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Eom J, Kim Y, Kim D, Lee E, Kwon SH, Jo MW, Jung J, Park H, Park B. Cost-benefit analysis of human adenovirus vaccine development in a Korean military setting. Vaccine 2024:S0264-410X(24)00622-4. [PMID: 38806354 DOI: 10.1016/j.vaccine.2024.05.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/16/2024] [Accepted: 05/21/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Human adenovirus (HAdV) is a prevalent causative agent of acute respiratory disease (ARD) and is frequently responsible for outbreaks, particularly in military environments. Current vaccines do not effectively cover HAdV subtypes commonly found among Korean military personnel, highlighting the need for a new targeted vaccine. This study presents a cost-benefit analysis to evaluate the economic viability of developing and implementing such a vaccine within a military context. METHODS We adopted a societal perspective for this cost-benefit analysis, which included estimating costs associated with vaccine development, production, and distribution over a projected timeline. We assumed a development period of five years, after which vaccine production and administration were initiated in the sixth year. The cost associated with vaccine development, production, and dispensation was considered. The benefits were calculated based on both direct and indirect cost savings from preventing HAdV infections through vaccination. All financial figures were expressed in 2023 US dollars. A sensitivity analysis was conducted to explore the impact of varying factors such as vaccination rate, incidence of infection, vaccine efficacy, and discount rate. RESULTS For the base case scenario, we assumed a vaccination rate of 100 %, an incidence rate of 0.02, and a vaccine efficacy of 95 %, applying a 3 % discount rate. Initially, in the sixth year, the benefit-cost ratio stood at 0.71, suggesting a cost disadvantage at the onset of vaccination. However, this ratio improved to 1.32 in the following years, indicating a cost benefit from the seventh year onward. The cumulative benefit-cost ratio over a decade reached 2.72. The outcomes from the sensitivity analysis were consistent with these findings. CONCLUSION Our cost-benefit analysis demonstrates that the introduction of an HAdV vaccine for the Korean military is economically advantageous, with substantial cost benefits accruing from the seventh year after the commencement of vaccination.
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Affiliation(s)
- Jungmin Eom
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, South Korea.
| | - Yeonjae Kim
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, South Korea.
| | - Donghoon Kim
- Department of Critical Care Medicine, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, South Korea.
| | - Eunyoung Lee
- Department of Laboratory Medicine, Armed Forces Capital Hospital, Seongnam, South Korea.
| | - Soon-Hwan Kwon
- Department of Infectious Diseases Research, Armed Forces Medical Research Institute, Daejeon, South Korea.
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, South Korea.
| | - Jaehun Jung
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, South Korea; Artificial Intelligence and Big-Data Convergence Centre, Gil Medical Centre, Gachon University College of Medicine, Incheon, South Korea.
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Graduate Program for System Health Science and Engineering, Ewha Womans University, Seoul, South Korea.
| | - Bomi Park
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, South Korea.
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2
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Hakre S, Maljkovic-Berry I, Hang J, Conte MA, Pollio AR, Fung CK, Gandhi J, Peel SA, Lidl GM, Huhtanen ME, Hall TL, Modjarrad K, Friberg HL, O’Connell RJ, Scott PT. Transmission of SARS-CoV-2 among recruits in a US Army training environment: a brief report. J Public Health (Oxf) 2023; 45:748-752. [PMID: 37132356 PMCID: PMC10470341 DOI: 10.1093/pubmed/fdad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/10/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND In 2020, preventive measures were implemented to mitigate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among 600-700 recruits arriving weekly at a basic combat training (BCT) facility in the southern United States. Trainees were sorted into companies and platoons (cocoons) at arrival, tested, quarantined for 14 days with daily temperature and respiratory-symptom monitoring and retested before release into larger groups for training where symptomatic testing was conducted. Nonpharmaceutical measures, such as masking, and social distancing, were maintained throughout quarantine and BCT. We assessed for SARS-CoV-2 transmission in the quarantine milieu. METHODS Nasopharyngeal (NP) swabs were collected at arrival and at the end of quarantine and blood specimens at both timepoints and at the end of BCT. Epidemiological characteristics were analyzed for transmission clusters identified from whole-genome sequencing of NP samples. RESULTS Among 1403 trainees enrolled from 25 August to 7 October 2020, epidemiological analysis identified three transmission clusters (n = 20 SARS-CoV-2 genomes) during quarantine, which spanned five different cocoons. However, SARS-CoV-2 incidence decreased from 2.7% during quarantine to 1.5% at the end of BCT; prevalence at arrival was 3.3%. CONCLUSIONS These findings suggest layered SARS-CoV-2 mitigation measures implemented during quarantine minimized the risk of further transmission in BCT.
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Affiliation(s)
- Shilpa Hakre
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Irina Maljkovic-Berry
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Cherokee Nation Technology Solutions, Tulsa, OK, USA
| | - Jun Hang
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Matthew A Conte
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Cherokee Nation Technology Solutions, Tulsa, OK, USA
| | - Adam R Pollio
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Cherokee Nation Technology Solutions, Tulsa, OK, USA
| | - Christian K Fung
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Cherokee Nation Technology Solutions, Tulsa, OK, USA
| | - Jaykumar Gandhi
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Cherokee Nation Technology Solutions, Tulsa, OK, USA
| | - Sheila A Peel
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Grace M Lidl
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Mark E Huhtanen
- Moncrief Army Health Clinic, Fort Jackson, Columbia, SC, USA
| | - Tara L Hall
- Moncrief Army Health Clinic, Fort Jackson, Columbia, SC, USA
| | - Kayvon Modjarrad
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Heather L Friberg
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | - Paul T Scott
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
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3
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Beaty S, Collins N, Karasavvas N, Kuschner R, Hang J, Adhikari A, Maljkovic Berry I, Fung C, Walls S, Betancourt E, Mendy J, Lock M, Gierman E, Bennett S, Shabram P, Warfield K. A Phase 1 Two-Arm, Randomized, Double-Blind, Active-Controlled Study of Live, Oral Plasmid-Derived Adenovirus Type 4 and Type 7 Vaccines in Seronegative Adults. Vaccines (Basel) 2023; 11:1091. [PMID: 37376480 DOI: 10.3390/vaccines11061091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
PXVX0047 is an investigational vaccine developed for active immunization to prevent febrile acute respiratory disease (ARD) caused by adenovirus serotypes 4 (Ad4) and 7 (Ad7). PXVX0047 consists of a modernized, plasmid-derived vaccine that was generated using a virus isolated from Wyeth Ad4 and Ad7 vaccine tablets. A phase 1 two-arm, randomized, double-blind, active-controlled study was conducted to evaluate the safety profile and immunogenicity of the investigational adenovirus vaccines. The two components of PXVX0047 were administered orally together in a single dose to 11 subjects. For comparison, three additional subjects received the Ad4/Ad7 vaccine that is currently in use by the US military. The results of this study show that the tolerability and immunogenicity of the PXVX0047 Ad7 component are comparable with that of the control Ad4/Ad7 vaccine; however, the immunogenicity of the PXVX0047 Ad4 component was lower than expected. Clinical trial number NCT03160339.
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Affiliation(s)
- Shannon Beaty
- Emergent BioSolutions Inc., Gaithersburg, MD 20879, USA
| | - Natalie Collins
- Walter Reed Army Institute of Research, Bethesda, MD 20814, USA
| | | | - Robert Kuschner
- Walter Reed Army Institute of Research, Bethesda, MD 20814, USA
| | - Jun Hang
- Walter Reed Army Institute of Research, Bethesda, MD 20814, USA
| | - Anima Adhikari
- Walter Reed Army Institute of Research, Bethesda, MD 20814, USA
| | | | - Christian Fung
- Walter Reed Army Institute of Research, Bethesda, MD 20814, USA
| | - Shannon Walls
- Walter Reed Army Institute of Research, Bethesda, MD 20814, USA
| | | | - Jason Mendy
- Emergent BioSolutions Inc., Gaithersburg, MD 20879, USA
| | - Michael Lock
- Emergent BioSolutions Inc., Gaithersburg, MD 20879, USA
| | - Emma Gierman
- Emergent BioSolutions Inc., Gaithersburg, MD 20879, USA
| | - Sean Bennett
- Emergent BioSolutions Inc., Gaithersburg, MD 20879, USA
| | - Paul Shabram
- Emergent BioSolutions Inc., Gaithersburg, MD 20879, USA
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4
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Pollio AR, Fries AC, Yang Y, Hughes JJ, Fung CK, Conte MA, Kuschner RA, Collins ND, Macias EA, Hang J. Clustered cases of human adenovirus types 4, 7, and 14 infections in US Department of Defense Beneficiaries during the 2018-2019 season. J Med Virol 2023; 95:e28571. [PMID: 36762593 DOI: 10.1002/jmv.28571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/01/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
Human adenoviruses (HAdV) are genetically diverse and can infect a number of tissues with severities varied from mild to fatal. HAdV types 3, 4, 7, 11, 14, 21, and 55 were associated with acute respiratory illnesses outbreaks in the United States and in other countries. The risk of outbreaks can be effectively controlled by HAdV vaccination or mitigated by screening and preventive measures. During the influenza season 2018-2019, the DoD Global Respiratory Pathogen Surveillance Program (DoDGRS) received 24 300 respiratory specimens. HAdV samples that produced positive cytopathic effects in viral cultivation were subjected to next-generation sequencing for genome sequence assembly, genome typing, whole genome phylogeny, and sequence comparative analyses. A variety of HAdV types were identified in this study, including HAdV types 1-7, 14, 55, and 56. HAdV types 4, 7, and 14 were found in clustered cases in Colorado, Florida, New York, and South Carolina. Comparative sequence analyses of these isolates revealed the emergence of novel genetic mutations despite the stability of adenovirus genomes. Genomic surveillance of HAdV suggested possible undetected outbreaks and shed light on prevalence, genetic divergence, and viral evolution of HAdV. Continued surveillance will inform risk assessment and countermeasures.
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Affiliation(s)
- Adam R Pollio
- Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Anthony C Fries
- US Air Force School of Aerospace Medicine, Wright-Patterson AFB, Dayton, Ohio, USA
| | - Yu Yang
- Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Jerry J Hughes
- Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Christian K Fung
- Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Matthew A Conte
- Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Robert A Kuschner
- Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Natalie D Collins
- Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Elizabeth A Macias
- US Air Force School of Aerospace Medicine, Wright-Patterson AFB, Dayton, Ohio, USA
| | - Jun Hang
- Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
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5
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An Old Acquaintance: Could Adenoviruses Be Our Next Pandemic Threat? Viruses 2023; 15:v15020330. [PMID: 36851544 PMCID: PMC9966032 DOI: 10.3390/v15020330] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
Human adenoviruses (HAdV) are one of the most important pathogens detected in acute respiratory diseases in pediatrics and immunocompromised patients. In 1953, Wallace Rowe described it for the first time in oropharyngeal lymphatic tissue. To date, more than 110 types of HAdV have been described, with different cellular tropisms. They can cause respiratory and gastrointestinal symptoms, even urinary tract inflammation, although most infections are asymptomatic. However, there is a population at risk that can develop serious and even lethal conditions. These viruses have a double-stranded DNA genome, 25-48 kbp, 90 nm in diameter, without a mantle, are stable in the environment, and resistant to fat-soluble detergents. Currently the diagnosis is made with lateral flow immunochromatography or molecular biology through a polymerase chain reaction. This review aimed to highlight the HAdV variability and the pandemic potential that a HAdV3 and 7 recombinant could have considering the aggressive outbreaks produced in health facilities. Herein, we described the characteristics of HAdV, from the infection to treatment, vaccine development, and the evaluation of the social determinants of health associated with HAdV, suggesting the necessary measures for future sanitary control to prevent disasters such as the SARS-CoV-2 pandemic, with an emphasis on the use of recombinant AdV vaccines to control other potential pandemics.
