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Owusu M, Adu E, Kalu LE, Martey E, Acheampong G, Enimil A, Appiah JA, Badu-Peprah A, Sylverken J, Sylverken AA, Nguah SB, Westeel E, Pouzol S, Drosten C, Adu-Sarkodie Y. Aetiological agents of pneumonia among HIV and non-HIV infected children in Ghana: A case-control study. PLoS One 2024; 19:e0299222. [PMID: 38517865 PMCID: PMC10959341 DOI: 10.1371/journal.pone.0299222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 02/05/2024] [Indexed: 03/24/2024] Open
Abstract
Pneumonia is the leading cause of death in children, however, the microbial aetiology of pneumonia is not well elucidated in low- and middle-income countries. Our study was aimed at determining the microbial aetiologies of childhood pneumonia and associated risk factors in HIV and non-HIV infected children. We conducted a case-control study that enrolled children with pneumonia as cases and non-pneumonia as controls from July 2017 to May 2020. Induced sputum and blood samples were investigated for microbial organisms using standard microbiological techniques. DNA/RNA was extracted from sputum samples and tested for viral and bacterial agents. Four hundred and four (404) subjects consisting of 231 (57.2%) cases and 173 (42.8%) controls were enrolled. We identified a significant (p = 0.011) proportion of viruses in cases (125; 54.1%, 95%CI: 47.4-60.7) than controls (71; 33.6%, 95%CI: 33.6-48.8) and these were mostly contributed to by Respiratory Syncytial Virus. Staphylococcus aureus (16; 4.0%), Klebsiella spp. (15, 3.7%) and Streptococcus pneumoniae (8, 2.0%) were the main bacterial agents identified in sputum or induced sputum samples. HIV infected children with viral-bacterial co-detection were found to have very severe pneumonia compared to those with only viral or bacterial infection. Indoor cooking (OR = 2.36; 95%CI:1.41-3.96) was found to be associated with pneumonia risk in patients. This study demonstrates the importance of various microbial pathogens, particularly RSV, in contributing to pneumonia in HIV and non-HIV paediatric populations. There is a need to accelerate clinical trials of RSV vaccines in African populations to support improvement of patient care.
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Affiliation(s)
- Michael Owusu
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
- Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eric Adu
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Lotenna Elsie Kalu
- Department of Child Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eugene Martey
- Department of Child Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Anthony Enimil
- Department of Child Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - John Adabie Appiah
- Department of Child Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Justice Sylverken
- Department of Child Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Augustina Angelina Sylverken
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel Blay Nguah
- Department of Child Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | | | - Yaw Adu-Sarkodie
- Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Kajon AE, Lamson DM, George KS. Characterization of Human Adenoviruses of Medical Importance: Isolation of Infectious Virus from Clinical Specimens and Molecular Typing. Curr Protoc 2023; 3:e916. [PMID: 37971417 PMCID: PMC10659126 DOI: 10.1002/cpz1.916] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Human adenoviruses (HAdVs) constitute a group of ubiquitous viruses that currently comprises 51 well-defined serotypes and more than 113 genotypes classified into seven species, HAdV-A through HAdV-G. The members of these species differ considerably in their genomic characteristics and also in their tropism and pathogenicity. Virus isolation in cell culture remains critical for the preservation and comprehensive characterization of viruses of biomedical interest but has been almost completely abandoned by diagnostic laboratories. Currently, the most frequently used approach for the detection of HAdV in clinical specimens is real-time qPCR targeting a region of the hexon gene, conserved among all genotypes described to the present. In the absence of typing, the detection of an HAdV in association with disease provides limited information. Molecular typing is therefore highly desirable and required in the epidemiological investigation of HAdV-associated disease. © 2023 Wiley Periodicals LLC. Basic Protocol 1: Virus isolation from plasma and whole blood Alternate Protocol 1: Virus isolation from stool Alternate Protocol 2: Virus isolation from respiratory specimens and urine Alternate Protocol 3: Virus isolation from tissue specimens Support Protocol: Inoculation of shell vials Basic Protocol 2: Extraction of highly pure viral genomic DNA from infected cells Basic Protocol 3: Molecular detection of human adenovirus by real-time PCR Basic Protocol 4: Molecular typing for basic identification of species and hexon type Basic Protocol 5: Typing human adenoviruses by next-generation whole-genome sequencing and analysis.
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Affiliation(s)
- Adriana E. Kajon
- Lovelace Biomedical Research Institute, 2425 Ridgecrest Drive SE, Albuquerque, New Mexico, USA +1(505) 348-9159
| | - Daryl M. Lamson
- Wadsworth Center, New York State Department of Health, David Axelrod Institute, 120 New Scotland Ave, Albany, New York, USA +1 (518) 402-4707
| | - Kirsten St. George
- Wadsworth Center, New York State Department of Health, David Axelrod Institute, 120 New Scotland Ave, Albany, New York, USA +1 (518) 402-4707
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3
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Maes M, Khokhar F, Wilkinson SAJ, Smith AD, Kovalenko G, Dougan G, Quick J, Loman NJ, Baker S, Curran MD, Skittrall JP, Houldcroft CJ. Multiplex MinION sequencing suggests enteric adenovirus F41 genetic diversity comparable to pre-COVID-19 era. Microb Genom 2023; 9:mgen000920. [PMID: 36748435 PMCID: PMC9973849 DOI: 10.1099/mgen.0.000920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/01/2022] [Indexed: 01/09/2023] Open
Abstract
Human adenovirus F41 causes acute gastroenteritis in children, and has recently been associated with an apparent increase in paediatric hepatitis of unknown aetiology in the UK, with further cases reported in multiple countries. Relatively little is known about the genetic diversity of adenovirus F41 in UK children; and it is unclear what, if any, impact the COVID-19 pandemic has had on viral diversity in the UK. Methods that allow F41 to be sequenced from clinical samples without the need for viral culture are required to provide the genomic data to address these questions. Therefore, we evaluated an overlapping-amplicon method of sequencing adenovirus genomes from clinical samples using Oxford Nanopore technology. We applied this method to a small sample of adenovirus-species-F-positive extracts collected as part of standard care in the East of England region in January-May 2022. This method produced genomes with >75 % coverage in 13/22 samples and >50 % coverage in 19/22 samples. We identified two F41 lineages present in paediatric patients in the East of England in 2022. Where F41 genomes from paediatric hepatitis cases were available (n=2), these genomes fell within the diversity of F41 from the UK and continental Europe sequenced before and after the 2020-2021 phase of the COVID-19 pandemic. Our analyses suggest that overlapping amplicon sequencing is an appropriate method for generating F41 genomic data from high-virus-load clinical samples, and currently circulating F41 viral lineages were present in the UK and Europe before the COVID-19 pandemic.
