Transmission Dynamics and Prospective Environmental Sampling of Adenovirus in a Military Recruit Setting

Russell, Kevin L.; Broderick, Michael; Franklin, Suzanne E.; Blyn, Lawrence B.; Freed, Nikki E.; Moradi, Emily; Ecker, David J.; Kammerer, Peter E.; Osuna, Miguel; Kajon, Adriana E.; Morn, Cassandra B.; Ryan, Margaret A. K.

doi:10.1086/507426

Cited by 111 publications

(93 citation statements)

References 28 publications

(27 reference statements)

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“…In addition, according to a former study, rifles were most commonly observed in the military environment. Therefore, FT may be a risk factor for the spread of adenovirus and a cause of FRI in the army (23). However, further studies are required to clarify these associations (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…The epidemiological investigation was conducted by 3 military doctors, namely 2 preventive medicine specialists and 1 infectious medicine specialist of the Armed Forces Medical Command, from March 22 to 23,2012. During the epidemiological investigation, we surveyed symptoms and identified 161 FRI cases and index cases by case definition and onset days, analyzed the association between different types of military training courses with the onset of FRI, and estimated the attack rate among 161 patients with FRI and pneumonia.…”

Section: Methodsmentioning

confidence: 99%

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Outbreak of Febrile Respiratory Illness Caused by Adenovirus at a South Korean Military Training Facility: Clinical and Radiological Characteristics of Adenovirus Pneumonia

Hwang

Park²,

Yong³

et al. 2013

Jpn J Infect Dis

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SUMMARY: Adenovirus often causes respiratory disease outbreaks in military training soldiers. Compared with adenovirus pneumonia in young military adults, symptoms arising from febrile respiratory illness (FRI) caused by adenovirus have not been previously evaluated in Korean soldiers. We conducted an event-based outbreak investigation involving 712 male soldiers aged 19 to 21 years from March 14 to 30, 2012 to evaluate the epidemiological and clinical characteristics of patients with pneumonia and FRI caused by adenovirus. We described the laboratory and radiological characteristics of patients with adenovirus pneumonia. Among these, 407 cases of FRI and 15 cases of pneumonia were identified through active surveillance (attack rate of FRI, 57.16z; attack rate of pneumonia, 2.11z). Fire training and march training may present environmental risk factors for adenovirus-associated outbreaks. Most symptoms were mild. The most frequent symptom in patients with pneumonia and FRI was cough. Patients with pneumonia were associated with an increased incidence of dizziness (crude odds ratio [cOR], 9.65; 95z confidence interval [CI], 2.38-37.15) and a decreased incidence of rhinorrhea (cOR, 0.15; 95z CI, 0.04-0.53) during adenovirus-associated outbreaks. Differential leukocyte count revealed high monocytes, low lymphocytes, and low eosinophils, and chest computed tomography revealed a consolidation pattern and right lobar pneumonia. These findings warrant a high level of suspicion for adenovirus pneumonia.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Outbreak of Febrile Respiratory Illness Caused by Adenovirus at a South Korean Military Training Facility: Clinical and Radiological Characteristics of Adenovirus Pneumonia

Hwang

Park²,

Yong³

et al. 2013

Jpn J Infect Dis

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“…Compared with the general population, our population is known to be highly immune to Ad-4 and to have a relatively high degree of immunity to Ad-7. 22 However, although theoretically possible, Ad-4…”

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confidence: 99%

“…Ad4 and Ad7, for example, cross-react despite their being from different species. 22 Nevertheless, there is no evidence that these cross-react with Ad-36. One possible limitation to the study's conduct was the misidentification of obese subjects.…”

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confidence: 99%

Adenovirus 36 seropositivity is strongly associated with race and gender, but not obesity, among US military personnel

et al. 2009

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Background: Although several studies have shown a positive association between evidence of anti-adenovirus 36 (Ad-36) antibodies (Ad-36 exposure) and (1) obesity and (2) serum cholesterol in animals, there is limited research demonstrating this association in humans. There is also limited research on transmission, presentation and demographics of Ad-36 infection. Design: (1) Body mass (body mass index (BMI)), (2) fasting serum cholesterol and triglyceride levels and (3) demographic characteristics were compared between Ad-36 seropositive and seronegative groups. The majority of subjects were matched as cases versus controls on a number of demographic variables. Subjects: A total of 150 obese and 150 lean active-duty military personnel were studied. Measurements: Subjects completed a questionnaire regarding demographic and behavioral characteristics. Subject serum samples were tested by serum neutralization assay for the presence of anti-Ad-36 antibodies. Results: In all, 34% of obese and 39% of lean subjects had Ad-36 exposure, an insignificant difference. Serum cholesterol and triglyceride levels were significantly higher among the obese subjects than among the lean, but there were no associations between serum cholesterol and triglyceride levels and Ad-36 exposure. Positive associations were found between Ad-36 exposure and age, race and gender. Conclusion: The study stands in contrast to previous work that has shown a positive relationship between Ad-36 exposure and (1) obesity, and (2) levels of serum cholesterol and triglycerides. In this study there was no association in either case. Unanticipated relationships between Ad-36 exposure and age, race and gender were found, and this is the first time that such a link between Ad-36 exposure and demographics has been found.

