Investigation of an Adenovirus-Induced Respiratory Disease Outbreak

Xingyi Geng, Ji Zhang, Guoliang Yang

Jinan Municipal Center for Disease Control and Prevention, Jinan, China.

DOI: 10.4236/aid.2013.34039                

Abstract

Objective: An epidemiological investigation was carried out in school X in Jinan, Shandong Province, China, to identify the cause, epidemiology, and etiological characteristics of a febrile respiratory disease outbreak; and therefore to control the dissemination. Methods: Both field epidemiological investigations and laboratory examinations were carried out. Results: Forty cases were identified, in which 38 cases were students and two were teachers. Clinical manifestations included fever, coughing, headache, and sore throat. A total of 21 pharyngeal swab specimens were collected and 18 tested positive for adenovirus. The adenovirus hexon gene was sequenced in three of the 18 positive specimens and the results showed a 100% homology with the standard HAdV-55 HEXO. Conclusions: The outbreak originated from an adenovirus-infected student, who spread the pathogen to her classmates and teacher. The teacher then further disseminated the disease within the school which led to 40 febrile respiratory infections.

 

Keywords

Epidemiology; Research Methods; Laboratory Examination; Adenovirus; Respiratory Disease

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	J. P. Lynch, M. Fishbein and M. Echavarria, “Adenovirus. Seminars in Respiratory and Critical Care Medicine,” Thieme Medical Publishers, 2011.
[2]	M. Echavarria, et al., “Rapid Detection of Adenovirus in Throat Swab Specimens by PCR during Respiratory Disease Outbreaks among Military Recruits,” Journal of Clinical Microbiology, Vol. 41, No. 2, 2003, pp. 810-812. http://dx.doi.org/10.1128/JCM.41.2.810-812.2003
[3]	P. Yu, et al., “An Outbreak of Acute Respiratory Disease Caused by ‘Human Adenovirus Type 7’ in a Military Training Camp in Shaanxi, China. Microbiology and Immunology,” 2013. http://dx.doi.org/10.1111/1348-0421.12074
[4]	Z. Yang, et al., “Genomic Analyses of Recombinant Adenovirus Type 11a in China,” Journal of Clinical Microbiology, Vol. 47, No. 10, 2009, pp. 3082-3090. http://dx.doi.org/10.1128/JCM.00282-09
[5]	M. P. Walsh, et al., “Computational Analysis Identifies Human Adenovirus Type 55 as a Re-Emergent Acute Respiratory Disease Pathogen,” Journal of Clinical Microbiology, Vol. 48, No. 3, 2010, pp. 991-993. http://dx.doi.org/10.1128/JCM.01694-09
[6]	S. Dey, et al., “Short Report Prevalence, Seasonality, and Peak Age of Infection of Enteric Adenoviruses in Japan, 1995-2009,” 2012.
[7]	L. Zou, et al., “Human Adenovirus Infection in Children with Acute Respiratory Tract Disease in Guangzhou, China,” Apmis, Vol. 120, No. 8, 2012, pp. 683-688. http://dx.doi.org/10.1111/j.1600-0463.2012.02890.x
[8]	A. Hong-Wu, et al., “Research on Etiology of Acute Respiratory Tract Infection in Children from Wuhan during Winter and Spring,” Chinese Journal of Nosocomiology, Vol. 5, 2012, p. 095.
[9]	S. Fletcher, et al., “Gastrointestinal Pathogen Distribution in Symptomatic Children in Sydney, Australia,” Journal of Epidemiology and Global Health, 2013.
[10]	T. V. Chan, “The Patient with Sore Throat,” Medical Clinics of North America, Vol. 94, No. 5, 2010, p. 923. http://dx.doi.org/10.1016/j.mcna.2010.06.001
[11]	T. C. Mast, et al., “International Epidemiology of Human Pre-Existing Adenovirus (Ad) Type-5, Type-6, Type-26 and Type-36 Neutralizing Antibodies: Correlates of High Ad5 Titers and Implications for Potential HIV Vaccine Trials,” Vaccine, Vol. 28, No. 4, 2010, pp. 950-957. http://dx.doi.org/10.1016/j.vaccine.2009.10.145
[12]	G. Cleghorn, et al., “Acute Infectious Diarrhea Lessons Learned from the Past?” Journal of Pediatric Gastroenterology and Nutrition, Vol. 55, No. 5, 2012, pp. 489-493. http://dx.doi.org/10.1097/MPG.0b013e318272acc6
[13]	B. Lan, et al., “Analysis on Epidemiologic Characteristics of Viral Diarrhea among Infants in Taiyuan, Shanxi Province, 2007-2008],” Chinese Journal of Experimental and Clinical Virology, Vol. 24, No. 1, 2010, p. 8.
[14]	L. van der Hoek, et al., “Identification of a New Human Coronavirus,” Nature Medicine, Vol. 10, No. 4, 2004, pp. 368-373. http://dx.doi.org/10.1038/nm1024