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Scarsella L, Ehrke-Schulz E, Paulussen M, Thal SC, Ehrhardt A, Aydin M. Advances of Recombinant Adenoviral Vectors in Preclinical and Clinical Applications. Viruses 2024; 16:377. [PMID: 38543743 PMCID: PMC10974029 DOI: 10.3390/v16030377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/14/2024] [Accepted: 02/19/2024] [Indexed: 05/23/2024] Open
Abstract
Adenoviruses (Ad) have the potential to induce severe infections in vulnerable patient groups. Therefore, understanding Ad biology and antiviral processes is important to comprehend the signaling cascades during an infection and to initiate appropriate diagnostic and therapeutic interventions. In addition, Ad vector-based vaccines have revealed significant potential in generating robust immune protection and recombinant Ad vectors facilitate efficient gene transfer to treat genetic diseases and are used as oncolytic viruses to treat cancer. Continuous improvements in gene delivery capacity, coupled with advancements in production methods, have enabled widespread application in cancer therapy, vaccine development, and gene therapy on a large scale. This review provides a comprehensive overview of the virus biology, and several aspects of recombinant Ad vectors, as well as the development of Ad vector, are discussed. Moreover, we focus on those Ads that were used in preclinical and clinical applications including regenerative medicine, vaccine development, genome engineering, treatment of genetic diseases, and virotherapy in tumor treatment.
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Affiliation(s)
- Luca Scarsella
- Department of Anesthesiology, Center for Clinical and Translational Research, Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany;
- Virology and Microbiology, Center for Biomedical Education and Research (ZBAF), Department Human Medicine, Faculty of Health, Witten/Herdecke University, 58453 Witten, Germany; (E.E.-S.); (A.E.)
- Laboratory of Experimental Pediatric Pneumology and Allergology, Center for Biomedical Education and Science (ZBAF), Department of Human Medicine, Faculty of Medicine, Witten/Herdecke University, 58453 Witten, Germany
| | - Eric Ehrke-Schulz
- Virology and Microbiology, Center for Biomedical Education and Research (ZBAF), Department Human Medicine, Faculty of Health, Witten/Herdecke University, 58453 Witten, Germany; (E.E.-S.); (A.E.)
| | - Michael Paulussen
- Chair of Pediatrics, University Children’s Hospital, Vestische Kinder- und Jugendklinik Datteln, Witten/Herdecke University, 45711 Datteln, Germany;
| | - Serge C. Thal
- Department of Anesthesiology, Center for Clinical and Translational Research, Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany;
| | - Anja Ehrhardt
- Virology and Microbiology, Center for Biomedical Education and Research (ZBAF), Department Human Medicine, Faculty of Health, Witten/Herdecke University, 58453 Witten, Germany; (E.E.-S.); (A.E.)
| | - Malik Aydin
- Virology and Microbiology, Center for Biomedical Education and Research (ZBAF), Department Human Medicine, Faculty of Health, Witten/Herdecke University, 58453 Witten, Germany; (E.E.-S.); (A.E.)
- Laboratory of Experimental Pediatric Pneumology and Allergology, Center for Biomedical Education and Science (ZBAF), Department of Human Medicine, Faculty of Medicine, Witten/Herdecke University, 58453 Witten, Germany
- Chair of Pediatrics, University Children’s Hospital, Vestische Kinder- und Jugendklinik Datteln, Witten/Herdecke University, 45711 Datteln, Germany;
- Institute for Medical Laboratory Diagnostics, Center for Clinical and Translational Research, Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany
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Saha R, Majumdar A, Chaudhuri RD, Chatterjee A, Lo M, Dutta S, Chawla-Sarkar M. Molecular epidemiology of circulating human adenoviruses among acute respiratory infection patients seeking healthcare facilities in West Bengal, India. Virology 2023; 588:109912. [PMID: 37913611 DOI: 10.1016/j.virol.2023.109912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023]
Abstract
Human adenovirus (HAdV) causes acute respiratory infections leading to mortality in children. This study analyzes the circulating respiratory HAdV genotypes in West Bengal, India during 2018-2022 among symptomatic patients. The overall positivity rate was 6.8%, out of which 26.4% were co-infected with other respiratory viruses. Children aged 2 to 5 years were mostly infected. Phylogenetic analysis revealed that the recombinant HAdV-B type 7/3, which has remarkable outbreak potential, predominantly circulated in this region followed by the non-recombinant HAdV-B type 3/3. Moreover, the amino acid sequences encoded by both the hexon and fiber genes of these two circulating strains possessed a few mutations that mostly diverged from the prototype strain, although the divergence was less pronounced in case of the amino acids encoded by the fiber gene of HAdV-B type 3/3. Overall, the results underscore the need for continuous surveillance of respiratory HAdV types to combat future possible epidemics.
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Affiliation(s)
- Ritubrita Saha
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Agniva Majumdar
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Ratul Datta Chaudhuri
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Ananya Chatterjee
- Regional Virus Research and Diagnostic Laboratory, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Mahadeb Lo
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Shanta Dutta
- Regional Virus Research and Diagnostic Laboratory, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Mamta Chawla-Sarkar
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India.
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Mazboudi R, Mulhall Maasz H, Resch MD, Wen K, Gottlieb P, Alimova A, Khayat R, Collins ND, Kuschner RA, Galarza JM. A recombinant virus-like particle vaccine against adenovirus-7 induces a potent humoral response. NPJ Vaccines 2023; 8:155. [PMID: 37821505 PMCID: PMC10567840 DOI: 10.1038/s41541-023-00754-3] [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: 03/27/2023] [Accepted: 10/02/2023] [Indexed: 10/13/2023] Open
Abstract
Adenoviruses (AdVs) cause infections in humans that range from mild to severe, and can cause outbreaks particularly in close contact settings. Several human AdV types have been identified, which can cause a wide array of clinical manifestations. AdV types 4 and 7 (AdV-4 and AdV-7), which are among the most commonly circulating types in the United States, are known to cause acute respiratory disease that can result in hospitalization and rarely, death. Currently, the only vaccines approved for use in humans are live virus vaccines against AdV-4 and AdV-7, though these vaccines are only authorized for use in U.S. military personnel. While they are efficacious, use of these live virus vaccines carries considerable risks of vaccine-associated viral shedding and recombination. Here, we present an alternative vaccination strategy against AdV-7 using the virus-like particle platform (AdVLP-7). We describe the production of stable recombinant AdVLP-7, and demonstrate that AdVLP-7 is structurally analogous to wild-type AdV-7 virions (WT AdV-7). Preclinical immunogenicity studies in mice show that AdVLP-7 elicits a potent humoral immune response, comparable to that observed in mice immunized with WT AdV-7. Specifically, AdVLP-7 induces high titers of antibodies against AdV-7-specific antigens that can effectively neutralize AdV-7.
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Affiliation(s)
- Ryan Mazboudi
- TechnoVax, Inc., 6 Westchester Plaza, Elmsford, NY, 10523, USA
| | | | - Matthew D Resch
- TechnoVax, Inc., 6 Westchester Plaza, Elmsford, NY, 10523, USA
| | - Ke Wen
- TechnoVax, Inc., 6 Westchester Plaza, Elmsford, NY, 10523, USA
| | - Paul Gottlieb
- CUNY School of Medicine, The City College of New York, New York, NY, 10031, USA
| | - Aleksandra Alimova
- CUNY School of Medicine, The City College of New York, New York, NY, 10031, USA
| | - Reza Khayat
- Department of Chemistry and Biochemistry, The City College of New York, New York, NY, 10031, USA
| | - Natalie D Collins
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD, 20910, USA
| | - Robert A Kuschner
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD, 20910, USA
| | - Jose M Galarza
- TechnoVax, Inc., 6 Westchester Plaza, Elmsford, NY, 10523, USA.
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Kimura H, Hayashi Y, Kitagawa M, Yoshizaki M, Saito K, Harada K, Okayama K, Miura Y, Kimura R, Shirai T, Fujita K, Machida S, Ito K, Kurosawa I. Pathogen Profiles in Outpatients with Non-COVID-19 during the 7th Prevalent Period of COVID-19 in Gunma, Japan. Microorganisms 2023; 11:2142. [PMID: 37763986 PMCID: PMC10536078 DOI: 10.3390/microorganisms11092142] [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: 07/28/2023] [Revised: 08/17/2023] [Accepted: 08/19/2023] [Indexed: 09/29/2023] Open
Abstract
The identification of pathogens associated with respiratory symptoms other than the novel coronavirus disease 2019 (COVID-19) can be challenging. However, the diagnosis of pathogens is crucial for assessing the clinical outcome of patients. We comprehensively profiled pathogens causing non-COVID-19 respiratory symptoms during the 7th prevalent period in Gunma, Japan, using deep sequencing combined with a next-generation sequencer (NGS) and advanced bioinformatics technologies. The study included nasopharyngeal swabs from 40 patients who tested negative for severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) using immuno-chromatography and/or quantitative reverse transcription polymerase chain reaction (qRT-PCR) methods. Comprehensive pathogen sequencing was conducted through deep sequencing using NGS. Additionally, short reads obtained from NGS were analyzed for comprehensive pathogen estimation using MePIC (Metagenomic Pathogen Identification Pipeline for Clinical Specimens) and/or VirusTap. The results revealed the presence of various pathogens, including respiratory viruses and bacteria, in the present subjects. Notably, human adenovirus (HAdV) was the most frequently detected virus in 16 of the 40 cases (40.0%), followed by coryneforms, which were the most frequently detected bacteria in 21 of the 40 cases (52.5%). Seasonal human coronaviruses (NL63 type, 229E type, HKU1 type, and OC43 type), human bocaviruses, and human herpesviruses (human herpesvirus types 1-7) were not detected. Moreover, multiple pathogens were detected in 50% of the subjects. These results suggest that various respiratory pathogens may be associated with non-COVID-19 patients during the 7th prevalent period in Gunma Prefecture, Japan. Consequently, for an accurate diagnosis of pathogens causing respiratory infections, detailed pathogen analyses may be necessary. Furthermore, it is possible that various pathogens, excluding SARS-CoV-2, may be linked to fever and/or respiratory infections even during the COVID-19 pandemic.
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Affiliation(s)
- Hirokazu Kimura
- Department of Health Science, Gunma Paz University Graduate School of Health Sciences, Takasaki-shi 370-0006, Gunma, Japan; (Y.H.); (K.H.); (K.O.); (Y.M.); (K.F.)
- Advanced Medical Science Research Center, Gunma Paz University Research Institute, Shibukawa-shi 377-0008, Gunma, Japan; (R.K.); (T.S.); (K.I.)
| | - Yuriko Hayashi
- Department of Health Science, Gunma Paz University Graduate School of Health Sciences, Takasaki-shi 370-0006, Gunma, Japan; (Y.H.); (K.H.); (K.O.); (Y.M.); (K.F.)
| | - Masanari Kitagawa
- Project Department, Takara Bio Inc., Kusatsu-shi 525-0058, Shiga, Japan; (M.K.); (M.Y.); (K.S.)
| | - Miwa Yoshizaki
- Project Department, Takara Bio Inc., Kusatsu-shi 525-0058, Shiga, Japan; (M.K.); (M.Y.); (K.S.)
| | - Kensuke Saito
- Project Department, Takara Bio Inc., Kusatsu-shi 525-0058, Shiga, Japan; (M.K.); (M.Y.); (K.S.)
| | - Kazuhiko Harada
- Department of Health Science, Gunma Paz University Graduate School of Health Sciences, Takasaki-shi 370-0006, Gunma, Japan; (Y.H.); (K.H.); (K.O.); (Y.M.); (K.F.)
