Molecular Epidemiology of Human Adenovirus-Associated Febrile Respiratory Illness in Soldiers, South Korea1.

Joon Young Song,Ji Yun Noh,Woo Joo Kim,Jung Yeon Heo,Hye Won Jeong,Hee Jin Cheong,Kang-Won Choe

doi:10.3201/eid2407.171222

Abstract

During January 2013–April 2014, we subjected nasopharyngeal specimens collected from patients with acute febrile respiratory illness in a military hospital to PCR testing to detect 12 respiratory viruses and sequence a partial hexon gene for human adenovirus (HAdV) molecular typing. We analyzed the epidemiologic characteristics of HAdV infections and compared clinical characteristics of HAdV types. Among the 305 patients with acute febrile respiratory illness, we detected respiratory viruses in 139 (45.6%) patients; HAdV was the most prevalent virus (69 cases). Of the 40 adenoviruses identified based on type, HAdV-55 (29 cases) was the most prevalent, followed by HAdV-4 (9 cases). HAdV-55 was common in patients with pneumonia (odds ratio 2.17; 95% CI 0.48–9.86) and hospitalized patients (odds ratio 5.21; 95% CI 1.06–25.50). In soldiers with HAdV infection in Korea, HAdV-55 was the most prevalent type and might be associated with severe clinical outcomes.

Highlights

During January 2013–April 2014, we subjected nasopharyngeal specimens collected from patients with acute febrile respiratory illness in a military hospital to PCR testing to detect 12 respiratory viruses and sequence a partial hexon gene for human adenovirus (HAdV) molecular typing
In our study, HAdV was the most prevalent virus detected among soldiers with acute febrile respiratory illness (AFRI) in South Korea, representing 49.6% of the cases
HAdV-55 has recently received public attention as an emerging pathogen that causes outbreaks of respiratory illness and severe pneumonia in the general population and soldiers, acute respiratory illness associated with HAdV-55 has rarely been reported in the civilian population in South Korea [6,16,21,22,23]

Summary

Methods

The Armed Forces Capital Hospital is the only tertiary care hospital in the South Korea military healthcare system. Respiratory Virus Multiplex Reverse Transcription PCR We collected nasopharyngeal or throat swab specimens from the patients with AFRI within 24 hours after their hospital visit by using a flocked swab. Within 3 days of collection, we sent specimens to a commercial laboratory center (GC Labs, Yongin, South Korea), where they were subjected to respiratory virus multiplex reverse transcription PCR. We performed PCR by using the Seeplex RV12 ACE Detection Kit (Seegene Inc., South Korea), which is used for identifying influenza viruses A and B, respiratory syncytial viruses A and B, adenovirus, parainfluenza virus types 1–3, rhinovirus group A, human coronavirus 229E/NL63, human coronavirus OC43, and human metapneumovirus.

Results

Respiratory syncytial virus A or B

Discussion

Acute respiratory distress syndrome