237. Adenovirus Types in Children with Acute Respiratory Illnesses in Nashville Over Two Respiratory Seasons

Abstract

BackgroundHuman adenovirus (HAdV) types 1–7, 11, 14, 16, and 21 within species B, C, and E are commonly associated with acute respiratory illnesses (ARI) in children. We sought to compare demographics, clinical characteristics, and outcomes of HAdV types with children who presented with fever and/or respiratory symptoms.MethodsChildren < 18 years with fever and/or ARI seen at Vanderbilt Children’s Hospital inpatient and emergency department settings from December of 2016 to October of 2018 were enrolled. Interviews and chart abstraction were conducted. Mid-turbinate nose and throat swab specimens were collected and tested by real-time RT-PCR for common respiratory viruses including HAdV. HAdV molecular typing was performed by type-specific real-time PCR assays for types 1–7, 11, 14, 16, and 21 targeting the hexon gene using published methods.ResultsOf 5111 ARI cases, 206 (4%) were HAdV-positive with a median age of 16 months (IQR 9–30); 57% male, 47% White, 40% Black, 33% Hispanic, 20% admitted, and 24% of hospitalized required oxygen support. Of the 206, 186 (90%) were able to be typed with more than one types detected in 13 (7%) cases. Distribution of HAdV types among single detections (n = 173) is shown in Figure 1; HAdV-1 and HAdV-2 were most common. Children with HAdV-2 were younger (median age 12 months vs. 15 months (HAdV-1) and 59 months (all other types), P < 0.001), and those with HAdV-1 were less likely to be male (44% vs. 65% for both HAdV-2 and other types, P = 0.029). Figure 2 displays HAdV detections over time, with winter and early spring peaks. Co-detection with other respiratory viruses occurred in 47% of cases; the most common among typable HAdV were rhinovirus/enterovirus in 30/186 (16%) and RSV in 19/186 (10%). Distribution among HAdV types is shown in Figure 3.ConclusionHAdV-1 and HAdV-2 were more prevalent than other HAdV types over two respiratory seasons in the Nashville area with peak cases in December-March. Children with HAdV-1 and HAdV-2 had some demographic differences. Further studies with a larger sample size for HAdV typing are needed in the pediatric population to determine whether additional clinically-relevant differences between HAdV types exist. Disclosures All authors: No reported disclosures.