- Kurosawa Hospital, Takasaki-shi 370-1203, Gunma, Japan; (S.M.); (I.K.)
| | - Kaori Okayama
- Department of Health Science, Gunma Paz University Graduate School of Health Sciences, Takasaki-shi 370-0006, Gunma, Japan; (Y.H.); (K.H.); (K.O.); (Y.M.); (K.F.)
| | - Yusuke Miura
- Department of Health Science, Gunma Paz University Graduate School of Health Sciences, Takasaki-shi 370-0006, Gunma, Japan; (Y.H.); (K.H.); (K.O.); (Y.M.); (K.F.)
| | - Ryusuke Kimura
- Advanced Medical Science Research Center, Gunma Paz University Research Institute, Shibukawa-shi 377-0008, Gunma, Japan; (R.K.); (T.S.); (K.I.)
- Department of Bacteriology, Graduate School of Medicine, Gunma University, Maebashi-shi 371-8514, Gunma, Japan
| | - Tatsuya Shirai
- Advanced Medical Science Research Center, Gunma Paz University Research Institute, Shibukawa-shi 377-0008, Gunma, Japan; (R.K.); (T.S.); (K.I.)
| | - Kiyotaka Fujita
- Department of Health Science, Gunma Paz University Graduate School of Health Sciences, Takasaki-shi 370-0006, Gunma, Japan; (Y.H.); (K.H.); (K.O.); (Y.M.); (K.F.)
| | - Suguru Machida
- Kurosawa Hospital, Takasaki-shi 370-1203, Gunma, Japan; (S.M.); (I.K.)
| | - Kazuto Ito
- Advanced Medical Science Research Center, Gunma Paz University Research Institute, Shibukawa-shi 377-0008, Gunma, Japan; (R.K.); (T.S.); (K.I.)
- Kurosawa Hospital, Takasaki-shi 370-1203, Gunma, Japan; (S.M.); (I.K.)
| | - Isao Kurosawa
- Kurosawa Hospital, Takasaki-shi 370-1203, Gunma, Japan; (S.M.); (I.K.)
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Prevalence of human infection with respiratory adenovirus in China: A systematic review and meta-analysis. PLoS Negl Trop Dis 2023; 17:e0011151. [PMID: 36812245 PMCID: PMC9987798 DOI: 10.1371/journal.pntd.0011151] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/06/2023] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Human adenovirus (HAdV) is a major pathogen that causes acute respiratory tract infections (ARTI) and is frequently associated with outbreaks. The HAdV prevalence and the predominant types responsible for ARTI outbreaks remains obscure in China. METHODS A systematic review was performed to retrieve literature that reported outbreaks or etiological surveillance of HAdV among ARTI patients in China from 2009 to 2020. Patient information was extracted from the literature to explore the epidemiological characteristics and clinical manifestations of the infection of various HAdV types. The study is registered with PROSPERO, CRD42022303015. RESULTS A total of 950 articles (91 about outbreaks and 859 about etiological surveillance) meeting the selection criteria were included. Predominant HAdV types from etiological surveillance studies differed from those in outbreak events. Among 859 hospital-based etiological surveillance studies, positive detection rates of HAdV-3 (32.73%) and HAdV-7 (27.48%) were significantly higher than other virus types. While nearly half (45.71%) of outbreaks were caused by HAdV-7 with an overall attack rate of 22.32% among the 70 outbreaks for which the HAdVs were typed by the meta-analysis. Military camp and school were main outbreak settings with significantly different seasonal pattern and attack rate, where HAdV-55 and HAdV-7 were identified as the leading type, respectively. Clinical manifestations mainly depended on the HAdV types and patient's age. HAdV-55 infection tends to develop into pneumonia with poorer prognosis, especially in children <5 years old. CONCLUSIONS This study improves the understanding of epidemiological and clinical features of HAdV infections and outbreaks with different virus types, and helps to inform future surveillance and control efforts in different settings.
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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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Keramari S, Poutoglidou F, Poutoglidis A, Sotiropoulos D, Savopoulos C, Chlichlia K, Chatzis S, Xagorari A, Kaiafa G. Adenoviral Infections in Bone Marrow Transplanted Adult Patients: A Review of the 44 Cases Reported in the Last 25 Years. Cureus 2021; 13:e19865. [PMID: 34963865 PMCID: PMC8708484 DOI: 10.7759/cureus.19865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 11/24/2022] Open
Abstract
Adenoviral infections in immunocompromised individuals may be life-threatening conditions. The aim of this review is to document all the reported cases of adenoviral infection is patients having undergone bone marrow transplantation (BMT). A comprehensive literature search of the databases Pubmed, Science Direct, and Google Scholar was conducted to identify all the case reports of adenoviral infections in BMT patients. A total of 30 articles with 44 patients were included. The most common underlying condition was acute lymphocytic leukemia (23%) followed by acute myeloid leukemia (18%). The most common site of infection was disseminated (50%), followed by liver infection (8%) and hemorrhagic cystitis (8%). Cidofovir was administered in 40.9% of the cases, and death was reported in 34.4% of them. Ribavirin was administered as monotherapy in 15.9% of patients, with a mortality rate of 57.1%. We found that the antiviral drug option had no statistically significant effect on the mortality rate (p=0.242). Also, the absence of graft-versus-host disease (GVHD) was not associated with an improved outcome (p=0.523). There was, however, a statistically significant difference in the outcome based on the site of infection (p=0.005), with a higher rate of mortality in the disseminated and gastrointestinal cases. To the best of our knowledge, this is the first review documenting all the cases of adenoviral infections in BMT patients. Future randomized studies are needed to validate the results of the present study.
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Affiliation(s)
- Stergiani Keramari
- Department of Paediatrics, University General Hospital of Thessaloniki AHEPA, Thessaloniki, GRC
| | - Frideriki Poutoglidou
- Department of Clinical Pharmacology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Alexandros Poutoglidis
- Department of Otorhinolaryngology-Head and Neck Surgery, "G. Papanikolaou" General Hospital of Thessaloniki, Thessaloniki, GRC
| | - Damianos Sotiropoulos
- Department of Haematology and Public Cord Blood Bank, "G. Papanikolaou" General Hospital of Thessaloniki, Thessaloniki, GRC
| | - Christos Savopoulos
- First Propaedeutic Department of Internal Medicine, University General Hospital of Thessaloniki AHEPA, Thessaloniki, GRC
| | - Katerina Chlichlia
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, GRC
| | | | - Angeliki Xagorari
- Department of Haematology and Public Cord Blood Bank, "G. Papanikolaou" General Hospital of Thessaloniki, Thessaloniki, GRC
| | - Georgia Kaiafa
- First Propaedeutic Department of Internal Medicine, University General Hospital of Thessaloniki AHEPA, Thessaloniki, GRC
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Lynch JP, Kajon AE. Adenovirus: Epidemiology, Global Spread of Novel Types, and Approach to Treatment. Semin Respir Crit Care Med 2021; 42:800-821. [PMID: 34918322 DOI: 10.1055/s-0041-1733802] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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 vast majority of cases are self-limited. However, the clinical spectrum is broad and fatalities may occur. 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 100 genotypes and 52 serotypes of AdV have been identified and classified into seven species designated HAdV-A through -G. Different types display different tissue tropisms that correlate with clinical manifestations of infection. The predominant types 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 done. Cidofovir has been 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 UCLA, Los Angeles, California
| | - Adriana E Kajon
- Infectious Disease Program, Lovelace Biomedical Research Institute, Albuquerque, New Mexico
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Du J, Zhao X, Tang F, Huang D, Pei G, Zhang X, Jiang B, Lu Q, Liu W, Tong Y. Outbreaks of Acute Respiratory Disease Associated with Human Adenovirus Infection in Closed Camps, China, December 2011-March 2014. China CDC Wkly 2021; 3:793-798. [PMID: 34594992 PMCID: PMC8477058 DOI: 10.46234/ccdcw2021.197] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 09/14/2021] [Indexed: 11/14/2022] Open
Abstract
What is already known on this topic? Human adenovirus (HAdV) was frequently associated with acute respiratory disease (ARD) outbreaks in military camps. What is added by this report? HAdV-B7, HAdV-B14, and HAdV-B55 were determined to be responsible for 3, 2, and 4 ARD outbreaks in military camps, China, respectively, with a total attack rate of 28.0% during 2011 to 2014. What are the implications for public health practice? The findings suggest that vaccine development and administration in military camps must be prioritized. Quarantining among new recruits before entering into the military and the identification of the major responsible genotypes at the current stage is warranted.
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Affiliation(s)
- Juan Du
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Xiaodong Zhao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Fang Tang
- Center for Diseases Control and Prevention of Chinese People's Armed Police Forces, Beijing, China
| | - Doudou Huang
- The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Guangqian Pei
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Xiaoai Zhang
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Baogui Jiang
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Qingbin Lu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Wei Liu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China.,State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Yigang Tong
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China.,College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
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Kujawski SA, Lu X, Schneider E, Blythe D, Boktor S, Farrehi J, Haupt T, McBride D, Stephens E, Sakthivel SK, Bachaus B, Waller K, Bauman L, Marconi A, Lewis R, Dettinger L, Ernst R, Kinsey W, Lindstrom S, Gerber SI, Watson JT, Biggs HM. Outbreaks of Adenovirus-associated Respiratory Illness on 5 College Campuses in the United States, 2018-2019. Clin Infect Dis 2021; 72:1992-1999. [PMID: 32322889 DOI: 10.1093/cid/ciaa465] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/21/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Human adenoviruses (HAdVs) are commonly associated with acute respiratory illness. HAdV outbreaks are well documented in congregate military training settings, but less is known about outbreaks on college campuses. During fall 2018 and spring 2019, 5 United States (US) colleges reported increases in HAdV-associated respiratory illness. Investigations were performed to better understand HAdV epidemiology in this setting. METHODS A case was defined as a student at one of the 5 colleges, with acute respiratory illness and laboratory-confirmed HAdV infection during October 2018-December 2018 or March-May 2019. Available respiratory specimens were typed by HAdV type-specific real-time polymerase chain reaction assays, and for a subset, whole genome sequencing was performed. We reviewed available medical records and cases were invited to complete a questionnaire, which included questions on symptom presentation, social history, and absenteeism. RESULTS We identified 168 HAdV cases. Median age was 19 (range, 17-22) years and 102 cases (61%) were male. Eleven cases were hospitalized, 10 with pneumonia; 2 cases died. Among questionnaire respondents, 80% (75/94) missed ≥ 1 day of class because of their illness. Among those with a type identified (79%), HAdV types 4 and 7 were equally detected, with frequency of each varying by site. Genome types 4a1 and 7d were identified, respectively, by whole genome sequence analysis. CONCLUSIONS HAdV respiratory illness was associated with substantial morbidity and missed class time among young, generally healthy adults on 5 US college campuses. HAdVs should be considered a cause of respiratory illness outbreaks in congregate settings such as college campuses.