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Affiliation(s)
- Mailis Maes
- Clinical Microbiology and Public Health Laboratory, UK Health Security Agency, Addenbrooke’s Hospital, Cambridge, UK
| | - Fahad Khokhar
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0AW, UK
| | - Sam A. J. Wilkinson
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Birmingham, UK
| | - Andrew D. Smith
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Birmingham, UK
| | - Ganna Kovalenko
- Division of Virology, Department of Pathology, University of Cambridge, Cambridge, UK
| | - Gordon Dougan
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0AW, UK
- Department of Medicine, School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Joshua Quick
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Birmingham, UK
| | - Nicholas J. Loman
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Birmingham, UK
| | - Stephen Baker
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0AW, UK
- Department of Medicine, School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Martin D. Curran
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Jordan P. Skittrall
- Clinical Microbiology and Public Health Laboratory, UK Health Security Agency, Addenbrooke’s Hospital, Cambridge, UK
- Division of Virology, Department of Pathology, University of Cambridge, Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Abstract
Adenoviruses result in a wide array of clinical presentations, including primarily respiratory, gastrointestinal, genitourinary, or systemic infections. Although adenovirus causes mild disease limited to a single organ system in immunocompetent individuals, severe and life-threatening infections do rarely occur. Disseminated disease and severe localized disease resulting in significant morbidity and mortality have been well described in the immunocompromised populations. Although asymptomatic viremia, respiratory tract, and gastrointestinal infections are the most common disease in most transplant patients, renal transplant patients more commonly experience urinary tract infections, including hemorrhagic cystitis or nephritis. Diagnosis requires astute clinical awareness of the patient's clinical presentation that would be compatible with adenovirus combined with cultures, molecular testing, polymerase chain reaction, and tissue sampling. There is no Food and Drug Administration-approved treatment for adenovirus; however, several studies have evaluated therapeutic options including cidofovir, brincidofovir, and immunotherapy. This article will summarize our current understanding of adenovirus in the transplant population.
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Affiliation(s)
- Omar M. Al-Heeti
- Divisions of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Helen P. Cathro
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA
| | - Michael G. Ison
- Divisions of Infectious Diseases and Organ Transplantation, Transplant and Immunocompromised Host Infectious Diseases Service, Northwestern University Feinberg School of Medicine, Chicago, IL
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Liu W, Zhang L, Cai Y, Zhang Q, Chen D, Qiu S, Wang Y, Xu D, Gu S, Li X, Dai J, Liu Q, Zhou R, Tian X. Human Adenovirus Subtype 21a Isolates From Children With Severe Lower Respiratory Illness in China. Front Microbiol 2022; 13:924172. [PMID: 35783397 PMCID: PMC9244545 DOI: 10.3389/fmicb.2022.924172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Human adenovirus type 21 (HAdV-21) is an important pathogen associated with acute respiratory infection (ARI), but it was rarely reported and characterized so far. In this study, 151 of 1,704 (8.9%) pediatric patients (≤14 years old) hospitalized with ARI in Guangzhou, China in 2019 were positive for HAdV which was the third most frequently detected pathogen. Two HAdV-21-positive patients presented with severe lower respiratory illness and had similar initial symptoms at onset of illness. Then two HAdV-21 strains were isolated and characterized. The two HAdV-21 strains were sequenced and classified as subtype 21a with genomes closely related to strain BB/201903 found in Bengbu, China in March 2019. Phylogenetic analysis for whole genome and major antigen proteins of global HAdV-21 strains showed that HAdV-21 could be classified into two branches, branch 1 including genotype 21p, branch 2 including all other strains dividing into genotype 21a and 21b. There was no significant difference in the plaque size, or the replication curves between the two HAdV-21a strains and the prototype strain HAdV-21p AV-1645. However, there were five highly variable regions (HVR1, HVR3, HVR4, HVR5, and HVR7) in the hexon protein that varied between two branches. Mice immunized with one branch strain showed 2-4-fold lower neutralizing antibody titers against another branch strain. In summary, this study firstly reported two HAdV-21a infections of children in China, characterized two isolates of HAdV-21a associated with severe lower respiratory illness; our results could be important for understanding the HAdV-21 epidemiology and pathogenic, and for developing HAdV-21 vaccine and drug.
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Affiliation(s)
- Wenkuan Liu
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health Guangzhou Medical University, Guangzhou, China
| | - Li Zhang
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health Guangzhou Medical University, Guangzhou, China
| | - Yong Cai
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health Guangzhou Medical University, Guangzhou, China
| | - Qiong Zhang
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health Guangzhou Medical University, Guangzhou, China
- Guangzhou Laboratory, Guangzhou, China
| | - Dehui Chen
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health Guangzhou Medical University, Guangzhou, China
| | - Shuyan Qiu
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health Guangzhou Medical University, Guangzhou, China
| | - Yanqun Wang
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health Guangzhou Medical University, Guangzhou, China
| | - Duo Xu
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health Guangzhou Medical University, Guangzhou, China
| | - Shujun Gu
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health Guangzhou Medical University, Guangzhou, China
| | - Xiao Li
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health Guangzhou Medical University, Guangzhou, China
| | - Jing Dai
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health Guangzhou Medical University, Guangzhou, China
| | - Qian Liu
- Scientific Research Center, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
- Qian Liu,
| | - Rong Zhou
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health Guangzhou Medical University, Guangzhou, China
- Guangzhou Laboratory, Guangzhou, China
- Rong Zhou,
| | - Xingui Tian
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health Guangzhou Medical University, Guangzhou, China
- *Correspondence: Xingui Tian,
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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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7
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Souza YFVPD, Souza EVD, Azevedo LSD, Medeiros RS, Timenetsky MDCST, Luchs A. Enteric adenovirus epidemiology from historical fecal samples in Brazil (1998-2005): Pre-rotavirus vaccine era. INFECTION GENETICS AND EVOLUTION 2021; 94:105007. [PMID: 34293482 DOI: 10.1016/j.meegid.2021.105007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 06/23/2021] [Accepted: 07/15/2021] [Indexed: 01/16/2023]
Abstract
Human adenovirus (HAdV) is recognized as frequent cause of acute gastroenteritis and enteric viruses can be preserved in frozen stored feces for long periods of times. The purpose of the present study was to investigate enteric HAdV genotypic diversity in archival fecal specimens stored from 1998 to 2005 in order to understand the natural history of HAdV in diarrheal patients in Brazil before rotavirus vaccine introduction. A total of 3346 specimens were tested for HAdV using conventional PCR. Genotypes were identified by sequencing. HAdV was detected in 6.8% (228/3346). Positivity was higher in children ≤ 5 years and males (p < 0.05). HAdV was most frequently observed during winter and spring seasons (p < 0.05). HAdV-F41 was the most prevalent genotype (59.2%;135/228), followed by HAdV-F40 (16.2%;37/228), HAdV-C1 (5.2%;12/228), HAdV-C2 (5.2%;12/228), HAdV-C5 (3.1%;7/228), HAdV-A12 (1.3%;3/228), HAdV-E4 (0.9%;2/228), HAdV-B3 (0.9%;2/228) and HAdV-B21 (0.4%;1/228). In 7.6% (17/228) only species D could be defined. HAdV-E4 strains were phylogenetic analyzed and classified as lineage (a)-like PG II. HAdV prevalence remained stable in Brazilian population, regardless rotavirus vaccine introduction. The predominant HAdV genotypes detected did not change over time, highlighting a high diversity of circulating strains in the country throughout decades. Due to the historical lack of HAdV genotyping surveillance in Brazil, HAdV-E4 epidemiology is virtually unknown in the country. The present study contributed significantly to the understanding of the natural history of HAdV in diarrheal patients in Brazil. The acquired data are important for clinical diagnosis, particularly for studies investigating enteric viruses' prevalence and molecular epidemiology of archival clinical specimens.