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Calzado-Dacasin C, Foronda JL, Arguelles VL, Daga CM, Quimpo MT, Lupisan S, Dapat C, Saito M, Okamoto M, Albano PM, Oshitani H. Serotype Identification of Human Adenoviruses Associated with Influenza-Like Illnesses in the Philippines from 2006-2012 by Microneutralization and Molecular Techniques. Int J Infect Dis 2022; 117:326-333. [PMID: 35150916 DOI: 10.1016/j.ijid.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Human adenoviruses (HAdV) are known to cause a wide range of diseases including acute respiratory infections, conjunctivitis, and acute gastroenteritis. In this study, we aimed to determine the serotypes of HAdV in patients with influenza-like illness (ILI) in the Philippines from 2006-2012 and to describe the demographic and epidemiological characteristics of patients who tested positive for HAdV. METHODS Between 2006 and 2012, the Philippine National Influenza Centre detected HAdV in 1294 samples of patients with ILI. Serotype determination was done in select samples using microneutralization, polymerase chain reaction (PCR), and sequencing methods. RESULTS A total of 8 serotypes were identified (HAdV 1-7 and 11), with HAdV-2 (27.8%), and HAdV-3 (27.8%) being the most prevalent. The majority of HAdV infections were found in children below 5 years of age (79.9%). CONCLUSIONS The identification of HAdV circulating serotypes may serve as guide for designing disease intervention and control strategies and will provide important information regarding the contribution of this virus to respiratory infections, particularly in children, which remain a public health burden in the Philippines.
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Affiliation(s)
- Catherine Calzado-Dacasin
- Department of Virology, Research Institute for Tropical Medicine, Muntinlupa, Philippines; Graduate School, University of Santo Tomas, Manila, Philippines.
| | - Janiza Lianne Foronda
- Department of Virology, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Vina Lea Arguelles
- Department of Virology, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Chona Mae Daga
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Marie Therese Quimpo
- Department of Virology, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Socorro Lupisan
- Department of Virology, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Clyde Dapat
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mariko Saito
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan; RITM-Tohoku Collaborating Research Center on Emerging and Re-emerging Infectious Diseases, Muntinlupa, Philippines
| | - Michiko Okamoto
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan; RITM-Tohoku Collaborating Research Center on Emerging and Re-emerging Infectious Diseases, Muntinlupa, Philippines
| | - Pia Marie Albano
- Graduate School, University of Santo Tomas, Manila, Philippines; Department of Biological Sciences, College of Science, University of Santo Tomas, Manila, Philippines
| | - Hitoshi Oshitani
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan; RITM-Tohoku Collaborating Research Center on Emerging and Re-emerging Infectious Diseases, Muntinlupa, Philippines
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7
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Butler CR, Kasper KB, Huggins RA, Cropper TL, Frankel DN, Pawlak MT, Casey T, Casa DJ. Deaths Among U.S. Air Force Basic Military Trainees, 2008-2020. Mil Med 2022; 188:usab493. [PMID: 35043203 DOI: 10.1093/milmed/usab493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION The U.S. Air Force (USAF) Basic Military Training (BMT), a rigorous training program for all enlisted members of the USAF, trains roughly 36,000 recruits annually. Transforming civilians into ready warrior airmen has inherent risks to trainee health, which has infrequently included death. While the average death rate at USAF BMT has decreased between 1956 and 2007 due to process improvement and preventive medicine efforts, further review is warranted to examine the deaths that have occurred since the last published period (1997-2007) and to determine the impact policy changes and updates have had on death rates since that time. Therefore, the purpose of this paper is to identify death rates and types from 2008 to 2020, explore policy implementation, and identify areas needing further improvement or modifications to the overall safety, fitness, and health of USAF BMT trainees. MATERIALS AND METHODS All deaths were examined and reviewed from 2008 through 2020 for trainees attending the USAF BMT using medical records and autopsy reports. Death rates were calculated using the total population of trainees in a given year as well as over the entire 13-year study period. RESULTS From 2008 to 2020, five deaths occurred among USAF BMT trainees (one cardiac, two exertional sickling due to sickle cell trait, one infection, and one suicide). This resulted in an overall average death rate of 1.08 per 100,000 trainees, as compared to 1.46 per 100,000 from 1997 to 2007. The last death in the study period occurred in 2016. CONCLUSION A modest downward trend of average death rate has continued since 2007, and no deaths from 2016 through 2020 represents the longest time frame without any deaths at USAF BMT over all times reported (dating back to 1956) which suggest that emergency best practice policies are/have improved. However, cardiac death rate and suicide rate have not changed since the last report. Policies and practices should be continuously reviewed and refined to reduce the risk of death at USAF BMT.
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8
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Chu VT, Simon E, Lu X, Rockwell P, Abedi GR, Gardner C, Kujawski SA, Schneider E, Gentile M, Ramsey LA, Liu R, Jones S, Janik C, Siniscalchi A, Landry ML, Christopher J, Lindstrom S, Steiner S, Thomas D, Gerber SI, Biggs HM. Outbreak of Acute Respiratory Illness Associated with Human Adenovirus Type 4 at the U.S. Coast Guard Academy, 2019. J Infect Dis 2021; 225:55-64. [PMID: 34139752 DOI: 10.1093/infdis/jiab322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/16/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although a human adenovirus (HAdV) vaccine is available for military use, officers-in-training are not routinely vaccinated. We describe an HAdV-associated respiratory outbreak among unvaccinated cadets at the U.S. Coast Guard Academy and its impact on cadet training. METHODS We defined a case as a cadet with new onset cough or sore throat during August 1-October 4, 2019. We reviewed medical records and distributed a questionnaire to identify cases and to estimate impact on cadet training. We performed real-time PCR testing on patient and environmental samples and whole genome sequencing on a subset of positive patient samples. RESULTS Among the 1,072 cadets, 378 (35%) cases were identified by medical records (n=230) or additionally by the questionnaire (n=148). Of the 230 cases identified from medical records, 138 (60%) were male and 226 (98%) had no underlying conditions. From questionnaire responses, 113/228 (50%) cases reported duty restrictions. Of cases with respiratory specimens, 36/50 (72%) were HAdV positive; all 14 sequenced specimens were HAdV-4a1. Sixteen (89%) of 18 environmental specimens from the cadet dormitory were HAdV-positive. CONCLUSIONS The HAdV-4-associated outbreak infected a substantial number of cadets and significantly impacted cadet training. Routine vaccination could prevent HAdV respiratory outbreaks in this population.
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Affiliation(s)
- Victoria T Chu
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Esan Simon
- United States Coast Guard Academy, New London, Connecticut, USA.,United States Public Health Service, Rockville, Maryland, USA
| | - Xiaoyan Lu
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Glen R Abedi
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Christopher Gardner
- United States Coast Guard Academy, New London, Connecticut, USA.,Yale-New Haven Hospital and Yale University, New Haven, Connecticut, USA
| | - Stephanie A Kujawski
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Eileen Schneider
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Micah Gentile
- United States Coast Guard Academy, New London, Connecticut, USA
| | - Lee Ann Ramsey
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Robert Liu
- United States Coast Guard Academy, New London, Connecticut, USA
| | - Sydney Jones
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Connecticut Department of Public Health, Hartford, Connecticut, USA
| | - Christopher Janik
- United States Coast Guard Academy, New London, Connecticut, USA.,United States Public Health Service, Rockville, Maryland, USA
| | - Alan Siniscalchi
- Connecticut Department of Public Health, Hartford, Connecticut, USA
| | - Marie L Landry
- Yale-New Haven Hospital and Yale University, New Haven, Connecticut, USA
| | | | - Stephen Lindstrom
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shane Steiner
- United States Public Health Service, Rockville, Maryland, USA.,United States Coast Guard, Washington, D.C., USA
| | - Dana Thomas
- United States Public Health Service, Rockville, Maryland, USA.,United States Coast Guard, Washington, D.C., USA
| | - Susan I Gerber
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Holly M Biggs
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Coleman KK, Robie ER, Abdelgadir A, Kozhumam AS, Binder RA, Gray GC. Six Decades of Human Adenovirus Type 4 Infections Reviewed: Increasing Infections Among Civilians Are a Matter of Concern. Clin Infect Dis 2021; 73:740-746. [PMID: 33693635 DOI: 10.1093/cid/ciab146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/12/2021] [Indexed: 12/18/2022] Open
Abstract
Human adenovirus type 4 (HAdV-E4) frequently causes epidemics among military and civilian populations. We conducted a systematic review of 144 peer-reviewed articles reporting HAdV-E4 infections, published during the years 1960 - 2020. More than 24,500 HAdV-E4 infections, including 27 associated deaths, were documented. HAdV-E4 infections were reported from all geographic regions of the world except Central America and the Caribbean. The number of publications reporting civilian infections tripled in the last decade, with a steady increase in reported civilian infections over time. Infections commonly caused respiratory and ocular disease. North America reported the most infections, followed by Asia and Europe. The majority of deaths were reported in the USA, followed by China and Singapore. Civilians seem to increasingly suffer HAdV-E4 disease, with recent epidemics among U.S. college students. Public health officials should consider seeking emergency use authorization for the adenovirus vaccine such that it might be available to mitigate civilian epidemics.
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Affiliation(s)
- Kristen K Coleman
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Emily R Robie
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA.,Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
| | - Anfal Abdelgadir
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA.,Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
| | - Arthi S Kozhumam
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Raquel A Binder
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA.,Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
| | - Gregory C Gray
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore.,Duke Global Health Institute, Duke University, Durham, North Carolina, USA.,Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA.,Global Health Research Center, Duke Kunshan University, Kunshan, China
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10
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Tarim EA, Karakuzu B, Oksuz C, Sarigil O, Kizilkaya M, Al-Ruweidi MKAA, Yalcin HC, Ozcivici E, Tekin HC. Microfluidic-based virus detection methods for respiratory diseases. EMERGENT MATERIALS 2021; 4:143-168. [PMID: 33786415 PMCID: PMC7992628 DOI: 10.1007/s42247-021-00169-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 01/19/2021] [Indexed: 05/04/2023]
Abstract
With the recent SARS-CoV-2 outbreak, the importance of rapid and direct detection of respiratory disease viruses has been well recognized. The detection of these viruses with novel technologies is vital in timely prevention and treatment strategies for epidemics and pandemics. Respiratory viruses can be detected from saliva, swab samples, nasal fluid, and blood, and collected samples can be analyzed by various techniques. Conventional methods for virus detection are based on techniques relying on cell culture, antigen-antibody interactions, and nucleic acids. However, these methods require trained personnel as well as expensive equipment. Microfluidic technologies, on the other hand, are one of the most accurate and specific methods to directly detect respiratory tract viruses. During viral infections, the production of detectable amounts of relevant antibodies takes a few days to weeks, hampering the aim of prevention. Alternatively, nucleic acid-based methods can directly detect the virus-specific RNA or DNA region, even before the immune response. There are numerous methods to detect respiratory viruses, but direct detection techniques have higher specificity and sensitivity than other techniques. This review aims to summarize the methods and technologies developed for microfluidic-based direct detection of viruses that cause respiratory infection using different detection techniques. Microfluidics enables the use of minimal sample volumes and thereby leading to a time, cost, and labor effective operation. Microfluidic-based detection technologies provide affordable, portable, rapid, and sensitive analysis of intact virus or virus genetic material, which is very important in pandemic and epidemic events to control outbreaks with an effective diagnosis.