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Affiliation(s)
- Stephanie A Kujawski
- Division of Viral Diseases, 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
| | - Xiaoyan Lu
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Eileen Schneider
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - David Blythe
- Maryland Department of Health Prevention and Health Promotion, Baltimore, Maryland, USA
| | - Sameh Boktor
- Pennsylvania Department of Health, Harrisburg, Pennsylvania, USA
| | - Janice Farrehi
- University Health Service, University of Michigan, Ann Arbor, Michigan, USA
| | - Thomas Haupt
- Wisconsin Department of Health Services, Madison, Wisconsin, USA
| | - David McBride
- University Health Center, University of Maryland, College Park, Maryland, USA
| | | | - Senthilkumar K Sakthivel
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brian Bachaus
- Maryland Department of Health Prevention and Health Promotion, Baltimore, Maryland, USA
| | - Kirsten Waller
- Pennsylvania Department of Health, Harrisburg, Pennsylvania, USA
| | - Laura Bauman
- Washtenaw County Health Department, Ypsilanti, Michigan, USA
| | - Agustina Marconi
- University Health Services, University of Wisconsin, Madison, Wisconsin, USA
| | - Rebecca Lewis
- Henrico County Health Department, Virginia Department of Health, Richmond, Virginia, USA
| | - Lisa Dettinger
- Pennsylvania Department of Health, Harrisburg, Pennsylvania, USA
| | - Robert Ernst
- University Health Service, University of Michigan, Ann Arbor, Michigan, USA
| | - William Kinsey
- University Health Services, University of Wisconsin, Madison, Wisconsin, USA
| | - Stephen Lindstrom
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Susan I Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - John T Watson
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Holly M Biggs
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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11
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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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12
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Li J, Wei J, Xu Z, Jiang C, Li M, Chen J, Li Y, Yang M, Gu Y, Wang F, Shu Y, Yang Y, Sun L, Liu Y. Cytokine/Chemokine Expression Is Closely Associated Disease Severity of Human Adenovirus Infections in Immunocompetent Adults and Predicts Disease Progression. Front Immunol 2021; 12:691879. [PMID: 34163488 PMCID: PMC8215364 DOI: 10.3389/fimmu.2021.691879] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/20/2021] [Indexed: 12/12/2022] Open
Abstract
Increasing human Adenovirus (HAdV) infections complicated with acute respiratory distress syndrome (ARDS) even fatal outcome were reported in immunocompetent adolescent and adult patients. Here, we characterized the cytokine/chemokine expression profiles of immunocompetent patients complicated with ARDS during HAdV infection and identified biomarkers for disease severity/progression. Forty-eight cytokines/chemokines in the plasma samples from 19 HAdV-infected immunocompetent adolescent and adult patients (ten complicated with ARDS) were measured and analyzed in combination with clinical indices. Immunocompetent patients with ARDS caused by severe acute respiratory disease coronavirus (SARS-CoV)-2, 2009 pandemic H1N1 (panH1N1) or bacteria were included for comparative analyses. Similar indices of disease course/progression were found in immunocompetent patients with ARDS caused by HAdV, SARS-CoV-2 or panH1N infections, whereas the HAdV-infected group showed a higher prevalence of viremia, as well as increased levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and creatine kinase (CK). Expression levels of 33 cytokines/chemokines were increased significantly in HAdV-infected patients with ARDS compared with that in healthy controls, and many of them were also significantly higher than those in SARS-CoV-2-infected and panH1N1-infected patients. Expression of interferon (IFN)-γ, interleukin (IL)-1β, hepatocyte growth factor (HGF), monokine induced by IFN-γ (MIG), IL-6, macrophage-colony stimulating factor (M-CSF), IL-10, IL-1α and IL-2Ra was significantly higher in HAdV-infected patients with ARDS than that in those without ARDS, and negatively associated with the ratio of the partial pressure of oxygen in arterial blood/fraction of inspired oxygen (PaO2/FiO2). Analyses of the receiver operating characteristic curve (ROC) showed that expression of IL-10, M-CSF, MIG, HGF, IL-1β, IFN-γ and IL-2Ra could predict the progression of HAdV infection, with the highest area under the curve (AUC) of 0.944 obtained for IL-10. Of note, the AUC value for the combination of IL-10, IFN-γ, and M-CSF reached 1. In conclusion, the “cytokine storm” occurred during HAdV infection in immunocompetent patients, and expression of IL-10, M-CSF, MIG, HGF, IL-1β, IFN-γ and IL-2Ra was closely associated with disease severity and could predict disease progression.
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Affiliation(s)
- Jin Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Jinli Wei
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Zhixiang Xu
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Chunmei Jiang
- Department of Infectious Disease, The People's Hospital of Longhua, Shenzhen, China
| | - Mianhuan Li
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Jie Chen
- Research and Development Department, Guangzhou Sagene Biotech Co., Ltd., Guangzhou, China
| | - Yanjie Li
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Minghui Yang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yuchen Gu
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Fuxiang Wang
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Yuelong Shu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yang Yang
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Litao Sun
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yingxia Liu
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
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13
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Liu Z, Tian X, Liu W, Xian Y, Chen W, Zhou R. A Sensitive and High-Throughput Flow Cytometry-Based Assay for Measuring Antibody Neutralization of Human Adenovirus Type 3. Virol Sin 2021; 36:537-544. [PMID: 32990935 PMCID: PMC8257853 DOI: 10.1007/s12250-020-00295-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 08/24/2020] [Indexed: 11/28/2022] Open
Abstract
The assessment of neutralization activity is an important step in the evaluation of neutralizing antibodies (NAbs). The traditional methods for measuring the antibody neutralization of human adenovirus type 3 (HAdV-3) are the microneutralization (MN) assay, which has insufficient sensitivity, and the plaque reduction neutralization test (PRNT), which is not suitable for high-throughput screening. Herein, we describe the development of a flow cytometry-based neutralization (FCN) assay for measuring the neutralization of sera, cell culture supernatants, and chimeric antibodies against HAdV-3 on the basis of a recombinant HAdV-3 (rHAdV-3) construct expressing the enhanced green fluorescent protein (EGFP). For flow cytometry-based assays, the optimal cell confluence was determined as 90%, and the virus was titrated using the assay. The established FCN assay follows the percentage law and an optimal MOI of not less than 5 × 10-4 was determined by using a purified chimeric antibody. In addition, comparison of the anti-HAdV-3 NAb titers of 72 human serum samples by the MN and FCN assays, showed that both assays correlated strongly with each other. Our FCN assay was an improvement over the MN assay because the observation period was reduced from 3 to 1 days and data analysis could be performed objectively and robotically. Importantly, the newly established FCN assay allows measurement of the neutralization activity of chimeric antibodies expressed in cell culture supernatants. Thus, this sensitive and high-throughput FCN assay is a useful alternative to the MN assay for measuring the antibody neutralization of HAdV-3 and for screening anti-HAdV-3 NAbs in cell culture supernatants.
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Affiliation(s)
- Zhenwei Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510000, China
| | - Xingui Tian
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510000, China
| | - Wenkuan Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510000, China
| | - Yuting Xian
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510000, China
| | - Weilue Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510000, China
| | - Rong Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510000, China.
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14
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Ko JH, Woo HT, Oh HS, Moon SM, Choi JY, Lim JU, Kim D, Byun J, Kwon SH, Kang D, Heo JY, Peck KR. Ongoing outbreak of human adenovirus-associated acute respiratory illness in the Republic of Korea military, 2013 to 2018. Korean J Intern Med 2021; 36:205-213. [PMID: 31480827 PMCID: PMC7820655 DOI: 10.3904/kjim.2019.092] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/25/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND/AIMS Human adenovirus type 55 (HAdV-55), an emerging epidemic strain, has caused several large outbreaks in the Korean military since 2014, and HAdV-associated acute respiratory illness (HAdV-ARI) has been continuously reported thereafter. METHODS To evaluate the epidemiologic characteristics of HAdV-ARI in the Korean military, we analyzed respiratory virus polymerase chain reaction (RV-PCR) results, pneumonia surveillance results, and severe HAdV cases from all 14 Korean military hospitals from January 2013 to May 2018 and compared these data with nationwide RV surveillance data for the civilian population. RESULTS A total of 14,630 RV-PCRs was performed at military hospitals. HAdV (45.4%) was the most frequently detected RV, followed by human rhinovirus (12.3%) and influenza virus (6.3%). The percentage of the military positive for HAdV was significantly greater than the percentage of civilians positive for HAdV throughout the study period, with a large outbreak occurring during the winter to spring of 2014 to 2015. The outbreak continued until the end of the study, and non-seasonal detections increased over time. The reported number of pneumonia patients also increased during the outbreak. Case fatality rate was 0.075% overall but 15.6% in patients with respiratory failure. The proportion of severe patients did not change significantly during the study period. CONCLUSION A large HAdV outbreak is currently ongoing in the Korean military, with a trend away from seasonality, and HAdV-55 is likely the predominant strain. Persistent efforts to control the outbreak, HAdV type-specific surveillance, and vaccine development are required.
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Affiliation(s)
- Jae-Hoon Ko
- Division of Infectious Diseases, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyeong-taek Woo
- Department of Preventive Medicine, Armed Forces Medical Command, Seongnam, Korea
| | - Hong Sang Oh
- Division of Infectious Diseases, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Song Mi Moon
- Division of Infectious Diseases, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Joon Young Choi
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Jeong Uk Lim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Donghoon Kim
- Department of Preventive Medicine, Armed Forces Medical Command, Seongnam, Korea
| | - Junsu Byun
- Department of Preventive Medicine, Armed Forces Medical Command, Seongnam, Korea
| | - Soon-Hwan Kwon
- Department of Infectious Diseases, Research Center of Infectious and Environmental Diseases, Armed Forces Medical Research Institute, Daejeon, Korea
| | - Daeyoun Kang
- Department of Infectious Diseases, Research Center of Infectious and Environmental Diseases, Armed Forces Medical Research Institute, Daejeon, Korea
| | - Jung Yeon Heo
- Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Correspondence to Kyong Ran Peck, M.D. Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea Tel: +82-2-3410-0329, Fax: +82-2-3410-0064, E-mail:
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15
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Vanderburg S, Wijayaratne G, Danthanarayana N, Jayamaha J, Piyasiri B, Halloluwa C, Sheng T, Amarasena S, Kurukulasooriya R, Nicholson BP, Peiris JSM, Gray GC, Gunasena S, Nagahawatte A, Bodinayake CK, Woods CW, Devasiri V, Tillekeratne LG. Outbreak of severe acute respiratory infection in Southern Province, Sri Lanka in 2018: a cross-sectional study. BMJ Open 2020; 10:e040612. [PMID: 33158834 PMCID: PMC7651749 DOI: 10.1136/bmjopen-2020-040612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES To determine aetiology of illness among children and adults presenting during outbreak of severe respiratory illness in Southern Province, Sri Lanka, in 2018. DESIGN Prospective, cross-sectional study. SETTING 1600-bed, public, tertiary care hospital in Southern Province, Sri Lanka. PARTICIPANTS 410 consecutive patients, including 371 children and 39 adults, who were admitted with suspected viral pneumonia (passive surveillance) or who met case definition for acute respiratory illness (active surveillance) in May to June 2018. RESULTS We found that cocirculation of influenza A (22.6% of cases), respiratory syncytial virus (27.8%) and adenovirus (AdV) (30.7%; type B3) was responsible for the outbreak. Mortality was noted in 4.5% of paediatric cases identified during active surveillance. Virus type and viral coinfection were not significantly associated with mortality. CONCLUSIONS This is the first report of intense cocirculation of multiple respiratory viruses as a cause of an outbreak of severe acute respiratory illness in Sri Lanka, and the first time that AdV has been documented as a cause of a respiratory outbreak in the country. Our results emphasise the need for continued vigilance in surveying for known and emerging respiratory viruses in the tropics.