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Affiliation(s)
| | - Ellen Viana de Souza
- Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo, Brazil
| | | | | | | | - Adriana Luchs
- Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo, Brazil.
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Georgi F, Andriasyan V, Witte R, Murer L, Hemmi S, Yu L, Grove M, Meili N, Kuttler F, Yakimovich A, Turcatti G, Greber UF. The FDA-Approved Drug Nelfinavir Inhibits Lytic Cell-Free but Not Cell-Associated Nonlytic Transmission of Human Adenovirus. Antimicrob Agents Chemother 2020; 64:e01002-20. [PMID: 32601166 PMCID: PMC7449217 DOI: 10.1128/aac.01002-20] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 06/19/2020] [Indexed: 02/07/2023] Open
Abstract
Adenoviruses (AdVs) are prevalent and give rise to chronic and recurrent disease. Human AdV (HAdV) species B and C, such as HAdV-C2, -C5, and -B14, cause respiratory disease and constitute a health threat for immunocompromised individuals. HAdV-Cs are well known for lysing cells owing to the E3 CR1-β-encoded adenovirus death protein (ADP). We previously reported a high-throughput image-based screening framework and identified an inhibitor of HAdV-C2 multiround infection, nelfinavir mesylate. Nelfinavir is the active ingredient of Viracept, an FDA-approved inhibitor of human immunodeficiency virus (HIV) aspartyl protease that is used to treat AIDS. It is not effective against single-round HAdV infections. Here, we show that nelfinavir inhibits lytic cell-free transmission of HAdV, indicated by the suppression of comet-shaped infection foci in cell culture. Comet-shaped foci occur upon convection-based transmission of cell-free viral particles from an infected cell to neighboring uninfected cells. HAdV lacking ADP was insensitive to nelfinavir but gave rise to comet-shaped foci, indicating that ADP enhances but is not required for cell lysis. This was supported by the notion that HAdV-B14 and -B14p1 lacking ADP were highly sensitive to nelfinavir, although HAdV-A31, -B3, -B7, -B11, -B16, -B21, -D8, -D30, and -D37 were less sensitive. Conspicuously, nelfinavir uncovered slow-growing round HAdV-C2 foci, independent of neutralizing antibodies in the medium, indicative of nonlytic cell-to-cell transmission. Our study demonstrates the repurposing potential of nelfinavir with postexposure efficacy against different HAdVs and describes an alternative nonlytic cell-to-cell transmission mode of HAdV.
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Affiliation(s)
- Fanny Georgi
- Department of Molecular Life Sciences, University of Zurich, Zurich, Switzerland
| | - Vardan Andriasyan
- Department of Molecular Life Sciences, University of Zurich, Zurich, Switzerland
| | - Robert Witte
- Department of Molecular Life Sciences, University of Zurich, Zurich, Switzerland
| | - Luca Murer
- Department of Molecular Life Sciences, University of Zurich, Zurich, Switzerland
| | - Silvio Hemmi
- Department of Molecular Life Sciences, University of Zurich, Zurich, Switzerland
| | - Lisa Yu
- Department of Molecular Life Sciences, University of Zurich, Zurich, Switzerland
| | - Melanie Grove
- Department of Molecular Life Sciences, University of Zurich, Zurich, Switzerland
| | - Nicole Meili
- Department of Molecular Life Sciences, University of Zurich, Zurich, Switzerland
| | - Fabien Kuttler
- Biomolecular Screening Facility, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Artur Yakimovich
- Department of Molecular Life Sciences, University of Zurich, Zurich, Switzerland
- MRC Laboratory for Molecular Cell Biology, University College London, London, United Kingdom
- Artificial Intelligence for Life Sciences CIC, London, United Kingdom
| | - Gerardo Turcatti
- Biomolecular Screening Facility, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Urs F Greber
- Department of Molecular Life Sciences, University of Zurich, Zurich, Switzerland
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9
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Collins ND, Adhikari A, Yang Y, Kuschner RA, Karasavvas N, Binn LN, Walls SD, Graf PCF, Myers CA, Jarman RG, Hang J. Live Oral Adenovirus Type 4 and Type 7 Vaccine Induces Durable Antibody Response. Vaccines (Basel) 2020; 8:vaccines8030411. [PMID: 32718082 PMCID: PMC7564809 DOI: 10.3390/vaccines8030411] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/18/2020] [Accepted: 07/21/2020] [Indexed: 11/26/2022] Open
Abstract
Human adenoviruses (AdV) are mostly associated with minimal pathology. However, more severe respiratory tract infections and acute respiratory diseases, most often caused by AdV-4 and AdV-7, have been reported. The only licensed vaccine in the United States, live oral AdV-4 and AdV-7 vaccine, is indicated for use in the military, nearly exclusively in recruit populations. The excellent safety profile and prominent antibody response of the vaccine is well established by placebo-controlled clinical trials, while, long-term immunity of vaccination has not been studied. Serum samples collected over 6 years from subjects co-administered live oral AdV-4 and AdV-7 vaccine in 2011 were evaluated to determine the duration of the antibody response. Group geometric mean titers (GMT) at 6 years post vaccination compared to previous years evaluated were not significantly different for either AdV-4 or AdV-7 vaccine components. There were no subjects that demonstrated waning neutralization antibody (NAb) titers against AdV-4 and less than 5% of subjects against AdV-7. Interestingly, there were subjects that had a four-fold increase in NAb titers against either AdV-4 or AdV-7, at various time points post vaccination, suggesting either homotypic or heterotypic re-exposure. This investigation provided strong evidence that the live oral AdV-4 and AdV-7 vaccine induced long-term immunity to protect from AdV-4 and AdV-7 infections.