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“…Further, outbreaks of shigellosis (6), cryptosporidiosis (7), and giardiasis (8,9) indicate that other highly infectious enteric pathogens can spread from person to person after being introduced into a community through water, food, or other sources (9). Recent adenovirus outbreak data indicate that persons with asymptomatic infection who are shedding virus can be a primary cause of continual transmission of infection (10). And in a prolonged giardiasis outbreak that occurred in late 2003 in a Boston, Massachusetts, suburb, 30 primary cases of giardiasis attributed to a children's swimming pool resulted in 105 secondary cases among persons from the same or socially related households.…”

mentioning

confidence: 99%

Strategies to Reduce Person-to-Person Transmission during WidespreadEscherichia coliO157:H7 Outbreak

Seto

Soller²,

Colford

2007

Emerg. Infect. Dis.

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RESEARCHDuring the Escherichia coli O157:H7 outbreak in 2006 in the United States, the primary strategy to prevent illness was to advise consumers not to eat spinach. No widespread warnings were issued about preventing person-to-person (secondary) transmission. A disease transmission model, fi tted to the current data, was used to investigate likely reductions in illnesses that could result from interventions to prevent secondary transmission. The model indicates that exposure to contaminated spinach occurred early in the outbreak and that secondary transmission was similar to that in previous E. coli outbreaks (≈12%). The model also suggests that even a modestly effective strategy to interrupt secondary transmission (prevention of only 2%-3% of secondary illnesses) could result in a reduction of ≈5%-11% of symptomatic cases. This analysis supports the use of widespread public health messages during outbreaks of E. coli O157:H7 with specifi c advice on how to interrupt secondary transmission.W idespread distribution of contaminated spinach was implicated in an Escherichia coli O157:H7 (E. coli O157) outbreak in the United States in 2006. As of September 24, 2006, a total of 173 cases had been reported in 25 states; 88% of cases were reported over an 18-day period from August 19 through September 5, 2006 (1). The outbreak strain was particularly virulent, resulting in 1 death, 53% of patients being hospitalized, and a 16% rate of hemolytic uremic syndrome. At the time of our analysis, the potential extent of the outbreak was unknown because new cases were still being reported. The Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration advised consumers not to eat spinach as the primary strategy for protecting against foodborne transmission of E. coli O157 (2). No warnings, however, were issued regarding the prevention of person-to-person (secondary) transmission.According to recent studies on the extent of secondary transmission for E. coli O157 and other pathogens, the initially reported foodborne illnesses in the outbreak may have represented only a small fraction of a larger outbreak that included asymptomatic infections and secondary infections among household members of infected persons and other close contacts. Specifi cally, the E. coli O157 literature indicates that a large proportion (72%) of infections are asymptomatic (3), exposure to low doses can result in infection (4), and reported secondary transmission rates are on the order of 4%-16% (5). Further, outbreaks of shigellosis (6), cryptosporidiosis (7), and giardiasis (8,9) indicate that other highly infectious enteric pathogens can spread from person to person after being introduced into a community through water, food, or other sources (9). Recent adenovirus outbreak data indicate that persons with asymptomatic infection who are shedding virus can be a primary cause of continual transmission of infection (10). And in a prolonged giardiasis outbreak that occurred in late 2003 in a Boston, Massachusetts, suburb, 30 ...

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Transmission Dynamics and Prospective Environmental Sampling of Adenovirus in a Military Recruit Setting

Cited by 111 publications

References 28 publications

Outbreak of Febrile Respiratory Illness Caused by Adenovirus at a South Korean Military Training Facility: Clinical and Radiological Characteristics of Adenovirus Pneumonia

Outbreak of Febrile Respiratory Illness Caused by Adenovirus at a South Korean Military Training Facility: Clinical and Radiological Characteristics of Adenovirus Pneumonia

Adenovirus 36 seropositivity is strongly associated with race and gender, but not obesity, among US military personnel

Strategies to Reduce Person-to-Person Transmission during WidespreadEscherichia coliO157:H7 Outbreak

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