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Affiliation(s)
- E. Alperay Tarim
- Department of Bioengineering, Izmir Institute of Technology, Urla, Izmir, Turkey
| | - Betul Karakuzu
- Department of Bioengineering, Izmir Institute of Technology, Urla, Izmir, Turkey
| | - Cemre Oksuz
- Department of Bioengineering, Izmir Institute of Technology, Urla, Izmir, Turkey
| | - Oyku Sarigil
- Department of Bioengineering, Izmir Institute of Technology, Urla, Izmir, Turkey
| | - Melike Kizilkaya
- Department of Bioengineering, Izmir Institute of Technology, Urla, Izmir, Turkey
| | | | | | - Engin Ozcivici
- Department of Bioengineering, Izmir Institute of Technology, Urla, Izmir, Turkey
| | - H. Cumhur Tekin
- Department of Bioengineering, Izmir Institute of Technology, Urla, Izmir, Turkey
- METU MEMS Center, Ankara, Turkey
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Hang J, Kajon AE, Graf PCF, Berry IM, Yang Y, Sanborn MA, Fung CK, Adhikari A, Balansay-Ames MS, Myers CA, Binn LN, Jarman RG, Kuschner RA, Collins ND. Human Adenovirus Type 55 Distribution, Regional Persistence, and Genetic Variability. Emerg Infect Dis 2020; 26:1497-1505. [PMID: 32568062 PMCID: PMC7323512 DOI: 10.3201/eid2607.191707] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Human adenovirus type 55 (HAdV-55) causes acute respiratory disease of variable severity and has become an emergent threat in both civilian and military populations. HAdV-55 infection is endemic to China and South Korea, but data from other regions and time periods are needed for comprehensive assessment of HAdV-55 prevalence from a global perspective. In this study, we subjected HAdV-55 isolates from various countries collected during 1969-2018 to whole-genome sequencing, genomic and proteomic comparison, and phylogenetic analyses. The results show worldwide distribution of HAdV-55; recent strains share a high degree of genomic homogeneity. Distinct strains circulated regionally for several years, suggesting persistent local transmission. Several cases of sporadic introduction of certain strains to other countries were documented. Among the identified amino acid mutations distinguishing HAdV-55 strains, some have potential impact on essential viral functions and may affect infectivity and transmission.
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McNeil MM, Paradowska-Stankiewicz I, Miller ER, Marquez PL, Seshadri S, Collins LC, Cano MV. Adverse events following adenovirus type 4 and type 7 vaccine, live, oral in the Vaccine Adverse Event Reporting System (VAERS), United States, October 2011-July 2018. Vaccine 2019; 37:6760-6767. [PMID: 31548014 DOI: 10.1016/j.vaccine.2019.08.087] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 08/14/2019] [Accepted: 08/30/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND In March 2011, the U.S. Food and Drug Administration licensed adenovirus type 4 and type 7 vaccine, live, oral (Barr Labs, Inc.) (adenovirus vaccine) for use in military personnel 17 through 50 years of age. The vaccine was first universally administered to U.S. military recruits in October 2011. We investigated adverse event (AE) reports following the adenovirus vaccine submitted to the Vaccine Adverse Event Reporting System (VAERS). METHODS We searched the VAERS database for U.S. reports among persons who received adenovirus vaccine during October 2011 through July 2018 including participants in a military observational study. We reviewed all serious reports and accompanying medical records. We compared the proportion of serious reports in a proxy military recruit population and reviewed all reports of suspected allergic reactions following adenovirus vaccination. RESULTS During the analytic period, VAERS received 100 reports following adenovirus vaccination; 39 (39%) were classified as serious and of these, 17 (44%) were from the observational study. One death was reported. Males accounted for 72% of reports. Median age of vaccinees was 19 years (range 17-32). The most frequently reported serious AEs were Guillain Barré syndrome (GBS) (n = 12) and anaphylaxis (n = 8); of these, two GBS and all the anaphylaxis reports were reported in the observational study. Reports documented concurrent receipt of multiple other vaccines (95%) and penicillin G (IM Pen G) or other antibiotics (50%). CONCLUSIONS The reporting rate for serious AEs was higher than with other vaccines administered in the comparison military recruit population (39% vs 18%); however, we identified no unexpected or concerning pattern of adenovirus vaccine AEs. Co-administration of vaccines and IM Pen G was commonly reported in this military population. These exposures may have contributed to the GBS and anaphylaxis outcomes observed with the adenovirus vaccine. Future adenovirus vaccine safety studies in a population without these co-administrations would be helpful in clarifying the vaccine's safety profile.
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Affiliation(s)
- Michael M McNeil
- Immunization Safety Office, Division of Healthcare Quality Promotion (DHQP), National Center for Zoonotic and Emerging Infectious Diseases (NCZEID), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA.
| | - Iwona Paradowska-Stankiewicz
- Immunization Safety Office, Division of Healthcare Quality Promotion (DHQP), National Center for Zoonotic and Emerging Infectious Diseases (NCZEID), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Elaine R Miller
- Immunization Safety Office, Division of Healthcare Quality Promotion (DHQP), National Center for Zoonotic and Emerging Infectious Diseases (NCZEID), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Paige L Marquez
- Immunization Safety Office, Division of Healthcare Quality Promotion (DHQP), National Center for Zoonotic and Emerging Infectious Diseases (NCZEID), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Srihari Seshadri
- Immunization Healthcare Division, Public Health Division, Defense Health Agency, Falls Church, VA 22042, USA
| | - Limone C Collins
- Immunization Healthcare Division, Public Health Division, Defense Health Agency, Falls Church, VA 22042, USA
| | - Maria V Cano
- Immunization Safety Office, Division of Healthcare Quality Promotion (DHQP), National Center for Zoonotic and Emerging Infectious Diseases (NCZEID), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
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Characterization of a replication-competent vector encoding DsRed based on a human adenovirus type 4 a-like strain. Virus Res 2019; 270:197662. [PMID: 31301331 DOI: 10.1016/j.virusres.2019.197662] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 06/04/2019] [Accepted: 07/09/2019] [Indexed: 02/06/2023]
Abstract
Human adenovirus type 4 (HAdV4) is an etiological agent of acute respiratory disease (ARD) in pediatric and adult patients. HAdV4 strains can be divided into two major genomic clusters, namely prototype (p)-like viruses and a-like viruses. Here, the complete genome sequence of HAdV4 strain GZ01, isolated from a child with ARD in southern China, is first reported and analyzed. This strain was determined to be of the 4a1 genome-type based on in silico restriction profiles. Then, a replication-competent rAd4DsRed virus, containing the HAdV4 GZ01 infectious genome and expressing the reporter molecule DsRed, was generated and characterized. Recombinant rAd4DsRed can infect AD293, hamster, and mouse cells in which DsRed protein was expressed. No changes in antigenicity and genome replication were detected for rAd4DsRed and wild-type HAdV4. Mice immunized with rAd4DsRed was elicited a marked antibody response to DsRed. A rapid method of testing neutralizing antibodies against HAdV3 and HAdV4 was also established using a mixture of rAd4DsRed and rAd3EGFP. Our results provide the foundation to develop HAdV4 vaccines, potential vector platforms for vaccine and gene therapy, and rapid methods for serological and antiviral screening.
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Kajon AE, Lamson DM, Bair CR, Lu X, Landry ML, Menegus M, Erdman DD, St George K. Adenovirus Type 4 Respiratory Infections among Civilian Adults, Northeastern United States, 2011-2015 1. Emerg Infect Dis 2019; 24:201-209. [PMID: 29350143 PMCID: PMC5782899 DOI: 10.3201/eid2402.171407] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Human adenovirus type 4 (HAdV-4) is most commonly isolated in military settings. We conducted detailed molecular characterization on 36 HAdV-4 isolates recovered from civilian adults with acute respiratory disease (ARD) in the northeastern United States during 2011–2015. Specimens came from college students, residents of long-term care facilities or nursing homes, a cancer patient, and young adults without co-morbidities. HAdV-4 genome types 4a1 and 4a2, the variants most frequently detected among US military recruits in basic training before the restoration of vaccination protocols, were isolated in most cases. Two novel a-like variants were recovered from students enrolled at a college in Tompkins County, New York, USA, and a prototype-like variant distinguishable from the vaccine strain was isolated from an 18-year-old woman visiting a physician’s office in Ulster County, New York, USA, with symptoms of influenza-like illness. Our data suggest that HAdV-4 might be an underestimated causative agent of ARD among civilian adults.
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Hammond-Collins K, Strauss B, Barnes K, Demczuk W, Domingo MC, Lamontagne MC, Lu D, Martin I, Tepper M. Group A Streptococcus Outbreak in a Canadian Armed Forces Training Facility. Mil Med 2018; 184:e197-e204. [DOI: 10.1093/milmed/usy198] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 07/10/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Karon Hammond-Collins
- Canadian Field Epidemiology Program, Public Health Agency of Canada, 100 Colonnade Drive, Ottawa, ON, Canada
| | - Barbara Strauss
- Directorate of Force Health Protection, Canadian Forces Medical Group Headquarters, Carling Campus, 101 Colonel By Drive, Ottawa, ON, Canada
| | - Kirsten Barnes
- Directorate of Force Health Protection, Canadian Forces Medical Group Headquarters, Carling Campus, 101 Colonel By Drive, Ottawa, ON, Canada
| | - Walter Demczuk
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington St, Winnipeg, MB, Canada
| | - Marc-Christian Domingo
- Laboratoire de santé publique du Québec, 20045 Sainte Marie Rd, Sainte-Anne-de-Bellevue, QC, Canada
| | - Marie-Christine Lamontagne
- Directorate of Force Health Protection, Canadian Forces Medical Group Headquarters, Carling Campus, 101 Colonel By Drive, Ottawa, ON, Canada
| | - Diane Lu
- Directorate of Force Health Protection, Canadian Forces Medical Group Headquarters, Carling Campus, 101 Colonel By Drive, Ottawa, ON, Canada
| | - Irene Martin
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington St, Winnipeg, MB, Canada
| | - Martin Tepper
- Directorate of Force Health Protection, Canadian Forces Medical Group Headquarters, Carling Campus, 101 Colonel By Drive, Ottawa, ON, Canada
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Abstract
Human mastadenovirus (HAdVs) can cause a broad spectrum of diseases in both children and adults, including acute respiratory infection, gastroenteritis, epidemic keratoconjunctivitis. Populations susceptible to adenovirus infection include children, immunocompromised patients and military recruits. To date, seven species (A-G) including more than 79 genotypes have been characterized, of which HAdV-B3, B4, B7 and the recently reemerged types 14 and 55 often lead to severe pneumonia. The live oral enteric-coated adenovirus type 4 and 7 vaccine, which was approved for use in US military personnel of 17 through 50 years of age, had been shown to be safe and highly effective in numerous clinical trials and by ongoing surveillance of febrile respiratory illness. However, there is currently no vaccine approved for general use in children and adults in any part of the world. This review article will summarize the epidemiological data available for adenovirus and the effectiveness of the adenovirus vaccine in the US military. It will also provide a brief overview of innovative vaccine strategies, animal models for vaccine evaluation, and issues regarding vaccine production.