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Affiliation(s)
- Natalie D. Collins
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
- Correspondence: ; Tel.: +1-301-319-3062
| | - Anima Adhikari
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
| | - Yu Yang
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
| | - Robert A. Kuschner
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
| | - Nicos Karasavvas
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
| | - Leonard N. Binn
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
| | - Shannon D. Walls
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
| | - Paul C. F. Graf
- Naval Health Research Center, San Diego, CA 92186, USA; (P.C.F.G.); (C.A.M.)
- U.S. Navy Medical Research Unit Six, Lima 07006, Peru
| | | | - Richard G. Jarman
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
| | - Jun Hang
- Viral Diseases Branch, Walter Reed Army Institute for Research, Silver Spring, MD 20910, USA; (A.A.); (Y.Y.); (R.A.K.); (N.K.); (L.N.B.); (S.D.W.); (R.G.J.); (J.H.)
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10
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Hang J, Kajon AE, Graf PCF, Berry IM, Yang Y, Sanborn MA, Fung CK, Adhikari A, Balansay-Ames MS, Myers CA, Binn LN, Jarman RG, Kuschner RA, Collins ND. Human Adenovirus Type 55 Distribution, Regional Persistence, and Genetic Variability. Emerg Infect Dis 2020; 26:1497-1505. [PMID: 32568062 PMCID: PMC7323512 DOI: 10.3201/eid2607.191707] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Human adenovirus type 55 (HAdV-55) causes acute respiratory disease of variable severity and has become an emergent threat in both civilian and military populations. HAdV-55 infection is endemic to China and South Korea, but data from other regions and time periods are needed for comprehensive assessment of HAdV-55 prevalence from a global perspective. In this study, we subjected HAdV-55 isolates from various countries collected during 1969-2018 to whole-genome sequencing, genomic and proteomic comparison, and phylogenetic analyses. The results show worldwide distribution of HAdV-55; recent strains share a high degree of genomic homogeneity. Distinct strains circulated regionally for several years, suggesting persistent local transmission. Several cases of sporadic introduction of certain strains to other countries were documented. Among the identified amino acid mutations distinguishing HAdV-55 strains, some have potential impact on essential viral functions and may affect infectivity and transmission.
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11
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Ye F, Han Y, Zhu J, Li P, Zhang Q, Lin Y, Wang T, Lv H, Wang C, Wang C, Zhang J. First Identification of Human Adenovirus Subtype 21a in China With MinION and Illumina Sequencers. Front Genet 2020; 11:285. [PMID: 32318094 PMCID: PMC7155751 DOI: 10.3389/fgene.2020.00285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/09/2020] [Indexed: 12/03/2022] Open
Abstract
Human adenoviruses (HAdVs) have been demonstrated to cause a diversity of diseases among children and adults. The circulation of human adenovirus type 21 (HAdV21) has been mainly documented within closed environments in several countries. Nonetheless, respiratory infections or outbreaks due to HAdV21 have never been reported in China. MinION and Illumina platforms were employed to identify the potential pathogen from a throat swab. Discrepancies between MinION and Illumina sequencing were validated and corrected via polymerase chain reaction (PCR). Genomic characterization and recombinant event detection were then performed. Among the 35,466 high-quality MinION reads, a total of 5,999 reads (16.91%) could be aligned to HAdV21 reference genomes (genome sizes ≈35.3 kb), among which 20 had a length of >30 kb. A genome sequence assembled from MinION reads was further classified as HAdV subtype 21a. Random downsampling revealed as few as 500 nanopore reads could cover ≥96.49% of current genome. Illumina sequencing displayed good consistency (pairwise nucleotide identity = 99.91%) with MinION sequencing but with 31 discrepancies that were further validated and confirmed by PCR coupled with Sanger sequencing. Restriction enzymes such as BamHI and KpnI were able to distinguish the present genome from HAdV21 prototype and HAdV21b. Phylogenetic analysis employing whole-genome sequences placed our genome with members only from subtype 21a. Common features among HAdV21a strains were identified, including polymorphisms discovered in penton and 100 kDa hexon assembly–associated proteins and a recombinant event in the E4 gene. Using MinION and Illumina sequencers, we identified the first HAdV21a strain from China, which could provide key genomic data for disease control and epidemiological investigations.