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Affiliation(s)
- Sky Vanderburg
- Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
| | | | | | - Jude Jayamaha
- Medical Research Institute Sri Lanka, Colombo, Sri Lanka
| | | | | | - Tianchen Sheng
- Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Global Health Institute, Durham, North Carolina, USA
| | | | | | | | | | - Gregory C Gray
- Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Global Health Institute, Durham, North Carolina, USA
| | | | - Ajith Nagahawatte
- Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
- Duke Global Health Institute, Durham, North Carolina, USA
| | - Champica K Bodinayake
- Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
- Duke Global Health Institute, Durham, North Carolina, USA
| | - Christopher W Woods
- Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Global Health Institute, Durham, North Carolina, USA
| | | | - L Gayani Tillekeratne
- Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
- Duke Global Health Institute, Durham, North Carolina, USA
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16
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Binding Mechanism Elucidation of the Acute Respiratory Disease Causing Agent Adenovirus of Serotype 7 to Desmoglein-2. Viruses 2020; 12:v12101075. [PMID: 32992715 PMCID: PMC7599583 DOI: 10.3390/v12101075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 09/21/2020] [Accepted: 09/21/2020] [Indexed: 12/12/2022] Open
Abstract
The study of viruses causing acute respiratory distress syndromes (ARDS) is more essential than ever at a time when a virus can create a global pandemic in a matter of weeks. Among human adenoviruses, adenovirus of serotype 7 (HAdV7) is one of the most virulent serotypes. This virus regularly re-emerges in Asia and has just been the cause of several deaths in the United States. A critical step of the virus life cycle is the attachment of the knob domain of the fiber (HAd7K) to the cellular receptor desmoglein-2 (DSG2). Complexes between the fiber knob and two extracellular domains of DSG2 have been produced. Their characterization by biochemical and biophysical methods show that these two domains are sufficient for the interaction and that the trimeric HAd7K could accommodate up to three DSG2 receptor molecules. The cryo-electron microscopy (cryo-EM) structure of these complexes at 3.1 Å resolution confirmed the biochemical data, and allowed the identification of the critical amino acid residues for this interaction, which shows similarities with other DSG2 interacting adenoviruses, despite a low homology in the primary sequences.
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17
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Otto WR, Behrens EM, Teachey DT, Lamson DM, Barrett DM, Bassiri H, Lambert MP, Mount S, Petrosa WL, Romberg N, Sullivan KE, Topjian AA, Fisher BT, Kajon AE. Human Adenovirus 7-Associated Hemophagocytic Lymphohistiocytosis-Like Illness: Clinical and Virological Characteristics in a Cluster of Five Pediatric Cases. Clin Infect Dis 2020; 73:e1532-e1538. [PMID: 32866230 DOI: 10.1093/cid/ciaa1277] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 08/26/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening condition of immune dysregulation. Children often suffer from primary genetic forms of HLH, which can be triggered by infection. Others suffer from secondary HLH as a complication of infection, malignancy, or rheumatologic disease. Identifying the exact cause of HLH is crucial, as definitive treatment for primary disease is hematopoietic stem cell transplant. Adenoviruses have been associated with HLH but molecular epidemiology data are lacking. METHODS We describe the clinical and virologic characteristics of 5 children admitted with adenovirus infection during 2018-2019 who developed HLH or HLH-like illness. Detailed virologic studies, including virus isolation and comprehensive molecular typing were performed. RESULTS All patients recovered; clinical management varied but included immunomodulating and antiviral therapies. A genetic predisposition for HLH was not identified in any patient. Adenovirus isolates were recovered from 4/5 cases; all were identified as genomic variant 7d. Adenovirus type 7 DNA was detected in the fifth case. Phylogenetic analysis of genome sequences identified two clusters - one related to strains implicated in 2016-2017 outbreaks in Pennsylvania and New Jersey, the other related to a 2009 Chinese strain. CONCLUSIONS It can be challenging to determine whether HLH is the result of an infectious pathogen alone or genetic predisposition triggered by an infection. We describe 5 children from the same center presenting with an HLH-like illness after onset of adenovirus type 7 infection. None of the patients were found to have a genetic predisposition to HLH. These findings suggest that adenovirus 7 infection alone can result in HLH.
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Affiliation(s)
- William R Otto
- Division of Infectious Diseases, Department of Pediatrics, The Children's Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania, USA.,Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Edward M Behrens
- Immune Dysregulation Program, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Division of Rheumatology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - David T Teachey
- Immune Dysregulation Program, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Division of Oncology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Daryl M Lamson
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, USA
| | - David M Barrett
- Immune Dysregulation Program, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Division of Oncology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Hamid Bassiri
- Division of Infectious Diseases, Department of Pediatrics, The Children's Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania, USA.,Immune Dysregulation Program, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Michelle P Lambert
- Immune Dysregulation Program, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Division of Hematology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Suzanne Mount
- Infectious Disease Diagnostics Laboratory, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Whitney L Petrosa
- Immune Dysregulation Program, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Neil Romberg
- Immune Dysregulation Program, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Division of Immunology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Kathleen E Sullivan
- Immune Dysregulation Program, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Division of Immunology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Alexis A Topjian
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Brian T Fisher
- Division of Infectious Diseases, Department of Pediatrics, The Children's Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania, USA.,Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Immune Dysregulation Program, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Adriana E Kajon
- Lovelace Respiratory Research Institute, Albuquerque, New Mexico
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18
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Ko JH, Lim JU, Choi JY, Oh HS, Yoo H, Jhun BW, Huh K, Peck KR. Early cidofovir administration might be associated with a lower probability of respiratory failure in treating human adenovirus pneumonia: a retrospective cohort study. Clin Microbiol Infect 2019; 26:646.e9-646.e14. [PMID: 31648000 PMCID: PMC7129699 DOI: 10.1016/j.cmi.2019.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/08/2019] [Accepted: 10/08/2019] [Indexed: 01/22/2023]
Abstract
Objective To compare outcomes of early and delayed treatment with cidofovir for human adenovirus (HAdV) pneumonia. Methods A retrospective cohort study in Korean military hospitals was conducted between January 2012 and December 2018. Patients with potentially severe HAdV pneumonia with risk factors for respiratory failure were included and divided into early (within 7 days from symptom onset) and delayed (after 7 days from symptom onset) treatment groups. The primary outcome was respiratory failure development within 21 days after symptom onset. Results A total of 89 patients with potentially severe HAdV pneumonia were enrolled in the cohort; they included 62 early and 27 delayed treatment patients. All patients were males in their early 20s. Significantly fewer patients in the early treatment group progressed to respiratory failure (8/62, 12.9%), compared to the delayed group (18/27, 66.7%, p < 0.001). Early treatment was associated with a lower 21-day probability of respiratory failure by the Kaplan–Meier method (p < 0.001). On multivariate analysis, monocyte count, hypoxaemia, confusion, whole lung involvement, and early cidofovir treatment within 7 days from symptom onset were included, and monocyte count (HR 0.995, 95%CI 0.991–1.000, p 0.042), confusion (HR 4.964, 95%CI 1.189–20.721, p = 0.028), and early cidofovir treatment (HR 0.319, 95%CI 0.115–0.883, p = 0.028) were significantly associated with respiratory failure. Conclusions Early administration of cidofovir was associated with a lower hazard for respiratory failure development. It is suggested that cidofovir be administered within 7 days from symptom onset to prevent respiratory failure in patients with potentially severe HAdV pneumonia.
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Affiliation(s)
- J-H Ko
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J U Lim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J Y Choi
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea
| | - H S Oh
- Division of Infectious Diseases, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Republic of Korea
| | - H Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - B W Jhun
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - K Huh
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - K R Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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19
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Adenovirus Type 7 causing severe lower respiratory tract infection in immunocompetent adults: a comparison of two contrasting cases from an intensive care unit in North West England. CLINICAL INFECTION IN PRACTICE 2019; 2:100007. [PMID: 31886457 PMCID: PMC6919333 DOI: 10.1016/j.clinpr.2019.100007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 07/24/2019] [Accepted: 07/30/2019] [Indexed: 12/11/2022] Open
Abstract
Objectives Severe lower respiratory tract infection caused by adenovirus is well described in immunocompromised hosts and can cause significant morbidity and mortality. We compare and contrast the clinical presentation, radiological, and virological features of two rare cases in immunocompetent adults admitted to an intensive care unit in a large, teaching hospital in North West England. We then provide a concise, comprehensive literature review. Methods The first case was a 35-year old female asthmatic who presented with respiratory distress and pneumonitis during peak influenza season, and recovered after a prolonged hospital stay. The second case was a 73-year old male who presented with diarrhoea, vomiting, and general malaise outside of influenza season, developed respiratory compromise, and died. Adenovirus type 7 was identified in bronchoalveolar lavages and plasma samples of both patients, each of whom received cidofovir. No other infectious aetiology was identified. Results Clinical and radiological features of severe lower respiratory tract adenoviral infection are similar to other infectious causes of pneumonia and ARDS, including severe influenza. This can create diagnostic uncertainty, especially during influenza season. Positive adenovirus polymerase chain reaction results can support a diagnosis of severe lower respiratory tract adenovirus infection in patients with a clinically compatible syndrome and no other identified aetiology, with higher viral loads being associated with worse prognosis. Although treatment is predominantly supportive, early use of cidofovir may improve outcomes. Conclusions These rare cases highlight that severe lower respiratory tract adenoviral infection should be considered in the differential diagnoses of immunocompetent patients presenting with pneumonia and ARDS.
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20
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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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21
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Sudhindra P, Knoll B, Nog R, Singh N, Dhand A. Brincidofovir (CMX001) for the Treatment of Severe Adenoviral Pneumonia in Kidney Transplant Recipient. Cureus 2019; 11:e5296. [PMID: 31579636 PMCID: PMC6768614 DOI: 10.7759/cureus.5296] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Adenovirus causes significant morbidity and mortality in solid organ and hematological transplant recipients. Treatment of adenovirus infections includes supportive care, reduction of immune suppression, and in patients with severe disease, intravenous cidofovir. Brincidofovir (CMX001) is a lipid conjugate of cidofovir, with good oral bioavailability, no associated nephrotoxicity, and higher intracellular levels of the active drug compared to cidofovir. We describe a case of severe adenoviral pneumonia in an adult renal transplant recipient who was successfully treated with oral brincidofovir after developing renal insufficiency with intravenous cidofovir. Brincidofovir (CMX001) along with other supportive therapy, may offer an efficacious, safe, and well-tolerated treatment for severe adenoviral infections in solid organ transplant recipients.