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Affiliation(s)
- Shiying Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510182, China
| | - Xingui Tian
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510182, China
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17
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Gu H, Gao Y, Zhou S, Sun F, Zhao Z, Wang K, Zhao L, Zhang P, Wang Z, Zhang S, Wang X, Yang P. Bivalent vaccine platform based on ca influenza virus vaccine elicits protective immunity against human adenoviruses. Antiviral Res 2018; 153:78-84. [DOI: 10.1016/j.antiviral.2018.02.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 02/07/2018] [Accepted: 02/20/2018] [Indexed: 11/28/2022]
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Liu T, Zhou Z, Tian X, Liu W, Xu D, Fan Y, Liao J, Gu S, Li X, Zhou R. A recombinant trivalent vaccine candidate against human adenovirus types 3, 7, and 55. Vaccine 2018; 36:2199-2206. [PMID: 29548605 DOI: 10.1016/j.vaccine.2018.02.050] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/07/2018] [Accepted: 02/10/2018] [Indexed: 12/20/2022]
Abstract
Human adenoviruses types 3 (HAdV-3), 7 (HAdV-7) and 55 (HAdV-55) are major pathogens of acute respiratory infections (ARI) in children and adults. More than one type of HAdV can infect patients simultaneously, and the infections are sometimes fatal. However, there is currently no vaccine approved for general use in children and adults. Thus, development of a multivalent HAdV vaccine to combat HAdV infection becomes imperative. In this study, we constructed a new recombinant trivalent human adenovirus vaccine (rAdMHE3-h55), which expresses the hexon protein of HAdV-55 in the E3 region of rAdMHE3, a previously prepared bivalent vaccine candidate against HAdV-3 and HAdV-7. The results of in vitro neutralization assays indicate that rAdMHE3-h55 can induce the production of neutralizing antibodies against HAdV-3, HAdV-7, and HAdV-55 in mice. Furthermore, immunization with the recombinant trivalent vaccine candidate completely protected the mice challenged with HAdV-3, HAdV-7, orHAdV-55, respectively, showing lower lung viral loads and less lung Pathological changes was compared with those in unvaccinated mice. The current findings contribute to the development of a new adenovirus vaccine candidate and also advance this construction method for the generation of recombinant adenovirus vaccines. In conclusion, our recombinant trivalent vaccine rAdMHE3-h55 can provides protection against challenge with HAdV-3, HAdV-7, or HAdV-55 in mice. Future work of optimizing this vaccine candidate may lead to a more effective way of preventing respiratory diseases caused by common human adenoviruses.
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Affiliation(s)
- Tiantian Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Zhichao Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Xingui Tian
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Wenkuan Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Duo Xu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Ye Fan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Jiayi Liao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Shujun Gu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Xiao Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
| | - Rong Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
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Chehadeh W, Al-Adwani A, John SE, Al-Dhufairi S, Al-Dousari H, Alkhaledi M, Al-Nakib W. Adenovirus types associated with severe respiratory diseases: A retrospective 4-year study in Kuwait. J Med Virol 2018; 90:1033-1039. [PMID: 29446483 PMCID: PMC7167181 DOI: 10.1002/jmv.25059] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 12/20/2017] [Accepted: 01/23/2018] [Indexed: 12/26/2022]
Abstract
Human adenovirus (HAdV) infection can result in a severe respiratory disease. The aim of this study was to identify HAdV types detected in patients hospitalized for severe respiratory illness. The study population consisted of 743 patients with severe respiratory disease admitted to four major hospitals in Kuwait between January 2013 and December 2016. Respiratory specimens were retrospectively screened for 20 respiratory viruses by real-time PCR. The HAdV hexon gene was amplified and directly sequenced, and HAdV types were identified by performing Bayesian phylogenetic analysis. HAdV DNA was detected in 27 (3.6%) patients, with peaks in November and March. Most patients were infants and young children suffering from pneumonia or acute bronchiolitis. The detected HAdV types were C1, C2, C5, B3, and B7. Clusters of HAdV C1, C2, and C5 were observed with high posterior probability. All patients infected with HAdV C5 and 50% of patients infected with HAdV C2 or B7 were admitted to the intensive care unit (ICU). Co-infection with other viruses was detected in 44.4% of patients. The most common co-infecting virus was rhinovirus (HRV). HAdV/HRV co-infection was detected in two children who presumably developed disseminated HAdV infection and died. This is the first report describing the circulation of HAdV types associated with severe outcomes in Kuwait. These findings highlight the need for a national surveillance system to monitor changes in predominant HAdV types and increased numbers of severe respiratory infections.
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Affiliation(s)
- Wassim Chehadeh
- Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait
| | - Anfal Al-Adwani
- Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait
| | - Sonia Elezebeth John
- Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait
| | - Shaikhah Al-Dhufairi
- Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait
| | - Hessa Al-Dousari
- Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait
| | - Maha Alkhaledi
- Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait
| | - Widad Al-Nakib
- Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait
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20
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Identification of a Critical and Conformational Neutralizing Epitope in Human Adenovirus Type 4 Hexon. J Virol 2018; 92:JVI.01643-17. [PMID: 29093098 PMCID: PMC5752955 DOI: 10.1128/jvi.01643-17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 10/23/2017] [Indexed: 01/24/2023] Open
Abstract
Human adenovirus type 4 (HAdV-4) is an epidemic virus that contributes to serious acute respiratory disease (ARD) in both pediatric and adult patients. However, no licensed drug or vaccine is currently available to the civilian population. The identification of neutralizing epitopes of HAdV-4 should allow the development of a novel antiviral vaccine and a novel gene transfer vector, and an effective neutralizing monoclonal antibody (MAb) will be useful in developing appropriate antiviral drugs. In this study, we report that MAb MN4b shows strong neutralizing activity against HAdV-4. MN4b recognizes a conformational epitope (418AGSEK422) within hypervariable region 7 (HVR7). Mutations within this site permitted HAdV-4 mutants to escape neutralization by MN4b and to resist neutralization by animal and human anti-HAdV-4 sera. A recombinant virus, rAd3-A4R7-1, containing the identified neutralizing epitope in the HVR7 region of HAdV-3 hexon, successfully induced antiserum that inhibited HAdV-4 infection. These results indicate that a small surface loop of HAdV-4 hexon is a critical neutralization epitope for this virus. The generation of MN4b and the identification of this neutralizing epitope may be useful in developing therapeutic treatment, a subunit vaccine, and a novel vector that can escape preexisting neutralization for HAdV-4. IMPORTANCE Neutralizing antibodies are considered good tools for the prevention of human adenovirus type 4 (HAdV-4) infections. The identification of the epitopes recognized by such neutralizing antibodies is important for the generation of recombinant antiviral vaccines. However, until now, no neutralizing epitope has been reported for HAdV-4. Here, we developed a serotype-specific neutralizing MAb directed against HAdV-4, MN4b. We provide evidence that MN4b recognizes a conformational epitope within HVR7 of HAdV-4 hexon. Antisera generated to this conformational epitope displayed on HAdV-3 hexon inhibited infection of AD293 cells by HAdV-4. Our findings are very important for the development of therapeutic treatment, a subunit vaccine, and a novel vector for HAdV-4.
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22
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PHYLOGENETIC ANALYSIS OF THE GENOME OF AN ENTERITIS-ASSOCIATED BOTTLENOSE DOLPHIN MASTADENOVIRUS SUPPORTS A CLADE INFECTING THE CETARTIODACTYLA. J Wildl Dis 2017; 54:112-121. [PMID: 29077545 DOI: 10.7589/2017-03-052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
: Adenoviruses are nonenveloped, double-stranded DNA viruses, known to infect members of all tetrapod classes, with a similarity between phylogenies of hosts and viruses observed. We characterized bottlenose dolphin adenovirus 2 (BdAdV-2) found in a bottlenose dolphin ( Tursiops truncatus) with enteritis. Virions were seen by negative staining electron microscopy of feces. Initial sequences obtained using conserved PCR primers were expanded using primer walking techniques, and the complete coding sequence was obtained. Phylogenetic analyses were consistent with coevolution of this virus and its bottlenose dolphin host, placing BdAdV-2 into a monophyletic group with other mastadenoviruses of Cetartiodactyla. When considering the low guanine/cytosine (G/C) content of BdAdV-2 with the phylogenetic data, this virus may represent a host-jumping event from another member of Cetartiodactyla. Analysis of partial polymerase indicated that bottlenose dolphin adenovirus 1, previously identified in Spain, and BdAdV-2 are sister taxa with harbor porpoise adenovirus 1, forming a cetacean clade. Bottlenose dolphin adenovirus 2 includes a highly divergent fiber gene. Two genes homologous to the dUTPase superfamily are also present which could play a role in enabling viral replication in nondividing cells. We used sequence data to develop a probe hybridization quantitative PCR assay specific to BdAdV-2 with a limit of detection of 10 copies.
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Park CK, Kwon H, Park JY. Thin-section computed tomography findings in 104 immunocompetent patients with adenovirus pneumonia. Acta Radiol 2017; 58:937-943. [PMID: 28273735 DOI: 10.1177/0284185116681039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background To date, there has been no computed tomography (CT) evaluation of adenovirus pneumonia in a large number of immunocompetent patients. Purpose To describe the thin-section CT findings of immunocompetent patients with adenovirus pneumonia. Material and Methods We prospectively enrolled 104 patients with adenovirus pneumonia from a military hospital. CT scans of each patient were retrospectively and independently assessed by two radiologists for the presence of abnormalities, laterality and zonal predominance of the parenchymal abnormalities, and dominant imaging patterns and their anatomic distributions. Results CT findings included consolidation (n = 92), ground-glass opacity (GGO; n = 82), septal thickening (n = 34), nodules (n = 46), bronchial wall thickening (n = 32), pleural effusion (n = 16), and lymphadenopathy (n = 3). Eighty-four patients (81%) exhibited unilateral parenchymal abnormalities and 57 (57%) exhibited lower lung zone abnormalities. The most frequently dominant CT pattern was consolidation with surrounding GGO (n = 50), with subpleural (70%) and peribronchovascular (94%) distributions. Consolidation-the second-most common pattern (n = 33)-also exhibited subpleural (79%) and peribronchovascular (97%) distributions. The dominant nodule pattern (n = 14) exhibited mixed (64%) and peribronchovascular (100%) distributions. A dominant GGO pattern was only observed in four patients; none had central distribution. Conclusion Although the manifestations of adenovirus pneumonia on CT are varied, we found the most frequent pattern was consolidation with or without surrounding GGO, with subpleural and peribronchovascular distributions. Parenchymal abnormalities were predominantly unilateral and located in the lower lung zone. If dominant consolidation findings are present in immunocompetent patients during the early stages, adenovirus pneumonia should be considered.