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Affiliation(s)
- Fuqiang Ye
- Department of Disease Control and Prevention, Center for Disease Control and Prevention of Eastern Theater Command, Nanjing, China
| | - Yifang Han
- Department of Disease Control and Prevention, Center for Disease Control and Prevention of Eastern Theater Command, Nanjing, China
| | - Juanjuan Zhu
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, China
| | - Peng Li
- Center for Infectious Disease Control, Center for Disease Control and Prevention of People's Liberation Army of China, Beijing, China
| | - Qi Zhang
- Department of Disease Control and Prevention, Center for Disease Control and Prevention of Eastern Theater Command, Nanjing, China
| | - Yanfeng Lin
- Center for Infectious Disease Control, Center for Disease Control and Prevention of People's Liberation Army of China, Beijing, China
| | - Taiwu Wang
- Department of Disease Control and Prevention, Center for Disease Control and Prevention of Eastern Theater Command, Nanjing, China
| | - Heng Lv
- Department of Disease Control and Prevention, Center for Disease Control and Prevention of Eastern Theater Command, Nanjing, China
| | - Changjun Wang
- Center for Infectious Disease Control, Center for Disease Control and Prevention of People's Liberation Army of China, Beijing, China
| | - Chunhui Wang
- Department of Disease Control and Prevention, Center for Disease Control and Prevention of Eastern Theater Command, Nanjing, China
| | - Jinhai Zhang
- Department of Disease Control and Prevention, Center for Disease Control and Prevention of Eastern Theater Command, Nanjing, China
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12
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Characteristics of fever and response to antipyretic therapy in military personnel with adenovirus-positive community-acquired pneumonia. Mil Med Res 2020; 7:6. [PMID: 32079545 PMCID: PMC7033854 DOI: 10.1186/s40779-020-00235-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 02/12/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In 2014, an outbreak of adenoviral pneumonia occurred in the Korean military training center. However, there are limited data on the characteristics of the fever and its response to antipyretic therapy in immunocompetent adults with adenovirus-positive community-acquired pneumonia (CAP). METHODS The medical records of the patients who were admitted to the Armed Forces Chuncheon Hospital for the treatment of CAP between January 2014 and December 2016 were retrospectively analyzed. The patients were divided into three groups, namely, the adenovirus-positive (Adv) group, the adenovirus-negative (Non-Adv) group and the unknown pathogen group, according to the results of a polymerase chain reaction (PCR) test and sputum culture used to measure adenovirus and other bacteria or viruses in respiratory specimens. We evaluated and compared the demographics, clinicolaboratory findings and radiological findings upon admission between the two groups. RESULTS Out of the 251 military personnel with CAP during the study periods, 67 were classified into the Adv group, while 134 were classified into the Non-Adv group and 50 were classified into the unknown pathogen group. The patients in the Adv group had a longer duration of fever after admission (3.2 ± 1.6 vs. 1.9 ± 1.2 vs. 2.2 ± 1.5 days, P = 0.018) and symptom onset (5.8 ± 2.2 vs. 3.9 ± 2.5 vs. 3.7 ± 2.0 days, P = 0.006) than patients in the Non-Adv and unknown pathogen groups, respectively. The patients in the Adv group had a higher mean temperature at admission (37.8 ± 0.3 vs. 37.3 ± 0.3 vs. 37.3 ± 0.3, P = 0.005), and more patients were observed over 40 and 39 to 40(14.9% vs. 2.2% vs. 4.0%, 35.8% vs. 3.7% vs. 6.0%, P < 0.001) than those in the Non-Adv and unknown pathogen groups, respectively. The Adv group more commonly had no response or exhibited adverse events after antipyretic treatment compared to the Non-Adv group (17.9% vs. 1.5%, 35.0% vs. 4.3%, P < 0.001, P = 0.05, respectively). In addition, the time from admission to overall clinical stabilization was significantly longer in the patients in the Adv group than in those in the Non-Adv group (4.3 ± 2.8 vs. 2.9 ± 1.8 days, P = 0.034, respectively). Furthermore, no significant difference in the length of hospital stay was observed between the two groups, and no patient died in either group. CONCLUSION In this study, Adv-positive CAP in immunocompetent military personnel patients had distinct fever characteristics and responses to antipyretic treatment.
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13
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Wang R, Lu J, Zhou Q, Chen L, Huang Y, Yu Y, Yang Z. A Murine Monoclonal Antibody With Potent Neutralization Ability Against Human Adenovirus 7. Front Cell Infect Microbiol 2019; 9:417. [PMID: 31867291 PMCID: PMC6904267 DOI: 10.3389/fcimb.2019.00417] [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: 08/17/2019] [Accepted: 11/21/2019] [Indexed: 12/29/2022] Open
Abstract
B1-type human adenoviruses (HAdVs) HAdV-3, HAdV-7, and HAdV-55 have caused epidemics in North America, Asia, and Europe. However, to date, no adenovirus vaccines or antiviral drugs have been approved for general use. In the present work, a scFv-phage immune library was constructed and mouse monoclonal antibody (MMAb) 10G12 was obtained through selection. 10G12 is specific for HAdV-7 and binds the hexon loop1 and loop2 (LP12), resulting in strong neutralization activity against HAdV-7. Additionally, it is stable in serum and buffer at various pH values. The findings provide insight into adenovirus and antibody responses and may facilitate the design and development of adenovirus vaccines and antiviral drugs.
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Affiliation(s)
- Rong Wang
- Laboratory of Protein Engineering, Beijing Institute of Biotechnology, Beijing, China
| | - Jiansheng Lu
- Laboratory of Protein Engineering, Beijing Institute of Biotechnology, Beijing, China
| | - Quan Zhou
- Laboratory of Protein Engineering, Beijing Institute of Biotechnology, Beijing, China
| | - Lei Chen
- Laboratory of Protein Engineering, Beijing Institute of Biotechnology, Beijing, China
| | - Ying Huang
- Laboratory of Protein Engineering, Beijing Institute of Biotechnology, Beijing, China
| | - Yunzhou Yu
- Laboratory of Protein Engineering, Beijing Institute of Biotechnology, Beijing, China
| | - Zhixin Yang
- Laboratory of Protein Engineering, Beijing Institute of Biotechnology, Beijing, China
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14
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Gentile G, Fréchard G, Dia A, Buzens A, Vives R, Jego M, Pommier de Santi V, Simon F. Incidence of acute respiratory tract infections (2006-2015) and influenza (2006-2013) among French armed forces. Med Mal Infect 2019; 50:689-695. [PMID: 31759689 DOI: 10.1016/j.medmal.2019.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/21/2018] [Accepted: 10/24/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES We aimed to assess the incidence of respiratory tract infections in military settings between 2006 and 2015. PATIENTS AND METHODS We performed a retrospective epidemiological study of the entire military population from 2006 to 2015. Comprehensive data was collected from all medical centers, operational medical units, naval services, and army training hospitals and provided by the epidemiological surveillance of the armies. RESULTS The annual average population of the study was 331,394 soldiers. For acute respiratory tract infections (2006-2015), 22,818 cases were reported in metropolitan France, 3,211 cases in French overseas territories, 1,595 cases in the French Navy, and 1,318 cases in external military operations for a total of 28,942 cases. For influenza (2006-2013), 934 cases were reported in metropolitan France, 101 cases in French overseas territories, and 23 cases in external operations, for a total of 1,058 cases. The mean incidence rate of acute respiratory tract infections expressed as case number per 1,000 person-years (PY) was 8.7 PY (95% CI [8.6-8.8]) with an exceptional increased incidence rate in 2009 (25.9 PY, 95% CI [25.4-26.4]). The mean incidence rate of influenza was 0.35 PY (95% CI [0.33-0.37]) with a peak incidence rate of 1.9 PY in 2009. CONCLUSION Acute respiratory tract infections are at the forefront of infectious episodes in the French armies. Although not necessarily severe, current prevention measures are not enough to reduce the incidence threshold of these infections and need to be improved.