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Affiliation(s)
| | - Bettina Knoll
- Infectious Diseases, Westchester Medical Center, Valhalla, USA
| | - Rajat Nog
- Infectious Diseases, Westchester Medical Center, Valhalla, USA
| | - Nandita Singh
- Nephrology, Westchester Medical Center, Valhalla, USA
| | - Abhay Dhand
- Infectious Diseases, Westchester Medical Center, Valhalla, USA
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22
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Huh K, Kim I, Jung J, Lee JE, Jhun BW, Gu SH, Song DH, Lee EY, Jeong HJ, Yoo H. Prolonged shedding of type 55 human adenovirus in immunocompetent adults with adenoviral respiratory infections. Eur J Clin Microbiol Infect Dis 2019; 38:793-800. [PMID: 30693422 DOI: 10.1007/s10096-019-03471-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 01/02/2019] [Indexed: 11/28/2022]
Abstract
Human adenovirus (HAdV) is a common pathogen causing respiratory infections with outbreaks reported in the military and community. However, little information is available on the shedding kinetics. We performed a prospective study of immunocompetent adults confirmed with HAdV respiratory infection by multiplex real-time PCR during an outbreak of HAdV-55. Consecutive respiratory specimens of sputum or nasopharyngeal swab were collected from each patient every 2 days. Viral load was measured by real-time quantitative PCR. Of 32 enrolled patients, 27 (84.4%) had pneumonia. Five patients (15.6%) received cidofovir. Viral load was highest in the earliest samples at 8.69 log10 copies/mL. In a linear regression model, viral load declined consistently in a log-linear fashion at the rate of - 0.15 log10 copies/mL per day (95% confidence interval (CI): - 0.18, - 0.12; R2 = 0.32). However, the regression model estimated the viral shedding duration to be 55 days. The rate of decline in viral load did not differ between patients who received cidofovir and who did not. Patients with prominent respiratory symptoms or extensive involvement on chest radiograph had higher volume of viral excretion. Prolonged viral shedding was observed in otherwise healthy adults with HAdV-55 respiratory infection. This finding should be considered in the establishment of infection control and prevention strategies.
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Affiliation(s)
- Kyungmin Huh
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Inseon Kim
- Biosewoom, Inc., Seoul, Republic of Korea
| | - Jaehun Jung
- Armed Forces Medical Command, Seongnam, Republic of Korea
| | - Ji Eun Lee
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Armed Forces Capital Hospital, Seongnam, Republic of Korea
| | - Byung Woo Jhun
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Ilwon-ro 81, Gangnam-gu, Seoul, Republic of Korea
| | - Se Hun Gu
- Agency for Defense Development, Daejeon, Republic of Korea
| | - Dong Hyun Song
- Agency for Defense Development, Daejeon, Republic of Korea
| | - Eun Young Lee
- Department of Laboratory and Diagnostic Medicine, Armed Forces Capital Hospital, Seongnam, Republic of Korea
| | - Ho Jung Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Armed Forces Capital Hospital, Seongnam, Republic of Korea
| | - Hongseok Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Ilwon-ro 81, Gangnam-gu, Seoul, Republic of Korea.
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23
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Yoon HY, Cho HH, Ryu YJ. Adenovirus pneumonia treated with Cidofovir in an immunocompetent high school senior. Respir Med Case Rep 2019; 26:215-218. [PMID: 30733919 PMCID: PMC6354651 DOI: 10.1016/j.rmcr.2019.01.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/16/2019] [Accepted: 01/16/2019] [Indexed: 11/26/2022] Open
Abstract
Most adenovirus infections are self-limiting in immunocompetent individuals. Here, we report a case of adenovirus pneumonia in a 17-year-old immunocompetent male. He was admitted to our emergency room complaining of a febrile sense, cough, and diarrhea for four days. Crackles in the left lung and a high fever (40.7 °C) were revealed. Initial chest X-ray and computed tomography images showed consolidation in the left lung. We immediately started empirical antibiotic treatment, but his clinical symptoms and pneumonic consolidation in radiography had not improved by hospital day three. Because adenovirus was detected in his sputum using RT-PCR, he was administered Cidofovir. After 24 h of Cidofovir treatment, the symptoms and fever subsided, and the consolidation in his X-ray was significantly reduced by hospital day nine. The early administration of Cidofovir could be beneficial for the treatment of adenovirus infection in immunocompetent patients.
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Affiliation(s)
- Hee-Young Yoon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hyun-Hae Cho
- Department of Radiology, Ewha Womans University, College of Medicine, Seoul, Republic of Korea
| | - Yon Ju Ryu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
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24
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Killerby ME, Rozwadowski F, Lu X, Caulcrick-Grimes M, McHugh L, Haldeman AM, Fulton T, Schneider E, Sakthivel SK, Bhatnagar J, Rabeneck DB, Zaki S, Gerber SI, Watson JT. Respiratory Illness Associated With Emergent Human Adenovirus Genome Type 7d, New Jersey, 2016-2017. Open Forum Infect Dis 2019; 6:ofz017. [PMID: 30800698 DOI: 10.1093/ofid/ofz017] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/06/2018] [Accepted: 01/09/2019] [Indexed: 12/17/2022] Open
Abstract
Background Human adenoviruses (HAdVs) are known causes of respiratory illness outbreaks in congregate settings, but cases and clusters are less well described from community settings in the United States. During December 2016-February 2017, the New Jersey Department of Health received reports of HAdV infections from 3 sources in 3 adjacent counties. We investigated to characterize the epidemiologic, laboratory, and clinical features of this HAdV outbreak. Methods A case was defined as a New Jersey resident with acute respiratory illness during December 1, 2016-March 31, 2017 with laboratory identification of HAdV genome type 7d (HAdV-7d). Human adenovirus was detected by real-time and conventional polymerase chain reaction and molecular typed by partial hexon capsid protein gene sequencing. The HAdV genome type was identified by whole genome sequencing analysis. Available medical, public health, and surveillance records were reviewed. Results We identified 12 cases, including 3 treatment facility patients, 7 college students, and 2 cases at a tertiary-care hospital. Four cases died; all had underlying comorbidities. Nine HAdV-7d whole genome sequences obtained from all 3 sites were nearly identical. Conclusions Transmission of HAdV-7d occurred in community and congregate settings across 3 counties and resulted in severe morbidity and mortality in some cases with underlying comorbidities. Clinicians and local and state health departments should consider HAdV in patients with severe respiratory infection.
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Affiliation(s)
- Marie E Killerby
- Respiratory Viruses Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.,Epidemic Intelligence Service, Division of Scientific Education and Professional Development
| | - Faye Rozwadowski
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development.,New Jersey Department of Health, Trenton
| | - Xiaoyan Lu
- Respiratory Viruses Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | | | | | | | | | - Eileen Schneider
- Respiratory Viruses Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Senthilkumar K Sakthivel
- Respiratory Viruses Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.,Battelle, Columbus, Ohio
| | - Julu Bhatnagar
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Demi B Rabeneck
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sherif Zaki
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan I Gerber
- Respiratory Viruses Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - John T Watson
- Respiratory Viruses Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
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25
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Haque E, Banik U, Monowar T, Anthony L, Adhikary AK. Worldwide increased prevalence of human adenovirus type 3 (HAdV-3) respiratory infections is well correlated with heterogeneous hypervariable regions (HVRs) of hexon. PLoS One 2018; 13:e0194516. [PMID: 29590206 PMCID: PMC5874027 DOI: 10.1371/journal.pone.0194516] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 03/05/2018] [Indexed: 12/21/2022] Open
Abstract
Human adenovirus type 3 (HAdV-3) respiratory infections occurs worldwide in both children and adults, leading to severe morbidity and mortality, particularly in the paediatric age group and especially in neonates. During HAdV infection, neutralizing antibodies are formed against the epitopes located in the hyper variable regions (HVRs) of the hexon protein. These neutralizing antibodies provide protection against reinfection by viruses of the same type. Therefore it is reasonable to speculate that variations of HAdV-3 in the HVRs could impair the immunity acquired by previous infection with a different strain with variation in its HVRs. HAdV-3 has recently become the major agent of acute respiratory infection worldwide, being responsible for 15% to 87% of all adenoviral respiratory infections. However, despite the increased prevalence of HAdV-3 as respiratory pathogen, the diversity of hexon proteins in circulating strains remains unexplored. This study was designed to explore the variation in HVRs of hexon among globally distributed strains of HAdV-3 as well as to discover possible relationship among them, thus possibly shedding light on the cause for the increased prevalence of HAdV-3. In this study, for the first time we analysed the hexon proteins of all 248 available strains of HAdV-3 from the NCBI database and compared them with those of the HAdV-3 prototype (GB stain). We found that the HVRs of HAdV-3 strains circulating worldwide were highly heterogeneous and have been mutating continuously since -their original isolation. Based on their immense heterogeneity, the strains can be categorized into 25 hexon variants (3Hv-1 to 3Hv-25), 4 of which (3Hv-1 to 3Hv-4) comprises 80% of the strains. This heterogeneity may explain why HAdV-3 has become the most prevalent HAdVs type worldwide. The heterogeneity of hexon proteins also shows that the development of a vaccine against HAdV-3 might be challenging. The data on hexon variants provided here may be useful for the future epidemiological study of HAdV-3 infection.
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Affiliation(s)
- Ezazul Haque
- Unit of Microbiology, AIMST University, Faculty of Medicine, Jalan Bedong Semeling, Bedong, Kedah, Malaysia
| | - Urmila Banik
- Unit of Pathology, AIMST University, Faculty of Medicine, Jalan Bedong Semeling, Bedong, Kedah, Malaysia
| | - Tahmina Monowar
- Unit of Microbiology, AIMST University, Faculty of Medicine, Jalan Bedong Semeling, Bedong, Kedah, Malaysia
| | - Leela Anthony
- Unit of Community Medicine, AIMST University, Faculty of Medicine, Jalan Bedong Semeling, Bedong, Kedah, Malaysia
| | - Arun Kumar Adhikary
- Unit of Microbiology, AIMST University, Faculty of Medicine, Jalan Bedong Semeling, Bedong, Kedah, Malaysia
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26
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Scott MK, Chommanard C, Lu X, Appelgate D, Grenz L, Schneider E, Gerber SI, Erdman DD, Thomas A. Human Adenovirus Associated with Severe Respiratory Infection, Oregon, USA, 2013-2014. Emerg Infect Dis 2018; 22:1044-51. [PMID: 27191834 PMCID: PMC4880082 DOI: 10.3201/eid2206.151898] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Several human adenoviruses (HAdVs) can cause respiratory infections, some severe. HAdV-B7, which can cause severe respiratory disease, has not been recently reported in the United States but is reemerging in Asia. During October 2013-July 2014, Oregon health authorities identified 198 persons with respiratory symptoms and an HAdV-positive respiratory tract specimen. Among 136 (69%) hospitalized persons, 31% were admitted to the intensive care unit and 18% required mechanical ventilation; 5 patients died. Molecular typing of 109 specimens showed that most (59%) were HAdV-B7, followed by HAdVs-C1, -C2, -C5 (26%); HAdVs-B3, -B21 (15%); and HAdV-E4 (1%). Molecular analysis of 7 HAdV-B7 isolates identified the virus as genome type d, a strain previously identified only among strains circulating in Asia. Patients with HAdV-B7 were significantly more likely than those without HAdV-B7 to be adults and to have longer hospital stays. HAdV-B7 might be reemerging in the United States, and clinicians should consider HAdV in persons with severe respiratory infection.
