2006 to 2009) (2, 4, 7) and Europe (2009 and 2010) (1). Additionally, as one of the two parental viruses contributing to the genome of an emergent ARD pathogen, HAdV-B55 (14,16), it is valuable to have the genomes of current circulating strains available for study in order to determine if there is a propensity for HAdV-B14 and HAdV-B11 to recombine, creating a "Trojan horse" in which the presenting antibody epitope is of a renal pathogen and the virus chassis and clinical presentation are of a respiratory pathogen (12). The isolation of HAdV-B14 in China is intriguing, as three recent HAdV-B55 outbreaks were in China in 2006 (14,16) .…”

“…Additionally, as one of the two parental viruses contributing to the genome of an emergent ARD pathogen, HAdV-B55 (14,16), it is valuable to have the genomes of current circulating strains available for study in order to determine if there is a propensity for HAdV-B14 and HAdV-B11 to recombine, creating a "Trojan horse" in which the presenting antibody epitope is of a renal pathogen and the virus chassis and clinical presentation are of a respiratory pathogen (12). The isolation of HAdV-B14 in China is intriguing, as three recent HAdV-B55 outbreaks were in China in 2006 (14,16) . This is unusual in that the symptoms were not as previously described for published HAdV-B14 and HAdV-B55 infections (1, 2, 3, 7, 14, 16).…”