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Affiliation(s)
- Chan Kue Park
- Department of Radiology, The Armed Forces Daejeon Hospital, Daejeon, Republic of Korea
| | - Hoon Kwon
- Department of Radiology, The Busan National University Hospital, Busan, Republic of Korea
| | - Ji Young Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
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Hang J, Vento TJ, Norby EA, Jarman RG, Keiser PB, Kuschner RA, Binn LN. Adenovirus type 4 respiratory infections with a concurrent outbreak of coxsackievirus A21 among United States Army Basic Trainees, a retrospective viral etiology study using next-generation sequencing. J Med Virol 2017; 89:1387-1394. [PMID: 28198541 DOI: 10.1002/jmv.24792] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 01/30/2017] [Indexed: 11/09/2022]
Abstract
Human adenoviruses (HAdV), in particular types 4 and 7, frequently cause acute respiratory disease (ARD) during basic military training. HAdV4 and HAdV7 vaccines reduced the ARD risk in U.S. military. It is important to identify other respiratory pathogens and assess their potential impact on military readiness. In 2002, during a period when the HAdV vaccines were not available, throat swabs were taken from trainees (n = 184) with respiratory infections at Fort Jackson, South Carolina. Viral etiology was investigated initially with viral culture and neutralization assay and recently in this study by sequencing the viral isolates. Viral culture and neutralization assays identified 90 HAdV4 isolates and 27 additional cultures that showed viral cytopathic effects (CPE), including some with picornavirus-like CPE. Next-generation sequencing confirmed these results and determined viral genotypes, including 77 HAdV4, 4 HAdV3, 1 HAdV2, 17 coxsackievirus A21 (CAV21), and 1 enterovirus D68. Two samples were positive for both HAdV4 and CAV21. The identified genotypes are phylogenetically close to but distinct from those found during other years or in other military/non-military sites. HAdV4 is the predominant respiratory pathogen in unvaccinated military trainee. HAdV4 has temporal and demographic variability. CAV21 is a significant respiratory pathogen and needs to be evaluated for its current significance in military basic trainees.
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Affiliation(s)
- Jun Hang
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Todd J Vento
- Preventive Medicine Department, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Erica A Norby
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Richard G Jarman
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Paul B Keiser
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Robert A Kuschner
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Leonard N Binn
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland
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Cortés-Hinojosa G, Gulland FMD, Goldstein T, Venn-Watson S, Rivera R, Archer LL, Waltzek TB, Gray GC, Wellehan JFX. Development and validation of a quantitative PCR for rapid and specific detection of California sea lion adenovirus 1 and prevalence in wild and managed populations. J Vet Diagn Invest 2017; 29:193-197. [PMID: 28166696 DOI: 10.1177/1040638716689113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
California sea lion adenovirus 1 (CSLAdV-1) has been associated with hepatitis and enteritis in several wild and captive populations of diverse pinniped species. Currently available tests have been limited to pan-adenoviral polymerase chain reaction (PCR) followed by sequencing. We present the development of a quantitative probe-hybridization PCR (qPCR) assay for rapid, sensitive, and specific detection of this virus in California sea lions ( Zalophus californianus) and other pinnipeds. This assay did not amplify other mammalian adenoviruses and is able to detect consistently down to 10 viral copies per well. Compared with the gold standard conventional pan-adenovirus PCR/sequencing assay, diagnostic sensitivity and specificity of 100% and 88.2% were found, respectively. The lower diagnostic specificity of this qPCR assay may be the result of the lower limit of detection of this assay compared with the gold standard rather than the result of detection of true false-positives.
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Affiliation(s)
- Galaxia Cortés-Hinojosa
- Departments of Small Animal Clinical Sciences (Cortes-Hinojosa, Archer, Wellehan) and Infectious Diseases and Pathology (Waltzek), College of Veterinary Medicine, University of Florida, Gainesville, FL.,Global Health Institute, Duke University, Durham, NC (Gray).,The Marine Mammal Center, Sausalito, CA (Gulland).,Wildlife Health Center, School of Veterinary Medicine, University of California-Davis, Davis, CA (Goldstein).,National Marine Mammal Foundation, San Diego, CA (Venn-Watson).,Hubbs-SeaWorld Research Institute, San Diego, CA (Rivera)
| | - Frances M D Gulland
- Departments of Small Animal Clinical Sciences (Cortes-Hinojosa, Archer, Wellehan) and Infectious Diseases and Pathology (Waltzek), College of Veterinary Medicine, University of Florida, Gainesville, FL.,Global Health Institute, Duke University, Durham, NC (Gray).,The Marine Mammal Center, Sausalito, CA (Gulland).,Wildlife Health Center, School of Veterinary Medicine, University of California-Davis, Davis, CA (Goldstein).,National Marine Mammal Foundation, San Diego, CA (Venn-Watson).,Hubbs-SeaWorld Research Institute, San Diego, CA (Rivera)
| | - Tracey Goldstein
- Departments of Small Animal Clinical Sciences (Cortes-Hinojosa, Archer, Wellehan) and Infectious Diseases and Pathology (Waltzek), College of Veterinary Medicine, University of Florida, Gainesville, FL.,Global Health Institute, Duke University, Durham, NC (Gray).,The Marine Mammal Center, Sausalito, CA (Gulland).,Wildlife Health Center, School of Veterinary Medicine, University of California-Davis, Davis, CA (Goldstein).,National Marine Mammal Foundation, San Diego, CA (Venn-Watson).,Hubbs-SeaWorld Research Institute, San Diego, CA (Rivera)
| | - Stephanie Venn-Watson
- Departments of Small Animal Clinical Sciences (Cortes-Hinojosa, Archer, Wellehan) and Infectious Diseases and Pathology (Waltzek), College of Veterinary Medicine, University of Florida, Gainesville, FL.,Global Health Institute, Duke University, Durham, NC (Gray).,The Marine Mammal Center, Sausalito, CA (Gulland).,Wildlife Health Center, School of Veterinary Medicine, University of California-Davis, Davis, CA (Goldstein).,National Marine Mammal Foundation, San Diego, CA (Venn-Watson).,Hubbs-SeaWorld Research Institute, San Diego, CA (Rivera)
| | - Rebecca Rivera
- Departments of Small Animal Clinical Sciences (Cortes-Hinojosa, Archer, Wellehan) and Infectious Diseases and Pathology (Waltzek), College of Veterinary Medicine, University of Florida, Gainesville, FL.,Global Health Institute, Duke University, Durham, NC (Gray).,The Marine Mammal Center, Sausalito, CA (Gulland).,Wildlife Health Center, School of Veterinary Medicine, University of California-Davis, Davis, CA (Goldstein).,National Marine Mammal Foundation, San Diego, CA (Venn-Watson).,Hubbs-SeaWorld Research Institute, San Diego, CA (Rivera)
| | - Linda L Archer
- Departments of Small Animal Clinical Sciences (Cortes-Hinojosa, Archer, Wellehan) and Infectious Diseases and Pathology (Waltzek), College of Veterinary Medicine, University of Florida, Gainesville, FL.,Global Health Institute, Duke University, Durham, NC (Gray).,The Marine Mammal Center, Sausalito, CA (Gulland).,Wildlife Health Center, School of Veterinary Medicine, University of California-Davis, Davis, CA (Goldstein).,National Marine Mammal Foundation, San Diego, CA (Venn-Watson).,Hubbs-SeaWorld Research Institute, San Diego, CA (Rivera)
| | - Thomas B Waltzek
- Departments of Small Animal Clinical Sciences (Cortes-Hinojosa, Archer, Wellehan) and Infectious Diseases and Pathology (Waltzek), College of Veterinary Medicine, University of Florida, Gainesville, FL.,Global Health Institute, Duke University, Durham, NC (Gray).,The Marine Mammal Center, Sausalito, CA (Gulland).,Wildlife Health Center, School of Veterinary Medicine, University of California-Davis, Davis, CA (Goldstein).,National Marine Mammal Foundation, San Diego, CA (Venn-Watson).,Hubbs-SeaWorld Research Institute, San Diego, CA (Rivera)
| | - Gregory C Gray
- Departments of Small Animal Clinical Sciences (Cortes-Hinojosa, Archer, Wellehan) and Infectious Diseases and Pathology (Waltzek), College of Veterinary Medicine, University of Florida, Gainesville, FL.,Global Health Institute, Duke University, Durham, NC (Gray).,The Marine Mammal Center, Sausalito, CA (Gulland).,Wildlife Health Center, School of Veterinary Medicine, University of California-Davis, Davis, CA (Goldstein).,National Marine Mammal Foundation, San Diego, CA (Venn-Watson).,Hubbs-SeaWorld Research Institute, San Diego, CA (Rivera)
| | - James F X Wellehan
- Departments of Small Animal Clinical Sciences (Cortes-Hinojosa, Archer, Wellehan) and Infectious Diseases and Pathology (Waltzek), College of Veterinary Medicine, University of Florida, Gainesville, FL.,Global Health Institute, Duke University, Durham, NC (Gray).,The Marine Mammal Center, Sausalito, CA (Gulland).,Wildlife Health Center, School of Veterinary Medicine, University of California-Davis, Davis, CA (Goldstein).,National Marine Mammal Foundation, San Diego, CA (Venn-Watson).,Hubbs-SeaWorld Research Institute, San Diego, CA (Rivera)
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Knapik JJ, Jean RT, Austin KG, Steelman RA, Farina EK, Lieberman HR. Demographic factors associated with dietary supplement prescriptions filled by United States Military Service Members 2005-2013. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:84. [PMID: 28148262 PMCID: PMC5286846 DOI: 10.1186/s12906-017-1590-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 01/17/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Dietary supplements (DSs) can be purchased over-the-counter but may also be prescribed by medical personnel for specific therapeutic reasons. Few studies have examined this latter source of DSs despite the fact that 79% of physicians and 82% of nurses have recommended DSs to their patients. This investigation examined demographic factors associated with temporal trends in oral DS prescriptions filled by all United States (US) service members (SMs) from 2005 to 2013 (n = 1,427,080 ± 22,139, mean ± standard deviation per year). METHODS The Food and Drug Administration National Drug Code database and the formularies of the US Defense Health Agency's Pharmacoeconomic Center were queried to identify DSs available to SMs. The number of these DS prescriptions filled by all SMs from 2005 through 2013 was then obtained from the US Department of Defense Pharmacy Data Transaction System. Data were grouped by American Hospital Formulary System (AHFS) pharmacologic-therapeutic classifications and examined over time. Denominators (number of SMs each year) were obtained from the Defense Health Agency. RESULTS Major findings included 1) generally greater prevalence of prescriptions filled by women and older SMs for most AHFS categories; 2) a temporal decline in total prescriptions filled by Marine Corps personnel accounted for by a decline in the prevalence of zinc preparations filled by younger male Marines; 3) a temporal decline in the prevalence of iron preparations filled by women; 4) a temporal increase in the prevalence of prescriptions for replacement preparations filled by women accounted for largely by more prescriptions for calcium compounds; and 5) a temporal decline in the prevalence of prescriptions filled for cathartics/laxatives in older SMs accounted for largely by a decline in prescriptions for sodium/potassium compounds. CONCLUSIONS These temporal trends may be associated with the greater health care utilization of women and older SMs as well as the perceptions of prescribers and/or patients on appropriate roles of these substances in medicine and public health.
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Affiliation(s)
- Joseph J Knapik
- US Army Research Institute of Environmental Medicine, Natick, MA, USA.
- US Army Public Health Center, Aberdeen Proving Ground, MD, USA.
- Oak Ridge Institute for Science and Education, Belcamp, MD, USA.