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MESH Headings
- Adenovirus Infections, Human/diagnosis
- Adenovirus Infections, Human/epidemiology
- Adenovirus Infections, Human/history
- Adenovirus Infections, Human/virology
- Adenoviruses, Human/classification
- Adenoviruses, Human/genetics
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Child
- Child, Preschool
- Female
- Genotype
- History, 21st Century
- Hospitalization
- Humans
- Infant
- Infant, Newborn
- Male
- Middle Aged
- Oregon/epidemiology
- Phylogeny
- Population Surveillance
- Respiratory Tract Infections/diagnosis
- Respiratory Tract Infections/epidemiology
- Respiratory Tract Infections/history
- Respiratory Tract Infections/virology
- Severity of Illness Index
- Symptom Assessment
- Young Adult
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27
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Afrad MH, Avzun T, Haque J, Haque W, Hossain ME, Rahman AR, Ahmed S, Faruque ASG, Rahman MZ, Rahman M. Detection of enteric- and non-enteric adenoviruses in gastroenteritis patients, Bangladesh, 2012-2015. J Med Virol 2018; 90:677-684. [PMID: 29244212 DOI: 10.1002/jmv.25008] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 11/28/2017] [Indexed: 11/09/2022]
Abstract
Human adenoviruses (HAdVs) are common cause of nonbacterial acute gastroenteritis worldwide. Limited data exist on HAdVs molecular epidemiology associated with acute gastroenteritis in Bangladesh. We describe the genetic diversity and epidemiology of HAdVs among hospitalized diarrhea patients, including HAdV genotypes, clinical symptoms, and co-infecting enteric pathogens. Stool samples were collected from ongoing diarrhea surveillance during 2012-2015. HAdV was detected using PCR and genotyped by sequencing and phylogenetic analysis. Detailed socio-demographic and clinical information regarding each individual was recorded such as duration of diarrhea, dehydration status, vomiting, abdominal pain, fever, and severity. Of 871 fecal specimens, HAdV DNA was detected in 93 (10.7%). Among them 56% were co-infected with other known enteric viral and bacterial pathogens and 31.6% had severe gastroenteritis. The majority (55%) of HAdV positives were children <5 years of age. Two main clinical symptoms in HAdV infected patients were diarrhea and vomiting. HAdVs were detected throughout the year with low prevalence in winter (November-January). Five HAdV species (A, B, C, D, and F) including 17 different genotypes were identified during the study period, with enteric HAdV species F (HAdV-40/41) being the most dominant. However, non-enteric HAdV were also detected in substantial proportion of specimens (15% species C, 15% species D, 10.8% species A, and 4.3% species B). Our study demonstrates high genetic diversity of HAdVs including enteric and non-enteric HAdVs among diarrhea patients and provides a foundation for further clarification of the role of non-enteric HAdVs in diarrheal diseases.
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Affiliation(s)
- Mokibul Hassan Afrad
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Tasnuva Avzun
- Department of Biochemistry and Microbiology, North South University, Dhaka, Bangladesh
| | - Jahurul Haque
- Department of Biotechnology and Genetic Engineering, Islamic University, Kushtia, Bangladesh
| | - Warda Haque
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mohammad Enayet Hossain
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Afm Rajibur Rahman
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Shahnawaz Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Abu Syed Golam Faruque
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mohammed Ziaur Rahman
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mustafizur Rahman
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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Hage E, Dhingra A, Liebert UG, Bergs S, Ganzenmueller T, Heim A. Three novel, multiple recombinant types of species of human mastadenovirus D (HAdV-D 73, 74 & 75) isolated from diarrhoeal faeces of immunocompromised patients. J Gen Virol 2017; 98:3037-3045. [PMID: 29095687 DOI: 10.1099/jgv.0.000968] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Species D is the largest of the seven species of human mastadenoviruses (HAdV), but few of its multiple types are associated with asevere disease, e.g. epidemic keratoconjunctivitis. Many other types are hardly ever associated with significant diseases in immunocompetent patients, but have been isolated from the diarrhoeal faeces of terminal AIDS patients suggesting their role as opportunistic pathogens. Three novel HAdV-D strains were isolated from the faeces of three immunocompromised adult patients (clinical diagnoses: lymphoma, myelodysplastic syndrome and AIDS CDC3B, respectively). These strains were not typeable by imputed serology of the hexon and fibre gene and therefore complete genomic sequences were generated by next-generation sequencing (NGS). All three strains were multiple recombinants and fulfilled the criteria for designation as types 73, 74 and 75 with the penton/hexon/fibre genotype codes P67H45F27, P70H74F51 and P75H26F29, respectively. A novel genomic backbone and also a novel hexon neutralization epitope sequence were discovered in type 74, and a novel penton sequence in type 75. At the complete genome level, types 73, 74 and 75 were closely related neither to each other nor to type 70, which was previously isolated in the same region. However, these four HAdV-D types were closely related to each other in single genes and gene regions, e.g. penton, E1 and E4 due to recombination events in their phylogeny. In conclusion, regional co-circulation of opportunistic HAdV-D types facilitated co- and super-infections, which are essential for homologous recombination, and thus resulted in the evolution of novel genotypes by lateral gene transfer.
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Affiliation(s)
- Elias Hage
- Institut für Virologie, Adenovirus Konsiliarlabor, Medizinische Hochschule, Hannover, Germany.,Deutsches Zentrum Infektionsforschung, Hannover und Braunschweig, Germany
| | - Akshay Dhingra
- Institut für Virologie, Adenovirus Konsiliarlabor, Medizinische Hochschule, Hannover, Germany.,Deutsches Zentrum Infektionsforschung, Hannover und Braunschweig, Germany
| | - Uwe G Liebert
- Institut für Virologie, Universität Leipzig, Leipzig, Germany
| | - Sandra Bergs
- Institut für Virologie, Universität Leipzig, Leipzig, Germany
| | - Tina Ganzenmueller
- Institut für Virologie, Adenovirus Konsiliarlabor, Medizinische Hochschule, Hannover, Germany.,Deutsches Zentrum Infektionsforschung, Hannover und Braunschweig, Germany
| | - Albert Heim
- Institut für Virologie, Adenovirus Konsiliarlabor, Medizinische Hochschule, Hannover, Germany.,Deutsches Zentrum Infektionsforschung, Hannover und Braunschweig, Germany
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Patwary NIA, Islam MS, Sohel M, Ara I, Sikder MOF, Shahik SM. In silico structure analysis and epitope prediction of E3 CR1-beta protein of Human Adenovirus E for vaccine design. Biomed J 2016; 39:382-390. [PMID: 28043417 PMCID: PMC6138513 DOI: 10.1016/j.bj.2016.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 07/12/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Human Adenoviruses are divided into 7 species of Human Adenovirus A to G based on DNA genome homology. The Human Adenovirus E (HAdVs-E) genome is a linear, double-stranded DNA containing 38 protein-coding genes. Wild-type adenoviruses type E, are linked to a number of slight illnesses. The most important part of HAdVs-E is E3 CR1-beta protein which controls the host immune response and viral attachment. METHOD We use numerous bio-informatics and immuno-informatics implements comprising sequence and construction tools for construction of 3D model and epitope prediction for HAdVs-E. RESULTS The 3D structure of E3 CR1-beta protein was generated and total of ten antigenic B cell epitopes, 6 MHC class I and 11 MHC class II binding peptides were predicted. CONCLUSION The study was carried out to predict antigenic determinants/epitopes of the E3 CR1-beta protein of Human Adenovirus E along with the 3D protein modeling. The study revealed potential T-cell and B-cell epitopes that can raise the desired immune response against E3 CR1-beta protein and useful in developing effective vaccines against HAdVs-E.
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Affiliation(s)
- Noman Ibna Amin Patwary
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Sciences, University of Chittagong, Bangladesh
| | - Md Saiful Islam
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Sciences, University of Chittagong, Bangladesh
| | - Md Sohel
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Sciences, University of Chittagong, Bangladesh
| | - Ismot Ara
- Department of Computer Science and Engineering, Faculty of Science and Technology, Atish Dipankar University of Science and Technology, Bangladesh; Department of Computer Science and Engineering, American International University-Bangladesh, Bangladesh
| | - Mohd Omar Faruk Sikder
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Sciences, University of Chittagong, Bangladesh
| | - Shah Md Shahik
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Sciences, University of Chittagong, Bangladesh.
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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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Tan B, Yang XL, Ge XY, Peng C, Zhang YZ, Zhang LB, Shi ZL. Novel bat adenoviruses with an extremely large E3 gene. J Gen Virol 2016; 97:1625-1635. [PMID: 27032099 DOI: 10.1099/jgv.0.000470] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Bats carry diverse RNA viruses, some of which are responsible for human diseases. Compared to bat-borne RNA viruses, relatively little information is known regarding bat-borne DNA viruses. In this study, we isolated and characterized three novel bat adenoviruses (BtAdV WIV9-11) from Rhinolophus sinicus. Their genomes, which are highly similar to each other but distinct from those of previously sequenced adenoviruses (AdVs), are 37 545, 37 566 and 38 073 bp in size, respectively. An unusually large E3 gene was identified in their genomes. Phylogenetic and taxonomic analyses suggested that these isolates represent a distinct species of the genus Mastadenovirus. Cell susceptibility assays revealed a broad cell tropism for these isolates, indicating that they have a potentially wide host range. Our results expand the understanding of genetic diversity of bat AdVs.
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Affiliation(s)
- Bing Tan
- Key Laboratory of Special Pathogens and Center for Emerging Infectious Diseases, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
| | - Xing-Lou Yang
- Key Laboratory of Special Pathogens and Center for Emerging Infectious Diseases, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
| | - Xing-Yi Ge
- Key Laboratory of Special Pathogens and Center for Emerging Infectious Diseases, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
| | - Cheng Peng
- Key Laboratory of Special Pathogens and Center for Emerging Infectious Diseases, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
| | - Yun-Zhi Zhang
- Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Yunnan Institute of Endemic Diseases Control and Prevention, Dali, China
| | | | - Zheng-Li Shi
- Key Laboratory of Special Pathogens and Center for Emerging Infectious Diseases, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
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Hoppe E, Pauly M, Robbins M, Gray M, Kujirakwinja D, Nishuli R, Boji Mungu-Akonkwa DD, Leendertz FH, Ehlers B. Phylogenomic evidence for recombination of adenoviruses in wild gorillas. J Gen Virol 2015. [DOI: 10.1099/jgv.0.000250] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Eileen Hoppe
- Division 12 ‘Measles, Mumps, Rubella and Viruses affecting immunocompromised patients’, Robert Koch Institute, 13353 Berlin, Germany
| | - Maude Pauly
- Division 12 ‘Measles, Mumps, Rubella and Viruses affecting immunocompromised patients’, Robert Koch Institute, 13353 Berlin, Germany
- P3 ‘Epidemiology of highly pathogenic microorganisms’, Robert Koch Institute, 13353 Berlin, Germany
| | - Martha Robbins
- Department of Primatology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Maryke Gray
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Deo Kujirakwinja
- Wildlife Conservation Society, Grauer's Gorilla Project, Democratic Republic of the Congo
| | - Radar Nishuli
- Institut Congolais pour la Conservation de la Nature, Democratic Republic of the Congo
| | | | - Fabian H. Leendertz
- P3 ‘Epidemiology of highly pathogenic microorganisms’, Robert Koch Institute, 13353 Berlin, Germany
| | - Bernhard Ehlers
- Division 12 ‘Measles, Mumps, Rubella and Viruses affecting immunocompromised patients’, Robert Koch Institute, 13353 Berlin, Germany
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New Epidemiological and Clinical Signatures of 18 Pathogens from Respiratory Tract Infections Based on a 5-Year Study. PLoS One 2015; 10:e0138684. [PMID: 26406339 PMCID: PMC4583381 DOI: 10.1371/journal.pone.0138684] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 09/02/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Respiratory tract infections (RTIs) are a heavy burden on society. However, due to the complex etiology of RTIs, the clinical diagnosis, treatment, and prevention of these infections remain challenging, especially in developing countries. METHODS To determine the epidemiological and clinical characteristics of 18 respiratory pathogens, we analyzed 12,502 patients with acute respiratory infections (ARIs) by performing polymerase chain reaction (PCR) on patient pharyngeal swabs. RESULTS Samples positive for at least 1 pathogen were obtained from 48.42% of the total patients. Of these pathogen-positive patients, 17.99% were infected with more than 1 pathogen. Of the 18 pathogens analyzed, four were detected with a positive detection rate (PDR) > 5%: influenza A virus (IAV) > respiratory syncytial virus (RSV) >Mycoplasma pneumoniae (MP) > human coronavirus (HCoV). The pathogens with the 4 highest co-infection rates (CIRs) were as follows: HCoV > human bocavirus (HBoV) > enterovirus (EV) > parainfluenza virus (PIV). The overall positive detection rate (PDR) varied significantly according to patient age, the season and year of detection, and the disease subgroup, but not according to patient sex. The individual PDRs of the pathogens followed 3 types of distributions for patient sex, 4 types of distributions for patient age, 4 types of seasonal distributions, 2 types of seasonal epidemic trends, 4 types of yearly epidemic trends, and different susceptibility distributions in the disease subgroups. Additionally, the overall CIR showed significantly different distributions according to patient sex, patient age, and the disease subgroup, whereas the CIRs of individual pathogens suggested significant preference characteristics. CONCLUSION IAV remains the most common pathogen among the pathogens analyzed. More effort should be directed toward the prevention and control of pathogens that show a trend of increasing incidence such as HCoV, human adenovirus (ADV), and RSV. Although clinically distinguishing specific pathogens responsible for RTIs is difficult, the epidemiological and clinical characteristics of the various RTI-causing agents could provide clues for clinicians, thereby informing decisions regarding prevention and medication and guiding appropriate public health strategies.