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Affiliation(s)
- G Gentile
- Département universitaire de médecine générale, faculté de médecine, Aix Marseille université, 13885 Marseille, France; Inserm 1106, Institut des neurosciences des systèmes, Aix Marseille université, 13885 Marseille, France; Comité pédagogique, hôpital d'instruction des Armées Laveran, 13384 Marseille, France.
| | - G Fréchard
- Département universitaire de médecine générale, faculté de médecine, Aix Marseille université, 13885 Marseille, France
| | - A Dia
- Centre d'épidémiologie et de santé publique des armées, 13014 Marseille, France
| | - A Buzens
- Centre d'épidémiologie et de santé publique des armées, 13014 Marseille, France
| | - R Vives
- Centre d'épidémiologie et de santé publique des armées, 13014 Marseille, France
| | - M Jego
- Département universitaire de médecine générale, faculté de médecine, Aix Marseille université, 13885 Marseille, France; Centre d'études et de recherche sur les services de santé et qualité de vie (CERESS), Aix Marseille université, 13385 Marseille, France
| | - V Pommier de Santi
- Centre d'épidémiologie et de santé publique des armées, 13014 Marseille, France
| | - F Simon
- Comité pédagogique, hôpital d'instruction des Armées Laveran, 13384 Marseille, France; Department of infectious diseases and tropical medicine, Laveran military teaching hospital, 13384 Marseille, France
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15
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A Zoonotic Adenoviral Human Pathogen Emerged through Genomic Recombination among Human and Nonhuman Simian Hosts. J Virol 2019; 93:JVI.00564-19. [PMID: 31243128 DOI: 10.1128/jvi.00564-19] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 06/18/2019] [Indexed: 12/14/2022] Open
Abstract
Genomics analysis of a historically intriguing and predicted emergent human adenovirus (HAdV) pathogen, which caused pneumonia and death, provides insight into a novel molecular evolution pathway involving "ping-pong" zoonosis and anthroponosis. The genome of this promiscuous pathogen is embedded with evidence of unprecedented multiple, multidirectional, stable, and reciprocal cross-species infections of hosts from three species (human, chimpanzee, and bonobo). This recombinant genome, typed as HAdV-B76, is identical to two recently reported simian AdV (SAdV) genomes isolated from chimpanzees and bonobos. Additionally, the presence of a critical adenoviral replication element found in HAdV genomes, in addition to genes that are highly similar to counterparts in other HAdVs, reinforces its potential as a human pathogen. Reservoirs in nonhuman hosts may explain periods of apparent absence and then reemergence of human adenoviral pathogens, as well as present pathways for the genesis of those thought to be newly emergent. The nature of the HAdV-D76 genome has implications for the use of SAdVs as gene delivery vectors in human gene therapy and vaccines, selected to avoid preexisting and potentially fatal host immune responses to HAdV.IMPORTANCE An emergent adenoviral human pathogen, HAdV-B76, associated with a fatality in 1965, shows a remarkable degree of genome identity with two recently isolated simian adenoviruses that contain cross-species genome recombination events from three hosts: human, chimpanzee, and bonobo. Zoonosis (nonhuman-to-human transmission) and anthroponosis (human to nonhuman transmission) may play significant roles in the emergence of human adenoviral pathogens.
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16
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Pfortmueller CA, Barbani MT, Schefold JC, Hage E, Heim A, Zimmerli S. Severe acute respiratory distress syndrome (ARDS) induced by human adenovirus B21: Report on 2 cases and literature review. J Crit Care 2019; 51:99-104. [PMID: 30798099 PMCID: PMC7172394 DOI: 10.1016/j.jcrc.2019.02.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 09/29/2018] [Accepted: 02/12/2019] [Indexed: 01/01/2023]
Abstract
Severe pneumonia and ARDS caused by human adenovirus B21 infections (HAdV-B21) is a rare, but a devastating disease with rapid progression to multiorgan failure and death. However, only a few cases were reported so far. Infections appear associated with increased disease severity and higher mortality in infected critically ill patients. Possible factors contributing to infection are underlying psychiatric disease resulting in institutionalization of respective patients, and polytoxicomania. Controlled data on the therapy of severe adenovirus infections are lacking and remains experimental. In conclusion, data on HAdV-B21 infections causing severe pneumonia or ARDS are scarce. Controlled clinical trials on the therapy of adenovirus pneumonia are non existent and thus there is no established therapy so far. ICU physicians should be aware of this potentially devastating disease and further studies are needed.
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MESH Headings
- Adenovirus Infections, Human/complications
- Adenovirus Infections, Human/diagnosis
- Adenovirus Infections, Human/diagnostic imaging
- Adenovirus Infections, Human/virology
- Adenoviruses, Human/genetics
- Adenoviruses, Human/isolation & purification
- Adult
- Diagnosis, Differential
- Female
- Humans
- Male
- Middle Aged
- Pneumonia, Viral/complications
- Pneumonia, Viral/diagnosis
- Pneumonia, Viral/diagnostic imaging
- Pneumonia, Viral/virology
- Respiratory Distress Syndrome/complications
- Respiratory Distress Syndrome/diagnosis
- Respiratory Distress Syndrome/diagnostic imaging
- Respiratory Distress Syndrome/virology
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Affiliation(s)
- Carmen Andrea Pfortmueller
- Department of Intensive Care, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland.
| | - Maria Teresa Barbani
- Institute for Infectious Diseases, University of Bern, Friedbuehlstrasse 51, 3010 Bern, Switzerland.
| | - Joerg Christian Schefold
- Department of Intensive Care, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland.
| | - Elias Hage
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - Albert Heim
- Institute of Virology, Hannover Medical School, Hannover, Germany.
| | - Stefan Zimmerli
- Institute for Infectious Diseases, University of Bern, Friedbuehlstrasse 51, 3010 Bern, Switzerland; Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland.
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17
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Kajon AE, Lamson DM, St George K. Emergence and re-emergence of respiratory adenoviruses in the United States. Curr Opin Virol 2019; 34:63-69. [PMID: 30654272 DOI: 10.1016/j.coviro.2018.12.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/11/2018] [Indexed: 01/24/2023]
Abstract
Human adenoviruses (HAdVs) are prevalent causes of acute respiratory disease (ARD) in military and civilian communities. Over the last 20 years, collaborative efforts between US public health, military and academic laboratories have gathered comprehensive data documenting the emergence and re-emergence of specific HAdV types in association with outbreaks and unrelated cases of ARD, which have attracted national attention. New or reemerging HAdVs have included genomic variants of HAdV-B14, HAdV-B7, and HAdV-E4. Detailed molecular characterizations of virus strains are essential to understand the etiology and epidemiology of HAdV infections. The continuation of such studies is important for ongoing assessment of the national and global evolution of respiratory HAdVs and to inform decisions regarding antiviral drug and vaccine development and implementation.
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Affiliation(s)
- Adriana E Kajon
- Lovelace Respiratory Research Institute, 2425 Ridgecrest Drive SE, Albuquerque, NM 87108, USA
| | - Daryl M Lamson
- Wadsworth Center, New York State Department of Health, 120 New Scotland Avenue, Albany, NY 12208, USA
| | - Kirsten St George
- Wadsworth Center, New York State Department of Health, 120 New Scotland Avenue, Albany, NY 12208, USA.