- Research Physiologist, (USARIEM), 10 General Greene Ave, Natick, MA, 01760, USA.
| | - Rosenie T Jean
- Office of The US Army Surgeon's General Pharmacovigilance Center, Falls Church, VA, USA
| | - Krista G Austin
- US Army Research Institute of Environmental Medicine, Natick, MA, USA
- Oak Ridge Institute for Science and Education, Belcamp, MD, USA
| | | | - Emily K Farina
- US Army Research Institute of Environmental Medicine, Natick, MA, USA
- Oak Ridge Institute for Science and Education, Belcamp, MD, USA
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Clemmons NS, McCormic ZD, Gaydos JC, Hawksworth AW, Jordan NN. Acute Respiratory Disease in US Army Trainees 3 Years after Reintroduction of Adenovirus Vaccine 1. Emerg Infect Dis 2017; 23:95-98. [PMID: 27748651 PMCID: PMC5176242 DOI: 10.3201/eid2301.161297] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The 1999 cessation of vaccination against adenovirus types 4 and 7 among US Army trainees resulted in reemergence of acute respiratory disease (ARD) outbreaks. The 2011 implementation of a replacement vaccine led to dramatic and sustained decreases in ARD cases, supporting continuation of vaccination in this population at high risk for ARD.
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Characterization of Viral Exposures in United States Occupational Environments. EXPOSURE TO MICROBIOLOGICAL AGENTS IN INDOOR AND OCCUPATIONAL ENVIRONMENTS 2017. [PMCID: PMC7122517 DOI: 10.1007/978-3-319-61688-9_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Viruses are considered to be the most abundant biological particles and have the capability to infect all forms of life leading to a variety of diseases. American workers in specific occupational environments are threatened by viral exposures, highlighting the importance to recognize the type and risk of exposure, as well as the preventive measures that can be taken to reduce the risk of exposure. For example, healthcare workers can potentially be exposed to air and blood-borne pathogens, such as hepatitis and the human immunodeficiency virus. These types of exposures have led to the development of preventive equipment and regulations intended to reduce viral exposures in occupational settings. This chapter will discuss the characteristics of viruses and the occupationally relevant viruses of which people in varying occupations can potentially encounter. Regulatory guidelines and protective strategies will also be reviewed.
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Abstract
Pneumonia is of great global public health importance. Viral infections play both direct and indirect parts in its cause across the globe. Influenza is a leading cause of viral pneumonia in both children and adults, and respiratory syncytial virus is increasingly recognized as causing disease at both extremes of age. Vaccination offers the best prospect for prevention but current influenza vaccines do not provide universal and durable protection, and require yearly reformulation. In the future, it is hoped that influenza vaccines will give better and universal protection, and that new vaccines can be found for other causes of viral pneumonia.
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Affiliation(s)
- Clementine S Fraser
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London (St Mary's Campus), Norfolk Place, Paddington, London W2 1PG, UK
| | - Akhilesh Jha
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London (St Mary's Campus), Norfolk Place, Paddington, London W2 1PG, UK
| | - Peter J M Openshaw
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London (St Mary's Campus), Norfolk Place, Paddington, London W2 1PG, UK.
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Lee M, Kim S, Kwon OJ, Kim JH, Jeong I, Son JW, Na MJ, Yoon YS, Park HW, Kwon SJ. Treatment of Adenoviral Acute Respiratory Distress Syndrome Using Cidofovir With Extracorporeal Membrane Oxygenation. J Intensive Care Med 2016; 32:231-238. [PMID: 27903788 DOI: 10.1177/0885066616681272] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Adenovirus infections are associated with respiratory (especially upper respiratory) infection and gastrointestinal disease and occur primarily in infants and children. Although rare in adults, severe lower respiratory adenovirus infections including pneumonia are reported in specific populations, such as military recruits and immunocompromised patients. Antiviral treatment is challenging due to limited clinical experience and lack of well-controlled randomized trials. Several previously reported cases of adenoviral pneumonia showed promising efficacy of cidofovir. However, few reports discussed the efficacy of cidofovir in acute respiratory distress syndrome (ARDS). We experienced 3 cases of adenoviral pneumonia associated with ARDS and treated with cidofovir and respiratory support, including extracorporeal membrane oxygenation (ECMO). All 3 patients showed a positive clinical response to cidofovir and survival at 28 days. Cidofovir with early ECMO therapy may be a therapeutic option in adenoviral ARDS. A literature review identified 15 cases of adenovirus pneumonia associated with ARDS.
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Affiliation(s)
- Minhyeok Lee
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Seulgi Kim
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Oh Jung Kwon
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Ji Hye Kim
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Inbeom Jeong
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Ji Woong Son
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Moon Jun Na
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Yoo Sang Yoon
- 2 Department of Thoracic surgery, Cancer Center, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
| | - Hyun Woong Park
- 3 Division of Cardiology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Sun Jung Kwon
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
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COINFECTION OF CALIFORNIA SEA LION ADENOVIRUS 1 AND A NOVEL POLYOMAVIRUS IN A HAWAIIAN MONK SEAL (NEOMONACHUS SCHAUINSLANDI). J Zoo Wildl Med 2016; 47:427-37. [PMID: 27468013 DOI: 10.1638/2014-0252.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The Hawaiian monk seal (Neomonachus schauinslandi) is an endangered species. Here, we present a clinical case of a 26-yr-old male Hawaiian monk seal (HMS) kept in an aquarium with a history of intermittent anorexia and evidence of renal disease. Histologic examination revealed eosinophilic intranuclear inclusions in the liver. Conventional nested PCR protocols were used to test for viruses, and it tested positive for adenovirus and polyomavirus, and negative for herpesvirus. The adenovirus partial polymerase gene is 100% homologous to that of California sea lion adenovirus 1 (CSLAdV-1). CSLAdV-1 causes viral hepatitis in CSL, and has recently been reported in different species of otariids in an aquarium in Japan ( Otaria flavescens and Arctocephalus pusillus ) and a sequence from Spain has been submitted in NCBI as Otaria flavescens adenovirus-1. The polyomavirus in this animal is a novel virus, and is the first polyomavirus discovered in Hawaiian monk seals. This new virus is designated Hawaiian monk seal polyomavirus (HMSPyV-1), and is 83% homologous to California sea lion Polyomavirus-1 (CSLPyV-1). This is the first report of viral coinfection in a HMS and clinical significance in this case remains unclear but may be associated with advanced age.
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32
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Lynch JP, Kajon AE. Adenovirus: Epidemiology, Global Spread of Novel Serotypes, and Advances in Treatment and Prevention. Semin Respir Crit Care Med 2016; 37:586-602. [PMID: 27486739 PMCID: PMC7171713 DOI: 10.1055/s-0036-1584923] [Citation(s) in RCA: 307] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Adenoviruses (AdVs) are DNA viruses that typically cause mild infections involving the upper or lower respiratory tract, gastrointestinal tract, or conjunctiva. Rare manifestations of AdV infections include hemorrhagic cystitis, hepatitis, hemorrhagic colitis, pancreatitis, nephritis, or meningoencephalitis. AdV infections are more common in young children, due to lack of humoral immunity. Epidemics of AdV infection may occur in healthy children or adults in closed or crowded settings (particularly military recruits). The disease is more severe and dissemination is more likely in patients with impaired immunity (e.g., organ transplant recipients, human immunodeficiency virus infection). Fatality rates for untreated severe AdV pneumonia or disseminated disease may exceed 50%. More than 50 serotypes of AdV have been identified. Different serotypes display different tissue tropisms that correlate with clinical manifestations of infection. The predominant serotypes circulating at a given time differ among countries or regions, and change over time. Transmission of novel strains between countries or across continents and replacement of dominant viruses by new strains may occur. Treatment of AdV infections is controversial, as prospective, randomized therapeutic trials have not been conducted. Cidofovir is the drug of choice for severe AdV infections, but not all patients require treatment. Live oral vaccines are highly efficacious in reducing the risk of respiratory AdV infection and are in routine use in the military in the United States, but currently are not available to civilians.
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Affiliation(s)
- Joseph P Lynch
- Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, Department of Internal Medicine, The David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Adriana E Kajon
- Department of Infectious Disease, Lovelace Respiratory Research Institute, Albuquerque, New Mexico
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Choudhry A, Mathena J, Albano JD, Yacovone M, Collins L. Safety evaluation of adenovirus type 4 and type 7 vaccine live, oral in military recruits. Vaccine 2016; 34:4558-4564. [DOI: 10.1016/j.vaccine.2016.07.033] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 07/02/2016] [Accepted: 07/18/2016] [Indexed: 11/26/2022]
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Mölsä M, Hemmilä H, Rönkkö E, Virkki M, Nikkari S, Ziegler T. Molecular characterization of adenoviruses among finnish military conscripts. J Med Virol 2015; 88:571-7. [PMID: 26308159 DOI: 10.1002/jmv.24364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2015] [Indexed: 11/07/2022]
Abstract
Although adenoviruses were identified as important respiratory pathogens many years ago, little information is available concerning the prevalence of different adenovirus serotypes, which are circulating and causing epidemics in Finnish military training centers. Over a period of five years from 2008 to 2012, 3577 respiratory specimens were collected from military conscripts presenting with symptoms compatible with acute respiratory tract infection. Upon initial testing for certain respiratory viruses by real-time PCR, 837 of these specimens were identified as adenovirus-positive. For 672 of these specimens, the serotype of the adenovirus responsible was successfully determined by DNA sequencing. Serotypes 1, 2, 3, and 4 were detected in 1, 3, 181, and 487 samples, respectively. Adenovirus epidemics were observed during each year of this study. Based on these findings, adenovirus vaccination should be considered for military conscripts in the Finnish Defence Forces.
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Affiliation(s)
- Markos Mölsä
- Centres for Military Medicine and for Biological Threat Preparedness, Helsinki, Finland
| | - Heidi Hemmilä
- Centres for Military Medicine and for Biological Threat Preparedness, Helsinki, Finland
| | - Esa Rönkkö
- National Institute for Health and Welfare (THL), Virology Unit, Helsinki, Finland
| | - Maria Virkki
- Päijät-Häme Social and Health Care Group, Lahti, Finland
| | - Simo Nikkari
- Centres for Military Medicine and for Biological Threat Preparedness, Helsinki, Finland
| | - Thedi Ziegler
- National Institute for Health and Welfare (THL), Virology Unit, Helsinki, Finland.,Research Center for Child Psychiatry, University of Turku, Turku, Finland
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Yun HC, Young AN, Caballero MY, Lott L, Cropper TL, Murray CK. Changes in Clinical Presentation and Epidemiology of Respiratory Pathogens Associated With Acute Respiratory Illness in Military Trainees After Reintroduction of Adenovirus Vaccine. Open Forum Infect Dis 2015; 2:ofv120. [PMID: 26380351 PMCID: PMC4569648 DOI: 10.1093/ofid/ofv120] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 08/17/2015] [Indexed: 01/01/2023] Open
Abstract
Background. Adenovirus (Ad) has long been the predominant cause of acute respiratory illness (ARI) in military trainees. In 2011, live oral Ad vaccines for serotypes 4 and 7 were reintroduced into US basic military training populations. This study evaluated the impact on clinical presentations and other respiratory pathogens. Methods. The Center for Advanced Molecular Detection at Joint Base San Antonio-Lackland prospectively collects demographic, clinical, and polymerase chain reaction data from respiratory specimens (throat swab and nasal wash) among Air Force trainees presenting for care of ARI. Results. From June 2008 to August 2013, 2660 trainees enrolled and were tested for selected respiratory pathogens. Post-vaccine introduction (VI), reported systemic symptoms were less frequent, including fever (38% vs 94%) and myalgia (37% vs 67%; P < .01). Median temperature and heart rate decreased (98.4 vs 101.3°F, 81 vs 96 beats per minute; P < .01). Ad detection decreased for all Ad (3% vs 68%), Ad4 (1% vs 70%), 7 (0% vs 8%), 14 (0% vs 5%), and 3 (0.1% vs 2%); P < .01). Rhinovirus and cases with no pathogen identified increased in frequency (35% vs 18%, 51% vs 14%; P < .01). Conclusions. Acute respiratory illness in military trainees post-VI is associated with decreased severity of systemic symptoms and reduced fever and heart rate. Marked reductions in frequency of Ad serotypes are seen, including those in the vaccine, with no serotype shift. However, detection of several other respiratory pathogens, most notably rhinovirus, is observed in increasing proportions, and a majority are now undiagnosed clinical syndromes.