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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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Hage E, Gerd Liebert U, Bergs S, Ganzenmueller T, Heim A. Human mastadenovirus type 70: a novel, multiple recombinant species D mastadenovirus isolated from diarrhoeal faeces of a haematopoietic stem cell transplantation recipient. J Gen Virol 2015; 96:2734-2742. [DOI: 10.1099/vir.0.000196] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Elias Hage
- Institut für Virologie, Adenovirus Konsiliarlabor, Medizinische Hochschule Hannover, Hannover, Germany
- Deutsches Zentrum Infektionsforschung, Hannover and Braunschweig, Germany
| | | | - Sandra Bergs
- Institut für Virologie, Universität Leipzig, Leipzig, Germany
| | - Tina Ganzenmueller
- Institut für Virologie, Adenovirus Konsiliarlabor, Medizinische Hochschule Hannover, Hannover, Germany
- Deutsches Zentrum Infektionsforschung, Hannover and Braunschweig, Germany
| | - Albert Heim
- Deutsches Zentrum Infektionsforschung, Hannover and Braunschweig, Germany
- Institut für Virologie, Adenovirus Konsiliarlabor, Medizinische Hochschule Hannover, Hannover, Germany
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Sanchez JL, Cooper MJ, Myers CA, Cummings JF, Vest KG, Russell KL, Sanchez JL, Hiser MJ, Gaydos CA. Respiratory Infections in the U.S. Military: Recent Experience and Control. Clin Microbiol Rev 2015; 28:743-800. [PMID: 26085551 PMCID: PMC4475643 DOI: 10.1128/cmr.00039-14] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
This comprehensive review outlines the impact of military-relevant respiratory infections, with special attention to recruit training environments, influenza pandemics in 1918 to 1919 and 2009 to 2010, and peacetime operations and conflicts in the past 25 years. Outbreaks and epidemiologic investigations of viral and bacterial infections among high-risk groups are presented, including (i) experience by recruits at training centers, (ii) impact on advanced trainees in special settings, (iii) morbidity sustained by shipboard personnel at sea, and (iv) experience of deployed personnel. Utilizing a pathogen-by-pathogen approach, we examine (i) epidemiology, (ii) impact in terms of morbidity and operational readiness, (iii) clinical presentation and outbreak potential, (iv) diagnostic modalities, (v) treatment approaches, and (vi) vaccine and other control measures. We also outline military-specific initiatives in (i) surveillance, (ii) vaccine development and policy, (iii) novel influenza and coronavirus diagnostic test development and surveillance methods, (iv) influenza virus transmission and severity prediction modeling efforts, and (v) evaluation and implementation of nonvaccine, nonpharmacologic interventions.
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Affiliation(s)
- Jose L Sanchez
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Michael J Cooper
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | | | - James F Cummings
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Kelly G Vest
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Kevin L Russell
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Joyce L Sanchez
- Mayo Clinic, Division of General Internal Medicine, Rochester, Minnesota, USA
| | - Michelle J Hiser
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA Oak Ridge Institute for Science and Education, Postgraduate Research Participation Program, U.S. Army Public Health Command, Aberdeen Proving Ground, Aberdeen, Maryland, USA
| | - Charlotte A Gaydos
- International STD, Respiratory, and Biothreat Research Laboratory, Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland, USA
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Rajkumar V, Chiang CSM, Low JM, Cui L, Lin RTP, Tee NWS, Maiwald M, Chong CY, Thoon KC, Tan NWH. Risk Factors for Severe Adenovirus Infection in Children during an Outbreak in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2015; 44:50-59. [PMID: 25797817 DOI: 10.47102/annals-acadmedsg.v44n2p50] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
BACKGROUND Human adenoviruses (HAdVs) can cause a variety of human illnesses, with associated temporal and geographic changes in disease incidence. We report the emergence of an outbreak of HAdV infections in Singapore, presumably caused by a change of the predominating type to HAdV-7. We examined the clinical features of children admitted with HAdV infection to 1 institution and the risk factors for severe infection. MATERIALS AND METHODS This is a retrospective case-control study of all HAdV-infected children admitted during weeks 1 to 19 in 2013, as identified from laboratory records. A descriptive retrospective analysis of epidemiology, clinical data and the outcome of these children was also performed. Patients with severe infections were defined as cases, those with non-severe infections as controls, and the 2 groups were compared to find possible independent risk factors. RESULTS Eighty-five patients with HAdV infection were studied, including 11 (12.9%) cases and 74 (87.1%) controls. Binary logistic regression showed that cases were more likely to be <2 years old (adjusted OR 10.6, 95% CI, 1.8 to 63.2) and to have significant comorbidities (adjusted OR 19.9, 95% CI, 3.4 to 116.1) compared to controls. The predominant type in 2013 was HAdV-7, which differed from 2011 and 2012, when HAdV-3 was more common. There was a trend towards pneumonia being more common in patients infected with HAdV-7 than in patients infected with other types, although this did not reach statistical significance (OR 2.8, 95% CI, 0.9 to 8.7). CONCLUSION The emergence of HAdV-7 in a population where other HAdV types had circulated previously may have caused the outbreak in Singapore, and this was associated with more serious infections in children. Young age (<2 years) and significant comorbidities were associated with more severe HAdV infection.
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Affiliation(s)
- Veena Rajkumar
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
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Retrospective analysis of demographic and clinical factors associated with etiology of febrile respiratory illness among US military basic trainees. BMC Infect Dis 2014; 14:576. [PMID: 25475044 PMCID: PMC4264259 DOI: 10.1186/s12879-014-0576-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 10/17/2014] [Indexed: 12/02/2022] Open
Abstract
Background Basic trainees in the US military have historically been vulnerable to respiratory infections. Adenovirus and influenza are the most common etiological agents responsible for febrile respiratory illness (FRI) among trainees and present with similar clinical signs and symptoms. Identifying demographic and clinical factors associated with the primary viral pathogens causing FRI epidemics among trainees will help improve differential diagnosis and allow for appropriate distribution of antiviral medications. The objective of this study was to determine what demographic and clinical factors are associated with influenza and adenovirus among military trainees. Methods Specimens were systematically collected from military trainees meeting FRI case definition (fever ≥38.0°C with either cough or sore throat; or provider-diagnosed pneumonia) at eight basic training centers in the USA. PCR and/or cell culture testing for respiratory pathogens were performed on specimens. Interviewer-administered questionnaires collected information on patient demographic and clinical factors. Polychotomous logistic regression was employed to assess the association between these factors and FRI outcome categories: laboratory-confirmed adenovirus, influenza, or other FRI. Sensitivity, specificity, positive and negative predictive value were calculated for individual predictors and clinical combinations of predictors. Results Among 21,570 FRI cases sampled between 2004 and 2009, 63.6% were laboratory-confirmed adenovirus cases and 6.6% were laboratory-confirmed influenza cases. Subjects were predominantly young men (86.8% men; mean age 20.8 ± 3.8 years) from Fort Jackson (18.8%), Great Lakes (17.1%), Fort Leonard Wood (16.3%), Marine Corps Recruit Depot (MCRD) San Diego (19.0%), Fort Benning (13.3%), Lackland (7.5%), MCRD Parris Island (8.7%), and Cape May (3.2%). The best multivariate predictors of adenovirus were the combination of sore throat (odds ratio [OR], 2.94; 95% confidence interval [CI], 2.66-3.25), cough (OR, 2.33; 95% CI, 2.11-2.57), and fever (OR, 2.07; 95% CI, 1.90-2.26) with a PPV of 77% (p ≤.05). A combination of cough, fever, training week 0-2 and acute onset were most predictive of influenza (PPV =38%; p ≤ .05). Conclusions Specific demographic and clinical factors were associated with laboratory-confirmed influenza and adenovirus among military trainees. Findings from this study can guide clinicians in the diagnosis and treatment of military trainees presenting with FRI. Electronic supplementary material The online version of this article (doi:10.1186/s12879-014-0576-2) contains supplementary material, which is available to authorized users.
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Hage E, Huzly D, Ganzenmueller T, Beck R, Schulz TF, Heim A. A human adenovirus species B subtype 21a associated with severe pneumonia. J Infect 2014; 69:490-9. [PMID: 24975176 DOI: 10.1016/j.jinf.2014.06.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 06/16/2014] [Accepted: 06/20/2014] [Indexed: 12/19/2022]
Abstract
Between 2005 and 2013 six severe pneumonia cases (all requiring mechanical ventilation, two fatal outcomes) caused by human adenovirus type 21 (HAdV-B21) were observed in Germany. So far, HAdV-B21 was mainly associated with non-severe upper and lower respiratory tract infections. However, a few highly virulent HAdV types, e.g. HAdV-B14p1, were previously associated with severe, fatal pneumonia. Complete genomic sequences of the German HAdV-B21 pneumonia isolates formed a single phylogenetic cluster with very high sequence identity (≥ 99.897%). Compared to the HAdV-B21 prototype (only 99.319% identity), all isolates had a unique 15 amino acid deletion and a 2 amino acid insertion in the RGD loop of the penton base which may affect binding to the secondary receptor on the host cells. Moreover, a recombinant E4 gene region derived of HAdV-B3 was identified by bootscan analysis. Thus, the highly virulent, pneumotropic HAdV-B21 was denominated as subtype 21a. Surprisingly, there was 99.963% identity with agent Y/SIBU97 (only 13.4 kb available in GenBank of the 35.4 kb genome) which was associated with 10 fatalities due to cardiopulmonary failure in Sarawak, Malaysia, in 1997. In conclusion, a HAdV-B21 subtype (21a) associated with severe pneumonia in Germany was phylogenetically linked to an adenovirus isolated in Malaysia.
