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. 2016 Jun;22(6):1044-51.
doi: 10.3201/eid2206.151898.

Human Adenovirus Associated with Severe Respiratory Infection, Oregon, USA, 2013-2014

Magdalena Kendall Scott, Christina Chommanard, Xiaoyan Lu, Dianna Appelgate, LaDonna Grenz, Eileen Schneider, Susan I Gerber, Dean D Erdman, Ann Thomas

Human Adenovirus Associated with Severe Respiratory Infection, Oregon, USA, 2013-2014

Magdalena Kendall Scott et al. Emerg Infect Dis. 2016 Jun.

Abstract

Several human adenoviruses (HAdVs) can cause respiratory infections, some severe. HAdV-B7, which can cause severe respiratory disease, has not been recently reported in the United States but is reemerging in Asia. During October 2013-July 2014, Oregon health authorities identified 198 persons with respiratory symptoms and an HAdV-positive respiratory tract specimen. Among 136 (69%) hospitalized persons, 31% were admitted to the intensive care unit and 18% required mechanical ventilation; 5 patients died. Molecular typing of 109 specimens showed that most (59%) were HAdV-B7, followed by HAdVs-C1, -C2, -C5 (26%); HAdVs-B3, -B21 (15%); and HAdV-E4 (1%). Molecular analysis of 7 HAdV-B7 isolates identified the virus as genome type d, a strain previously identified only among strains circulating in Asia. Patients with HAdV-B7 were significantly more likely than those without HAdV-B7 to be adults and to have longer hospital stays. HAdV-B7 might be reemerging in the United States, and clinicians should consider HAdV in persons with severe respiratory infection.

Keywords: Human adenovirus; Human adenovirus 7; Oregon; outbreak; pneumonia; respiratory infection; viruses.

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Figures

Figure 1
Figure 1
HAdV detections from 2 major hospital systems (A and B), Oregon, USA, November–April 2010–2014. Historical data collected by the Oregon Public Health Division. Data for hospital system C were not available. HAdV, human adenovirus.
Figure 2
Figure 2
HAdV detections reported to the National Respiratory and Enteric Virus Surveillance System, Oregon, January 2010–May 2015. HAdV, human adenovirus.
Figure 3
Figure 3
HAdV detections by type and by month of symptom onset, Oregon, USA, October 2013–July 2014. If month of symptom onset was not available, month of specimen collection was used. Total HAdVs include 109 HAdV-positive specimens that were typed (including 1 HAdV-E4 specimen) and 89 specimens that were not available for typing. HAdV, human adenovirus.
Figure 4
Figure 4
Phylogenetic analysis of human adenovirus 7 genome type d (HAdV-B7d), Oregon, USA, 2014. Genomic sequences were aligned by using ClustalW implemented in BioEdit version 7.2.5 and the neighbor-joining phylogenetic tree constructed by using MEGA7 software (23,24). Numbers at selected nodes indicate level of support using 1,000 bootstrap replicates. Sequences are identifoed by GenBank accession number, geographic location, year of sample collection, and virus genome type identified. Boldface indicates 7 identical genomic sequences identified during this study; sequences are from HAdV-B7 isolates derived from 7 different cases spanning the outbreak period. Scale bar indicates estimated number of nucleotide substitutions per site.
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