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Affiliation(s)
- Heather C. Yun
- San Antonio Military Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Adam N. Young
- San Antonio Military Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas
| | | | - Lisa Lott
- 59MDW/ST Joint Base San Antonio-Lackland
| | | | - Clinton K. Murray
- San Antonio Military Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Abstract
OBJECTIVE Lung diseases associated with military service are often a reflection of the conditions seen in the local civilian population, and with a few notable exceptions, are often related to unique environmental and occupational exposures. METHODS This article reviews important pulmonary diseases that have been associated with military service in the past 100 years in a question-and-answer format. RESULTS Traditionally, bacterial and viral pneumonias were the most common sources of military morbidity and mortality. With improved preventive medicine and antimicrobial therapy, other diseases related to battlefield injuries or inhalational exposures have assumed greater importance. CONCLUSIONS The etiology of military morbidity and mortality has evolved over the past century. Many of the discoveries related to vaccine efficacy, trauma resuscitation, interstitial lung disease, and even carcinomas have a strong military association.
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37
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Heo JY, Choe KW, Yoon CG, Jeong HW, Kim WJ, Cheong HJ. Vaccination policy in Korean armed forces: current status and future challenge. J Korean Med Sci 2015; 30:353-9. [PMID: 25829800 PMCID: PMC4366953 DOI: 10.3346/jkms.2015.30.4.353] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 11/19/2014] [Indexed: 11/20/2022] Open
Abstract
Infectious diseases have historically resulted in suspended or cancelled military operations. Vaccination for disease prevention is a critical component of the military's force readiness doctrine. Until recently, Korea had not recognized the importance of vaccinating military personnel. However, a 2011 meningococcal disease outbreak at an army recruit training center led to dramatic changes in the paradigm of traditional medical practice in the Korean armed forces. A new vaccination policy was formed by a 2012 Military Healthcare Service Act. Since then, Neisseria meningitidis, hepatitis A, and measles-mumps-rubella vaccines have been routinely administered to all new recruits early in basic training to ensure protection against these diseases. All active-duty soldiers also receive seasonal influenza vaccination annually. Despite quantitative improvements in vaccination policies, several instances of major infectious diseases and adverse vaccine reactions have threatened soldier health. In the future, vaccination policies in the Korean armed forces should be based on epidemiologic data and military medical research for vaccine use and safety management.
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Affiliation(s)
- Jung Yeon Heo
- Division of Infectious Diseases, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Kang-Won Choe
- Department of Internal Medicine, The Armed Forces Capital Hospital, Seongnam, Korea
| | - Chang-Gyo Yoon
- Department of Preventive Medicine, The Armed Forces Medical Command, Seongnam, Korea
| | - Hye Won Jeong
- Division of Infectious Diseases, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Kuro Hospital, Seoul, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Kuro Hospital, Seoul, Korea
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Kajon AE, Hang J, Hawksworth A, Metzgar D, Hage E, Hansen CJ, Kuschner RA, Blair P, Russell KL, Jarman RG. Molecular Epidemiology of Adenovirus Type 21 Respiratory Strains Isolated From US Military Trainees (1996-2014). J Infect Dis 2015; 212:871-80. [PMID: 25748322 DOI: 10.1093/infdis/jiv141] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 02/27/2015] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The circulation of human adenovirus type 21 (HAdV21) in the United States has been documented since the 1960s in association with outbreaks of febrile respiratory illness (FRI) in military boot camps and civilian cases of respiratory disease. METHODS To describe the molecular epidemiology of HAdV21 respiratory infections across the country, 150 clinical respiratory isolates obtained from continuous surveillance of military recruit FRI, and 23 respiratory isolates recovered from pediatric and adult civilian cases of acute respiratory infection were characterized to compile molecular typing data spanning 37 years (1978-2014). RESULTS Restriction enzyme analysis and genomic sequencing identified 2 clusters of closely related genomic variants readily distinguishable from the prototype and designated 21a-like and 21b-like. A-like variants predominated until 1999. A shift to b-like variants was noticeable by 2007 after a 7-year period (2000-2006) of cocirculation of the 2 genome types. US strains are phylogenetically more closely related to European and Asian strains isolated over the last 4 decades than to the Saudi Arabian prototype strain AV-1645 isolated in 1956. CONCLUSIONS Knowledge of circulating HAdV21 variants and their epidemic behavior will be of significant value to local and global FRI surveillance efforts.
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Affiliation(s)
- Adriana E Kajon
- Lovelace Respiratory Research Institute, Albuquerque, New Mexico
| | - Jun Hang
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Anthony Hawksworth
- Operational Infectious Diseases Department, Naval Health Research Center, San Diego, California
| | - David Metzgar
- Operational Infectious Diseases Department, Naval Health Research Center, San Diego, California
| | - Elias Hage
- Institute of Virology, Hannover Medical School, Germany
| | - Christian J Hansen
- Operational Infectious Diseases Department, Naval Health Research Center, San Diego, California
| | - Robert A Kuschner
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Patrick Blair
- Operational Infectious Diseases Department, Naval Health Research Center, San Diego, California
| | - Kevin L Russell
- Armed Forces Health Surveillance Center, Silver Spring, Maryland
| | - Richard G Jarman
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland
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Cortés-Hinojosa G, Gulland FMD, Goldstein T, Venn-Watson S, Rivera R, Waltzek TB, Salemi M, Wellehan JFX. Phylogenomic characterization of California sea lion adenovirus-1. INFECTION GENETICS AND EVOLUTION 2015; 31:270-6. [PMID: 25660039 DOI: 10.1016/j.meegid.2015.01.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 01/27/2015] [Accepted: 01/27/2015] [Indexed: 11/30/2022]
Abstract
Significant adenoviral diversity has been found in humans, but in domestic and wild animals the number of identified viruses is lower. Here we present the complete genome of a recently discovered mastadenovirus, California sea lion adenovirus 1 (CSLAdV-1) isolated from California sea lions (Zalophus californianus), an important pathogen associated with hepatitis in pinnipeds. The genome of this virus has the typical mastadenoviral structure with some notable differences at the carboxy-terminal end, including a dUTPase that does not cluster with other mastadenoviral dUTPases, and a fiber that shows similarity to a trans-sialidase of Trypanosoma cruzi and choline-binding protein A (CbpA) of Streptococcus pneumoniae. The GC content is low (36%), and phylogenetic analyses placed the virus near the root of the clade infecting laurasiatherian hosts in the genus Mastadenovirus. These findings support the hypothesis that CSLAdV-1 in California sea lions represents a host jump from an unknown mammalian host in which it is endemic.
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Affiliation(s)
- Galaxia Cortés-Hinojosa
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | | | - Tracey Goldstein
- Wildlife Health Center, School of Veterinary Medicine, University of California, Davis, CA, USA
| | | | - Rebecca Rivera
- Hubbs-SeaWorld Research Institute, 2595 Ingraham St., San Diego, CA, USA
| | - Thomas B Waltzek
- Department of Infectious Diseases and Pathology, College of Veterinary Medicine University of Florida, Gainesville, FL, USA
| | - Marco Salemi
- Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - James F X Wellehan
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
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Heo JY, Lee JE, Kim HK, Choe KW. Acute lower respiratory tract infections in soldiers, South Korea, April 2011-March 2012. Emerg Infect Dis 2014; 20:875-7. [PMID: 24750820 PMCID: PMC4012816 DOI: 10.3201/eid2005.131692] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
During April 2011–March 2012, we retrospectively reviewed medical records for South Korea soldiers to assess the etiology and epidemiology of acute viral lower respiratory tract infections. Adenovirus was the most commonly identified virus (63.2%) and the most common cause of pneumonia (79.3%) and hospitalization (76.6%); 3 soldiers died of adenovirus-related illness.
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Korzeniewski K, Nitsch-Osuch A, Konior M, Lass A. Respiratory tract infections in the military environment. Respir Physiol Neurobiol 2014; 209:76-80. [PMID: 25278277 PMCID: PMC7172564 DOI: 10.1016/j.resp.2014.09.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 09/23/2014] [Accepted: 09/24/2014] [Indexed: 11/08/2022]
Abstract
Soldiers in combat zones are at risk of contracting respiratory infections. Troops deployed to the harsh environment have high rates of respiratory symptoms. Over 40% of soldiers’ respiratory illnesses have been due to unknown causative agents. Limited diagnostic capabilities make it difficult to estimate the number of cases.
Military personnel fighting in contemporary battlefields as well as those participating in combat training are at risk of contracting respiratory infections. Epidemiological studies have demonstrated that soldiers deployed to the harsh environment have higher rates of newly reported respiratory symptoms than non-deployers. Acute respiratory diseases are the principle reason for outpatient treatment and hospitalization among military personnel, with an incidence exceeding that of the adult civilian population by up to three-fold. Adenoviruses, influenza A and B viruses, Streptococcus pneumoniae, Streptococcus pyogenes, coronaviruses and rhinoviruses have been identified as the main causes of acute respiratory infections among the military population. Although infective pathogens have been extensively studied, a significant proportion of illnesses (over 40%) have been due to unknown causative agents. Other health hazards, which can lead to respiratory illnesses among troops, are extreme air temperatures, desert dust, emissions from burn pits, industrial pollutants, and airborne contaminants originating from degraded soil. Limited diagnostic capabilities, especially inside the area of operations, make it difficult to accurately estimate the exact number of respiratory diseases in the military environment. The aim of the study was to discuss the occurrence of respiratory tract infections in army personnel, existing risk factors and preventive measures.
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Affiliation(s)
- Krzysztof Korzeniewski
- Military Institute of Medicine, Department of Epidemiology and Tropical Medicine, Gdynia, Poland.
| | - Aneta Nitsch-Osuch
- Warsaw Medical University, Department of Family Medicine, Warsaw, Poland
| | - Monika Konior
- Military Institute of Medicine, Department of Epidemiology and Tropical Medicine, Gdynia, Poland
| | - Anna Lass
- Medical University of Gdańsk, Department of Tropical Parasitology, Gdynia, Poland
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Radin JM, Hawksworth AW, Blair PJ, Faix DJ, Raman R, Russell KL, Gray GC. Dramatic decline of respiratory illness among US military recruits after the renewed use of adenovirus vaccines. Clin Infect Dis 2014; 59:962-8. [PMID: 24991024 DOI: 10.1093/cid/ciu507] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In late 2011, after a 12-year hiatus, oral vaccines against adenovirus types 4 (Ad4) and 7 (Ad7) were again produced and administered to US military recruits. This study examined the impact of the new adenovirus vaccines on febrile respiratory illness (FRI) and adenovirus rates and investigated if new serotypes emerged. FRI rates and their associated hospitalizations had markedly risen since vaccine production ceased in 1999. METHODS From 1996 to 2013, the Naval Health Research Center conducted FRI surveillance at 8 military recruit training centers in the United States. During this period, 58 103 FRI pharyngeal swab specimens were studied, yielding 37 048 adenovirus-positive cases, among which 64% were typed. RESULTS During the 2 years after reintroduction of the vaccines, military trainees experienced a 100-fold decline in adenovirus disease burden (from 5.8 to 0.02 cases per 1000 person-weeks, P < .0001), without evidence that vaccine pressure had increased the impact of adenovirus types other than Ad4 and Ad7. Although the percentage of type 14 increased following reintroduction of the vaccination, the actual number of cases decreased. We estimate that the vaccines prevent approximately 1 death, 1100-2700 hospitalizations, and 13 000 febrile adenovirus cases each year among the trainees. CONCLUSIONS These data strongly support the continued production and use of Ad4 and Ad7 vaccines in controlling FRI among US military trainees. Continued surveillance for emerging adenovirus subtypes is warranted.