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Affiliation(s)
- Elias Hage
- Institut für Virologie, Medizinische Hochschule, Hannover, Germany
| | - Daniela Huzly
- Institut für Virologie, Albert-Ludwigs-Universität, Freiburg, Germany
| | | | - Robert Beck
- Institut für Medizinische Virologie, Universitätsklinikum Tübingen, Germany
| | - Thomas F Schulz
- Institut für Virologie, Medizinische Hochschule, Hannover, Germany; Deutsches Zentrum Infektionsforschung, Hannover und Braunschweig, Germany
| | - Albert Heim
- Institut für Virologie, Medizinische Hochschule, Hannover, Germany; Netzwerk Atemwegsinfektionen des Robert-Koch-Institutes, Adenovirus Konsiliarlabor, Germany.
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Lee CY, Wu MC, Ho CL, Lai CC, Chou TY, Chan YJ. Design and application of a real-time polymerase chain for the detection and subsequent characterization of respiratory adenoviral infections. J Med Virol 2014; 86:2128-33. [PMID: 24916449 DOI: 10.1002/jmv.23940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2014] [Indexed: 11/06/2022]
Abstract
Human adenoviruses (HADVs) comprise at least 54 types and cause a wide spectrum of respiratory tract infections; early diagnosis and epidemiological monitoring of HADV infections requires a rapid and sensitive assay. The use of a real-time polymerase chain reaction (PCR) assay was evaluated with one set of in-house designed primers for respiratory adenoviral infections. The assay was first validated by detecting successfully 6 representative types and 100 clinical isolates. A concomitant prospective surveillance of viral aetiology using conventional cultures and PCR assays in 160 febrile children with acute respiratory tract symptoms was conducted between May 2010 and July 2011. Viral aetiologies were confirmed in 72 (45%) cases using conventional cultures, including 51 adenoviral infections. The concordance between the real-time PCR and culture was good (Kappa = 0.94), and two additional culture-negative adenovirus infections were identified. During the study period (January 2011), an adenoviral community epidemic occurred. Adenovirus B3 was the predominant type in this epidemic (69.8%), followed by C2 (5.7%), C1 (5.7%), C5 (1.9%), E4 (1.9%), C6 (1.9%), F41 (1.9%), and 4 unclassified species C (7.5%). Significantly prolonged duration of fever (>5 days), higher leukocyte counts, higher neutrophil counts, and higher C-reactive protein levels were in the adenoviral infected group (n = 53, P < 0.001), compared with the non-adenoviral infected group (n = 107). In conclusion, this in-house real-time PCR is capable of detecting adenoviral respiratory infections of various types in children; and patients with adenoviral aetiology suffered from more severe clinical manifestations.
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Affiliation(s)
- Chun-Yi Lee
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
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Lee WJ, Jung HD, Cheong HM, Kim K. Molecular epidemiology of a post-influenza pandemic outbreak of acute respiratory infections in Korea caused by human adenovirus type 3. J Med Virol 2014; 87:10-7. [PMID: 24889391 PMCID: PMC7167096 DOI: 10.1002/jmv.23984] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2014] [Indexed: 01/19/2023]
Abstract
An outbreak of upper respiratory tract infections associated with human adenovirus (HAdV) occurred on a national scale in Korea from September to December 2010, following a major H1N1 influenza pandemic. Data from the Korea Influenza and Respiratory Surveillance System (KINRESS) showed an unusually high positive rate accounting for up to 20% of all diagnosed cases. To determine the principal cause of the outbreak, direct polymerase chain reaction (PCR) amplification followed by sequence analysis targeting parts of the hexon gene of HAdV was performed. Serotypes of 1,007 PCR-diagnosed HAdV-positive samples from patients with an acute upper respiratory tract illness were determined and epidemiological characteristics including major aged group and clinical symptoms were analyzed. The principal symptom of HAdV infections was fever and the vulnerable aged group was 1-5 years old. Based on sequence analysis, HAdV-3 was the predominant serotype in the outbreak, with an incidence of 74.3%. From the beginning of 2010 until May, the major serotypes were HAdV-1, 2, and 5 (70-100%) in any given period. However, an outbreak dominated by HAdV-3 started between July and August and peaked in September. Phylogenetic analysis revealed that there was no genetic variation in HAdV-3. The results demonstrated that an outbreak of upper respiratory illness followed by H1N1 influenza pandemic in Korea was caused mainly by emerged HAdV-3. J.
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Affiliation(s)
- Wan-Ji Lee
- Division of Respiratory Viruses, Center for Infectious Diseases, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Chungbuk-do, CheongWon-gun, Korea
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Demian PN, Horton KC, Kajon A, Siam R, Hasanin AMN, Elgohary Sheta A, Cornelius C, Gaynor AM. Molecular identification of adenoviruses associated with respiratory infection in Egypt from 2003 to 2010. BMC Infect Dis 2014; 14:50. [PMID: 24479824 PMCID: PMC3925414 DOI: 10.1186/1471-2334-14-50] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 01/14/2014] [Indexed: 11/10/2022] Open
Abstract
Background Human adenoviruses of species B, C, and E (HAdV-B, –C, -E) are frequent causative agents of acute respiratory infections worldwide. As part of a surveillance program aimed at identifying the etiology of influenza-like illness (ILI) in Egypt, we characterized 105 adenovirus isolates from clinical samples collected between 2003 and 2010. Methods Identification of the isolates as HAdV was accomplished by an immunofluorescence assay (IFA) and confirmed by a set of species and type specific polymerase chain reactions (PCR). Results Of the 105 isolates, 42% were identified as belonging to HAdV-B, 60% as HAdV–C, and 1% as HAdV-E. We identified a total of six co-infections by PCR, of which five were HAdV-B/HAdV-C co-infections, and one was a co-infection of two HAdV-C types: HAdV-5/HAdV-6. Molecular typing by PCR enabled the identification of eight genotypes of human adenoviruses; HAdV-3 (n = 22), HAdV-7 (n = 14), HAdV-11 (n = 8), HAdV-1 (n = 22), HAdV-2 (20), HAdV-5 (n = 15), HAdV-6 (n = 3) and HAdV-4 (n = 1). The most abundant species in the characterized collection of isolates was HAdV-C, which is concordant with existing data for worldwide epidemiology of HAdV respiratory infections. Conclusions We identified three species, HAdV-B, -C and -E, among patients with ILI over the course of 7 years in Egypt, with at least eight diverse types circulating.
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Affiliation(s)
| | | | | | | | | | | | | | - Anne M Gaynor
- U,S, Naval Medical Research Unit No, 3, Cairo, Egypt.
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Lee N, Qureshi ST. Other viral pneumonias: coronavirus, respiratory syncytial virus, adenovirus, hantavirus. Crit Care Clin 2013; 29:1045-68. [PMID: 24094390 PMCID: PMC7126722 DOI: 10.1016/j.ccc.2013.07.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Severe viral pneumonia is an increasing problem among adults. The incidence and number of viruses known to cause pneumonia and respiratory failure have also expanded in recent years. This article provides an overview of severe respiratory disease caused by coronavirus, respiratory syncytial virus, adenovirus, and hantavirus. These emerging pathogens are easily overlooked and timely diagnosis requires a high index of suspicion and confirmation by molecular testing. Management of individual cases is mainly supportive and requires institution of appropriate infection control measures. Vaccines and effective therapeutics for these potentially devastating respiratory viruses are urgently required.
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Affiliation(s)
- Nelson Lee
- Division of Infectious Diseases, Department of Medicine and Therapeutics, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, China
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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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Tsou TP, Tan BF, Chang HY, Chen WC, Huang YP, Lai CY, Chao YN, Wei SH, Hung MN, Hsu LC, Lu CY, Shao PL, Mu JJ, Chang LY, Liu MT, Huang LM. Community outbreak of adenovirus, Taiwan, 2011. Emerg Infect Dis 2013; 18:1825-32. [PMID: 23092602 PMCID: PMC3559173 DOI: 10.3201/eid1811.120629] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Adenovirus type 7 caused a high proportion of severe infections. In 2011, a large community outbreak of human adenovirus (HAdV) in Taiwan was detected by a nationwide surveillance system. The epidemic lasted from week 11 through week 41 of 2011 (March 14–October 16, 2011). Although HAdV-3 was the predominant strain detected (74%), an abrupt increase in the percentage of infections caused by HAdV-7 occurred, from 0.3% in 2008–2010 to 10% in 2011. Clinical information was collected for 202 inpatients infected with HAdV; 31 (15.2%) had severe infection that required intensive care, and 7 of those patients died. HAdV-7 accounted for 10%, 12%, and 41% of infections among outpatients, inpatients with nonsevere infection, and inpatients with severe infection, respectively (p<0.01). The HAdV-7 strain detected in this outbreak is identical to a strain recently reported in the People’s Republic of China (HAdV7-HZ/SHX/CHN/2009). Absence of circulating HAdV-7 in previous years and introduction of an emerging strain are 2 factors that caused this outbreak.
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Sidestream smoke exposure increases the susceptibility of airway epithelia to adenoviral infection. PLoS One 2012; 7:e49930. [PMID: 23166798 PMCID: PMC3499494 DOI: 10.1371/journal.pone.0049930] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 10/17/2012] [Indexed: 12/24/2022] Open
Abstract
Background Although significant epidemiological evidence indicates that cigarette smoke exposure increases the incidence and severity of viral infection, the molecular mechanisms behind the increased susceptibility of the respiratory tract to viral pathogens are unclear. Adenoviruses are non-enveloped DNA viruses and important causative agents of acute respiratory disease. The Coxsackievirus and adenovirus receptor (CAR) is the primary receptor for many adenoviruses. We hypothesized that cigarette smoke exposure increases epithelial susceptibility to adenovirus infection by increasing the abundance of apical CAR. Methodology and Findings Cultured human airway epithelial cells (CaLu-3) were used as a model to investigate the effect of sidestream cigarette smoke (SSS), mainstream cigarette smoke (MSS), or control air exposure on the susceptibility of polarized respiratory epithelia to adenoviral infection. Using a Cultex air-liquid interface exposure system, we have discovered novel differences in epithelial susceptibility between SSS and MSS exposures. SSS exposure upregulates an eight-exon isoform of CAR and increases adenoviral entry from the apical surface whilst MSS exposure is similar to control air exposure. Additionally, the level of cellular glycogen synthase kinase 3β (GSK3β) is downregulated by SSS exposure and treatment with a specific GSK3β inhibitor recapitulates the effects of SSS exposure on CAR expression and viral infection. Conclusions This is the first time that SSS exposure has been shown to directly enhance the susceptibility of a polarized epithelium to infection by a common respiratory viral pathogen. This work provides a novel understanding of the impact of SSS on the burden of respiratory viral infections and may lead to new strategies to alter viral infections. Moreover, since GSK3β inhibitors are under intense clinical investigation as therapeutics for a diverse range of diseases, studies such as these might provide insight to extend the use of clinically relevant therapeutics and increase the understanding of potential side effects.
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