Abstract
BackgroundPneumonia caused by adenovirus infection is usually severe especially with adenovirus serotype 7 commonly associated with lower respiratory tract disease outbreaks. We reported an outbreak of 70 cases of severe pneumonia with one death of infants in Shaanxi Province, China. Sampling showed adenovirus 7 (Ad7) as the primary pathogen with some co-infections.ResultsTwo strains of adenovirus and two strains of enterovirus were isolated, the 21 pharynx swabs showed 14 positive amplifications for adenovirus; three co-infections with respiratory syncytial virus, two positive for rhinovirus, one positive for parainfluenza 3, and four negative. Adenovirus typing showed nine of the nine adenovirus positive samples were HAdV-7, three were HAdV-3 and two were too weak to perform sequencing. The entire hexon gene of adenovirus was sequenced and analyzed for the two adenovirus serotype 7 isolates, showing the nucleic acid homology was 99.8% between the two strains and 99.5% compared to the reference strain HAdV-7 (GenBank accession number AY769946). For the 21 acute phase serum samples from the 21 patients, six samples had positives results for ELISA detection of HAdV IgA, and the neutralization titers of the convalescent-phase samples were four times higher than those of the acute-phase samples in nine pairs.ConclusionsWe concluded adenovirus was the viral pathogen, primarily HAdV-7, with some co-infections responsible for the outbreak. This is the first report of an infant pneumonia outbreak caused by adenovirus serotype 7 in Shaanxi Province, China.
Highlights
Pneumonia caused by adenovirus infection is usually severe especially with adenovirus serotype 7 commonly associated with lower respiratory tract disease outbreaks
Of the 21 pharynx swabs taken, 14 cases were shown to be positive for adenovirus; six cases were positive for adenovirus antibody with ELISA-immunoglobulin A (IgA) detection in the 21 acute phase serum samples; while the neutralization titers of the convalescent-phase samples were four times higher than those of the acute-phase samples for nine pairs
These results showed that adenovirus was the primary pathogen in the outbreak
Summary
Pneumonia caused by adenovirus infection is usually severe especially with adenovirus serotype 7 commonly associated with lower respiratory tract disease outbreaks. We reported an outbreak of 70 cases of severe pneumonia with one death of infants in Shaanxi Province, China. Human adenoviruses cause a wide spectrum of diseases. During the last global survey, approximately one-fifth of all HAdV infections reported to the World Health Organization (WHO) were attributed to HAdV-7 [1,2], the diseases reported include respiratory tract illnesses and conjunctivitis. In infants and immuno-compromised populations, HAdV-7 can cause outbreaks of severe disease; and in a few cases can lead to death [3].
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