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Affiliation(s)
- Jennifer M Radin
- Operational Infectious Diseases Department, Naval Health Research Center Joint Doctoral Program in Public Health (Epidemiology), San Diego State University/University of California
| | | | - Patrick J Blair
- Operational Infectious Diseases Department, Naval Health Research Center
| | - Dennis J Faix
- Deployment Health Research Department, Naval Health Research Center
| | - Rema Raman
- Department of Family and Preventive Medicine, University of California, San Diego
| | - Kevin L Russell
- Armed Forces Health Surveillance Center, Silver Spring, Maryland
| | - Gregory C Gray
- College of Public Health and Health Professions Emerging Pathogens Institute, University of Florida, Gainesville
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Matrix and backstage: cellular substrates for viral vaccines. Viruses 2014; 6:1672-700. [PMID: 24732259 PMCID: PMC4014716 DOI: 10.3390/v6041672] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 03/28/2014] [Accepted: 04/02/2014] [Indexed: 01/04/2023] Open
Abstract
Vaccines are complex products that are manufactured in highly dynamic processes. Cellular substrates are one critical component that can have an enormous impact on reactogenicity of the final preparation, level of attenuation of a live virus, yield of infectious units or antigens, and cost per vaccine dose. Such parameters contribute to feasibility and affordability of vaccine programs both in industrialized countries and developing regions. This review summarizes the diversity of cellular substrates for propagation of viral vaccines from primary tissue explants and embryonated chicken eggs to designed continuous cell lines of human and avian origin.
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Chen WW, Nie WM, Xu W, Xie YX, Tu B, Zhao P, Qin EQ, Zhang YH, Zhang X, Li WG, Zhou ZP, Lv JY, Zhao M. Cross-sectional study of the relationship of peripheral blood cell profiles with severity of infection by adenovirus type 55. BMC Infect Dis 2014; 14:147. [PMID: 24646014 PMCID: PMC4000060 DOI: 10.1186/1471-2334-14-147] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 03/14/2014] [Indexed: 11/10/2022] Open
Abstract
Background The immunologic profiles of patients with human adenovirus serotype 55 (HAdV-55) infections were characterized in subjects diagnosed with silent infections (n = 30), minor infections (n = 27), severe infections (n = 34), and healthy controls (n = 30) during a recent outbreak among Chinese military trainees. Methods Blood was sampled at the disease peak and four weeks later, and samples were analyzed to measure changes in leukocyte and platelet profiles in patients with different severities of disease. Differential lymphocyte subsets and cytokine profiles were measured by flow cytometry and Luminex xMAP®, and serum antibodies were analyzed by ELISA and immunofluorescence staining. Results Patients with severe HAdV infections had higher proportions of neutrophils and reduced levels of lymphocytes (p < 0.005 for both). Patients with minor and severe infections had significantly lower platelet counts (p < 0.005 for both) than those with silent infections. The silent and minor infection groups had higher levels of dendritic cells than the severe infection group. Relative to patients with silent infections, patients with severe infections had significantly higher levels of IL-17+CD4+ cells, decreased levels of IL-17+CD8+ cells, and higher levels of IFN-γ, IL-4, IL-10, and IFN-α2 (p < 0.001 for all comparisons). Conclusions Patients with different severities of disease due to HAdV-55 infection had significantly different immune responses. These data provide an initial step toward the identification of patients at risk for more severe disease and the development of treatments against HAdV-55 infection.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Ji-Yun Lv
- School of Management, University of Chinese Academy of Sciences, No, 80 East Road Zhongguancun, 100190 Beijing, China.
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Yun HC, Fugate WH, Murray CK, Cropper TL, Lott L, McDonald JM. Pandemic influenza virus 2009 H1N1 and adenovirus in a high risk population of young adults: epidemiology, comparison of clinical presentations, and coinfection. PLoS One 2014; 9:e85094. [PMID: 24416345 PMCID: PMC3885690 DOI: 10.1371/journal.pone.0085094] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 11/22/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In 2009, pandemic H1N1 influenza virus (2009 H1N1) emerged worldwide, causing morbidity and mortality that disproportionately affected young adults. Upper respiratory infection (URI), largely due to adenovirus, is an endemic cause of morbidity in military training. Whether clinical presentations differ or excess morbidity results from coinfection is unclear. METHODS The Center for Advanced Molecular Detection evaluates epidemiology and rapid diagnostics of respiratory pathogens in trainees with URI. From May 1, 2009, to November 30, 2009, demographic, clinical, and PCR data from throat and nasal specimens for adenovirus and 2009 H1N1 were prospectively collected. RESULTS 375 trainees with URI enrolled and were tested for both adenovirus and 2009 H1N1 by PCR (median age 20; 89% male). Adenovirus PCR was positive in 72% (96% serotype E-4) and 2009 H1N1 in 20%. Males were more likely to have adenovirus and females more likely to have 2009 H1N1 (p = 0.047). Subjects with 2009 H1N1 presented an average of 1 week earlier in training, had shorter illness duration before enrollment, less sore throat, diarrhea, and fewer abnormal findings on throat exam. Coryza and cough were more common with 2009 H1N1 compared to adenovirus. Subjects with 2009 H1N1 were less likely to have adenovirus than those without, despite persistently high frequencies of adenovirus detections during peak 2009 H1N1 weeks (15% vs. 83%, p < 0.01). Coinfection with adenovirus and 2009 H1N1 was rare (4%). Rates of hospitalization and pneumonia did not differ between the adenovirus, 2009 H1N1, or coinfected groups. CONCLUSION Military trainees with 2009 H1N1 vs. adenovirus have differing clinical presentations, and males are more likely to have adenovirus. Despite high frequencies of adenovirus infection, coinfection with adenovirus and 2009 H1N1 is rare and apparently does not result in increased morbidity.
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Affiliation(s)
- Heather C. Yun
- San Antonio Military Medical Center, Joint Base San Antonio Fort Sam Houston, Texas, United States of America
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- * E-mail:
| | - William H. Fugate
- Center for Advanced Molecular Detection, 59th MDW/ST, Joint Base San Antonio-Lackland, Texas, United States of America
| | - Clinton K. Murray
- San Antonio Military Medical Center, Joint Base San Antonio Fort Sam Houston, Texas, United States of America
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Thomas L. Cropper
- Trainee Health Surveillance, Joint Base San Antonio-Lackland, Texas, United States of America
| | - Lisa Lott
- Center for Advanced Molecular Detection, 59th MDW/ST, Joint Base San Antonio-Lackland, Texas, United States of America
| | - J. Matthew McDonald
- Center for Advanced Molecular Detection, 59th MDW/ST, Joint Base San Antonio-Lackland, Texas, United States of America
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Huang G, Yu D, Zhu Z, Zhao H, Wang P, Gray GC, Meng L, Xu W. Outbreak of febrile respiratory illness associated with human adenovirus type 14p1 in Gansu Province, China. Influenza Other Respir Viruses 2013; 7:1048-54. [PMID: 23692915 PMCID: PMC3933759 DOI: 10.1111/irv.12118] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2013] [Indexed: 11/26/2022] Open
Abstract
Objectives Human adenovirus (HAdV) type 14 had been infrequently associated with outbreaks of febrile respiratory illness (FRI) until the HAdV‐14p1 emerged in 2006 and rapidly spread in the United States. Here, we report an outbreak of FRI caused by HadV‐14p1 that occurred in 2011 at a primary and middle school in China. Design The basic information of the outbreak was recored; throat swabs were collected from 17 patients, polymerase chain reaction, A549 cell culture, and sequencing were used to identify the pathogen of the outbreak.. Results Total of 43 students were infected in this outbreak. Boys were more than girls. We identified 11 HAdV‐positive specimens and 6 HAdV isolates. Genetic analysis showed that the complete hexon, fiber, and E1A sequences of isolates were nearly 100% identical with other HAdV‐14p1 sequences deposited in GenBank. Conclusions HadV‐14p1 has caused outbreaks of pneumonia and mortality among adults in the United States and Europe. It may cause similar conditions among Chinese adults due to poor hygiene and sanitation. It seems prudent for China to develop a national surveillance system to determine the etiology of severe respiratory diseases and deaths among adults and school‐aged children.
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Affiliation(s)
- Guohong Huang
- Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, China; Xinjiang Medical University, Urumqi, China
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Lukšić I, Kearns PK, Scott F, Rudan I, Campbell H, Nair H. Viral etiology of hospitalized acute lower respiratory infections in children under 5 years of age -- a systematic review and meta-analysis. Croat Med J 2013; 54:122-34. [PMID: 23630140 PMCID: PMC3641872 DOI: 10.3325/cmj.2013.54.122] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 04/10/2013] [Indexed: 01/26/2023] Open
Abstract
AIM To estimate the proportional contribution of influenza viruses (IV), parainfluenza viruses (PIV), adenoviruses (AV), and coronaviruses (CV) to the burden of severe acute lower respiratory infections (ALRI). METHODS The review of the literature followed PRISMA guidelines. We included studies of hospitalized children aged 0-4 years with confirmed ALRI published between 1995 and 2011. A total of 51 studies were included in the final review, comprising 56091 hospitalized ALRI episodes. RESULTS IV was detected in 3.0% (2.2%-4.0%) of all hospitalized ALRI cases, PIV in 2.7% (1.9%-3.7%), and AV in 5.8% (3.4%-9.1%). CV are technically difficult to culture, and they were detected in 4.8% of all hospitalized ALRI patients in one study. When respiratory syncytial virus (RSV) and less common viruses were included, at least one virus was detected in 50.4% (40.0%-60.7%) of all hospitalized severe ALRI episodes. Moreover, 21.9% (17.7%-26.4%) of these viral ALRI were mixed, including more than one viral pathogen. Among all severe ALRI with confirmed viral etiology, IV accounted for 7.0% (5.5%-8.7%), PIV for 5.8% (4.1%-7.7%), and AV for 8.8% (5.3%-13.0%). CV was found in 10.6% of virus-positive pneumonia patients in one study. CONCLUSIONS This article provides the most comprehensive analysis of the contribution of four viral causes to severe ALRI to date. Our results can be used in further cost-effectiveness analyses of vaccine development and implementation for a number of respiratory viruses.
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Affiliation(s)
- Ivana Lukšić
- Ivana Luksic, Institute of Publich Health Dr. Andrija Štampar, Department of Microbiology, Mirogojska cesta 16, 10000 Zagreb, Croatia.
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History of the restoration of adenovirus type 4 and type 7 vaccine, live oral (Adenovirus Vaccine) in the context of the Department of Defense acquisition system. Vaccine 2013; 31:1623-32. [DOI: 10.1016/j.vaccine.2012.12.029] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 12/07/2012] [Accepted: 12/10/2012] [Indexed: 11/19/2022]
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