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18
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Houldcroft CJ, Roy S, Morfopoulou S, Margetts BK, Depledge DP, Cudini J, Shah D, Brown JR, Romero EY, Williams R, Cloutman-Green E, Rao K, Standing JF, Hartley JC, Breuer J. Use of Whole-Genome Sequencing of Adenovirus in Immunocompromised Pediatric Patients to Identify Nosocomial Transmission and Mixed-Genotype Infection. J Infect Dis 2018; 218:1261-1271. [PMID: 29917114 DOI: 10.1093/infdis/jiy323] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/26/2018] [Indexed: 01/26/2023] Open
Abstract
Background Adenoviruses are significant pathogens for the immunocompromised, arising from primary infection or reinfection. Serotyping is insufficient to support nosocomial transmission investigations. We investigate whether whole-genome sequencing (WGS) provides clinically relevant information on transmission among patients in a pediatric tertiary hospital. Methods We developed a target-enriched adenovirus WGS technique for clinical samples and retrospectively sequenced 107 adenovirus-positive residual diagnostic samples, including viremias (>5 × 104 copies/mL), from 37 patients collected January 2011-March 2016. Whole-genome sequencing was used to determine genotype and for phylogenetic analysis. Results Adenovirus sequences were recovered from 105 of 107 samples. Full genome sequences were recovered from all 20 nonspecies C samples and from 36 of 85 species C viruses, with partial genome sequences recovered from the rest. Whole-genome phylogenetic analysis suggested linkage of 3 genotype A31 cases and uncovered an unsuspected epidemiological link to an A31 infection first detected on the same ward 4 years earlier. In 9 samples from 1 patient who died, we identified a mixed genotype adenovirus infection. Conclusions Adenovirus WGS from clinical samples is possible and useful for genotyping and molecular epidemiology. Whole-genome sequencing identified likely nosocomial transmission with greater resolution than conventional genotyping and distinguished between adenovirus disease due to single or multiple genotypes.
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Affiliation(s)
- Charlotte J Houldcroft
- Infection, Immunity and Inflammation Section, UCL Great Ormond Street Institute of Child Health, University College London, United Kingdom.,Division of Infection and Immunity, University College London, United Kingdom
| | - Sunando Roy
- Division of Infection and Immunity, University College London, United Kingdom
| | - Sofia Morfopoulou
- Division of Infection and Immunity, University College London, United Kingdom
| | - Ben K Margetts
- Infection, Immunity and Inflammation Section, UCL Great Ormond Street Institute of Child Health, University College London, United Kingdom.,Centre for Computation, Mathematics and Physics in the Life Sciences and Experimental Biology, University College London, United Kingdom.,Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Daniel P Depledge
- Infection, Immunity and Inflammation Section, UCL Great Ormond Street Institute of Child Health, University College London, United Kingdom
| | - Juliana Cudini
- Division of Infection and Immunity, University College London, United Kingdom
| | - Divya Shah
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Julianne R Brown
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Erika Yara Romero
- Division of Infection and Immunity, University College London, United Kingdom
| | - Rachel Williams
- Division of Infection and Immunity, University College London, United Kingdom
| | - Elaine Cloutman-Green
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Kanchan Rao
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Joseph F Standing
- Infection, Immunity and Inflammation Section, UCL Great Ormond Street Institute of Child Health, University College London, United Kingdom.,Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - John C Hartley
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Judith Breuer
- Infection, Immunity and Inflammation Section, UCL Great Ormond Street Institute of Child Health, University College London, United Kingdom.,Division of Infection and Immunity, University College London, United Kingdom.,Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
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19
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Philo SE, Anderson BD, Costa SF, Henshaw N, Lewis SS, Reynolds JM, Jayakumar J, Su YCF, Gray GC. Adenovirus Type 21 Outbreak Among Lung Transplant Patients at a Large Tertiary Care Hospital. Open Forum Infect Dis 2018; 5:ofy188. [PMID: 30151413 PMCID: PMC6105090 DOI: 10.1093/ofid/ofy188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 07/27/2018] [Indexed: 12/20/2022] Open
Abstract
Here we summarize an April 2016, 7-patient cluster of human adenovirus (HAdV) infections in a cardiothoracic surgery intensive care unit. We show that the patients were infected with a single HAdV21b type. Rapid HAdV typing diagnostics and effective antiviral interventions are needed for immunocompromised patients suffering from HAdV infections.
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Affiliation(s)
- Sarah E Philo
- Division of Infectious Disease, School of Medicine, Duke University, Durham, North Carolina.,Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Benjamin D Anderson
- Division of Infectious Disease, School of Medicine, Duke University, Durham, North Carolina.,Duke Global Health Institute, Duke University, Durham, North Carolina.,Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Sylvia F Costa
- Division of Infectious Disease, School of Medicine, Duke University, Durham, North Carolina
| | - Nancy Henshaw
- Department of Pathology, School of Medicine, Duke University, Durham, North Carolina
| | - Sarah S Lewis
- Division of Infectious Disease, School of Medicine, Duke University, Durham, North Carolina
| | - John M Reynolds
- Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Hospital, Durham, North Carolina
| | - Jayanthi Jayakumar
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Yvonne C F Su
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Gregory C Gray
- Division of Infectious Disease, School of Medicine, Duke University, Durham, North Carolina.,Duke Global Health Institute, Duke University, Durham, North Carolina.,Global Health Research Center, Duke Kunshan University, Kunshan, China.,Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
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20
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Barnadas C, Schmidt DJ, Fischer TK, Fonager J. Molecular epidemiology of human adenovirus infections in Denmark, 2011-2016. J Clin Virol 2018; 104:16-22. [PMID: 29704734 PMCID: PMC7106356 DOI: 10.1016/j.jcv.2018.04.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 04/09/2018] [Accepted: 04/17/2018] [Indexed: 12/19/2022]
Abstract
We developed new primers to improve genotyping of HAdV D. Six out of seven HAdV species from at least 13 HAdV types were identified. Young children (<5 years old) were more likely to be positive for HAdV. Co-infections with other gastrointestinal or respiratory viruses were common. A HAdV surveillance system is required to monitor circulating species and types.
