Severe Pediatric Adenovirus 7 Disease in Singapore Linked to Recent Outbreaks across Asia

Ng, Oon Tek; Thoon, Koh Cheng; Chua, Hui Ying; Tan, Natalie Woon Hui; Chong, Chia Yin; Tee, Nancy Wen Sim; Lin, Raymond Tzer Pin; Cui, Lin; Venkatachalam, Indumathi; Tambyah, Paul Anantharajah; Chew, Jonathan; Fong, Raymond Kok Choon; Oh, H. M. L.; Krishnan, Prabha; Lee, Vernon Jian Ming; Tan, Boon Huan; Ng, Sock Hoon; Ting, Pei Jun; Maurer‐Stroh, Sebastian; Gunalan, Vithiagaran; Khong, Wei Xin

doi:10.3201/eid2107.141443

Cited by 24 publications

(25 citation statements)

References 17 publications

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“…Our molecular typing findings suggest that genome type 7d might be circulating in the United States as a recently introduced newly emerging variant probably imported from Southeast Asia where increased incidence of severe HAdV7-associated respiratory disease has been reported ( 11 , 12 , 14 ). The 2 patients in this study had not traveled outside the United States and had not had contact with persons who recently traveled to Asia.…”

Section: Discussionmentioning

confidence: 81%

Severe Infections with Human Adenovirus 7d in 2 Adults in Family, Illinois, USA, 2014

Kajon

Ison

2016

Emerg. Infect. Dis.

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Section: Discussionmentioning

confidence: 81%

Severe Infections with Human Adenovirus 7d in 2 Adults in Family, Illinois, USA, 2014

Kajon

Ison

2016

Emerg. Infect. Dis.

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“…Clinical epidemiological data regarding HAdV infections are relatively sparse for Southeast Asia (SEA). However, existing data suggest that HAdV-B3 is ubiquitous and more often associated with milder illness when compared with recent HAdV-B7 infections in Singapore, Malaysia, Taiwan, and China [7][8][9][10][11][12][13][14]. Unlike HAdV-B3 and HAdV-B7, outbreaks of HAdV-E4 have not been as commonly reported globally until recently.…”

mentioning

confidence: 99%

Adenoviral Infections in Singapore: Should New Antiviral Therapies and Vaccines Be Adopted?

Coleman

Wong

Jayakumar

et al. 2019

The Journal of Infectious Diseases

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Background A number of serious human adenovirus (HAdV) outbreaks have been recently reported: HAdV-B7 (Israel, Singapore, and USA), HAdV-B7d (USA and China), HAdV-D8, -D54, and -C2 (Japan), HAdV-B14p1 (USA, Europe, and China), and HAdV-B55 (China, Singapore, and France). Methods To understand the epidemiology of HAdV infections in Singapore, we studied 533 HAdV-positive clinical samples collected from 396 pediatric and 137 adult patients in Singapore from 2012 to 2018. Genome sequencing and phylogenetic analyses were performed to identify HAdV genotypes, clonal clusters, and recombinant or novel HAdVs. Results The most prevalent genotypes identified were HAdV-B3 (35.6%), HAdV-B7 (15.4%), and HAdV-E4 (15.2%). We detected 4 new HAdV-C strains and detected incursions with HAdV-B7 (odds ratio [OR], 14.6; 95% confidence interval [CI], 4.1–52.0) and HAdV-E4 (OR, 13.6; 95% CI, 3.9–46.7) among pediatric patients over time. In addition, immunocompromised patients (adjusted OR [aOR], 11.4; 95% CI, 3.8–34.8) and patients infected with HAdV-C2 (aOR, 8.5; 95% CI, 1.5–48.0), HAdV-B7 (aOR, 3.7; 95% CI, 1.2–10.9), or HAdV-E4 (aOR, 3.2; 95% CI, 1.1–8.9) were at increased risk for severe disease. Conclusions Singapore would benefit from more frequent studies of clinical HAdV genotypes to identify patients at risk for severe disease and help guide the use of new antiviral therapies, such as brincidofovir, and potential administration of HAdV 4 and 7 vaccine.

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“…Recently, more and more ARD outbreaks with severe or even fatal cases caused by HAdV-7 have been reported in Asia, especially in China, which has a large and high-density population161113151628293031. 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.…”

mentioning

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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Severe Pediatric Adenovirus 7 Disease in Singapore Linked to Recent Outbreaks across Asia

Cited by 24 publications

References 17 publications

Severe Infections with Human Adenovirus 7d in 2 Adults in Family, Illinois, USA, 2014

Severe Infections with Human Adenovirus 7d in 2 Adults in Family, Illinois, USA, 2014

Adenoviral Infections in Singapore: Should New Antiviral Therapies and Vaccines Be Adopted?

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

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