Background Human adenoviruses (HAdVs) can cause respiratory tract infections, conjunctivitis, diarrhoea and outbreaks have been reported. However, little is known about the disease burden and the molecular epidemiology of HAdV. Objectives To retrospectively perform a molecular characterization of HAdV positive samples received at Statens Serum Institut during the period 2011–2016 and to compare this with demographic information, geographic location, sample collection date and type and co-infection with other viral pathogens. Study design 152 HAdV positive samples were genotyped by Sanger sequencing of a fragment of the hexon gene using published primers along with a newly developed primer set for enhanced genotyping of HAdV D. Phylogenetic analysis was used for genotyping and genotypes were compared with epidemiological information. In addition, HAdV burden and co-infection was evaluated for samples tested in laboratory analysis packages. Results Six out of seven HAdV species were identified and represented by 13 types. Young children (<5 years old) were more likely to be positive for HAdV and co-infections with other gastrointestinal or respiratory viruses were common. Possible outbreaks of ocular infections due to HAdV D could not be confirmed. Conclusion A diverse set of HAdV species were circulating in Denmark in the study period and although possible transmission clusters were identified, this could not be verified with current genotyping methods Young children were commonly affected by HAdV infection and co-infections with other viral pathogens were frequent suggesting a possible underestimation of the real HAdV burden.
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Affiliation(s)
- Céline Barnadas
- European Public Health Microbiology (EUPHEM) Training Programme, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; Virus & Microbiological Special Diagnostics, Infectious Disease Preparedness, Statens Serum Institute, Copenhagen, Denmark
| | - Dennis Jelsbak Schmidt
- Virus & Microbiological Special Diagnostics, Infectious Disease Preparedness, Statens Serum Institute, Copenhagen, Denmark
| | - Thea K Fischer
- Virus & Microbiological Special Diagnostics, Infectious Disease Preparedness, Statens Serum Institute, Copenhagen, Denmark; Department of Infectious Diseases and Centre for Global Health, University of Southern Denmark, Denmark
| | - Jannik Fonager
- Virus & Microbiological Special Diagnostics, Infectious Disease Preparedness, Statens Serum Institute, Copenhagen, Denmark.
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Abstract
Adenoviruses are a highly prevalent infection that can cause a range of clinical syndromes in immunocompromised patients, ranging from localized disease of the respiratory tract, gastrointestinal tract, or urinary tract to disseminated disease. Adenovirus infections may develop in this unique population as the result of primary infection or reactivation of latent virus. Disease can be potentially progressive with high rates of mortality in patients with pneumonia and disseminated disease. Fortunately, cidofovir and its lipid ester, brincidofovir, appear to be effective for the treatment of adenovirus, although neither is specifically approved for this indication. Adenovirus should always be considered when immunocompromised patients present with any clinical syndrome that could be compatible with adenoviral infection. Once disease is suspected, cultures or molecular testing of appropriate specimens should be obtained and blood should be sent for adenovirus polymerase chain reaction (PCR) whenever adenovirus is suspected. Monitoring of quantitative viral loads in blood is helpful in predicting response to therapy with a significant drop (>1 log) associated with a higher probability of clinical response.
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22
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Selection Pressure in the Human Adenovirus Fiber Knob Drives Cell Specificity in Epidemic Keratoconjunctivitis. J Virol 2016; 90:9598-9607. [PMID: 27512073 PMCID: PMC5068513 DOI: 10.1128/jvi.01010-16] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 08/05/2016] [Indexed: 11/20/2022] Open
Abstract
Human adenoviruses (HAdVs) contain seven species (HAdV-A to -G), each associated with specific disease conditions. Among these, HAdV-D includes those viruses associated with epidemic keratoconjunctivitis (EKC), a severe ocular surface infection. The reasons for corneal tropism for some but not all HAdV-Ds are not known. The fiber protein is a major capsid protein; its C-terminal "knob" mediates binding with host cell receptors to facilitate subsequent viral entry. In a comprehensive phylogenetic analysis of HAdV-D capsid genes, fiber knob gene sequences of HAdV-D types associated with EKC formed a unique clade. By proteotyping analysis, EKC virus-associated fiber knobs were uniquely shared. Comparative structural modeling showed no distinct variations in fiber knobs of EKC types but did show variation among HAdV-Ds in a region overlapping with the known CD46 binding site in HAdV-B. We also found signature amino acid positions that distinguish EKC from non-EKC types, and by in vitro studies we showed that corneal epithelial cell tropism can be predicted by the presence of a lysine or alanine at residue 240. This same amino acid residue in EKC viruses shows evidence for positive selection, suggesting that evolutionary pressure enhances fitness in corneal infection, and may be a molecular determinant in EKC pathogenesis. IMPORTANCE Viruses adapt various survival strategies to gain entry into target host cells. Human adenovirus (HAdV) types are associated with distinct disease conditions, yet evidence for connections between genotype and cellular tropism is generally lacking. Here, we provide a structural and evolutionary basis for the association between specific genotypes within HAdV species D and epidemic keratoconjunctivitis, a severe ocular surface infection. We find that HAdV-D fiber genes of major EKC pathogens, specifically the fiber knob gene region, share a distinct phylogenetic clade. Deeper analysis of the fiber gene revealed that evolutionary pressure at crucial amino acid sites has a significant impact on its structural conformation, which is likely important in host cell binding and entry. Specific amino acids in hot spot residues provide a link to ocular cell tropism and possibly to corneal pathogenesis.
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23
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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: 321] [Impact Index Per Article: 40.1] [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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Dynamic Changes in Clinical Characteristics During an Outbreak of Human Adenovirus Serotype 55 in China. Disaster Med Public Health Prep 2016; 12:464-469. [PMID: 26915755 DOI: 10.1017/dmp.2015.185] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine dynamic changes in clinical characteristics by examining an outbreak of adenovirus infection that occurred from December 20, 2012, to February 25, 2013, in Tianjin, China. METHODS Active surveillance for febrile respiratory illnesses was conducted, and medical records of patients were collected. Real-time quantitative polymerase chain reaction and sequencing were used for pathogen identification and viral genome study, respectively. Student's t-test was used to compare the mean values of normally distributed continuous variables. Mann-Whitney U or Kruskal-Wallis tests were used if continuous variables were not normally distributed. Pearson's chi-square test or Fisher's exact test was used to compare categorical variables. RESULTS The outbreak was sourced from the index case diagnosed as the common cold on December 20, 2012; a total of 856 cases were reported in the following 66 days. The pathogen was identified as human adenovirus (HAdV) 55. The symptoms manifested differently in severe and mild cases. Routine blood examinations, liver function indexes, and heart function indexes showed different dynamic patterns over time in hospitalized patients. CONCLUSIONS Clinical characteristics and laboratory examinations may reveal unique patterns over the course of HAdV-55 infection. (Disaster Med Public Health Preparedness. 2018;12:464-469).
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