Molecular epidemiology of fowl adenoviruses in Greece

Outbreaks of inclusion body hepatitis (IBH) and adenoviral gizzard erosion have been anecdotally reported in Greece since approximately 2011. However, a relevant increase in clinical outbreaks compatible with IBH has been described since 2014. Unfortunately, with limited exceptions, only serological assays were performed, and involved strains were not properly characterized. In the present study, 35 outbreaks were investigated in the period between July 2017 and February 2018 in Greece. In addition to clinical and histopathological diagnosis, fowl adenovirus (FAdV) presence was investigated by PCR and sequencing. Thirty-four out of 35 samples tested FAdV positive. Twenty-nine (85.29%) and 5 (14.71%) strains were classified as FAdV-E and FAdV-D, respectively. Fowl adenovirus-E strains were genetically homogeneous and formed an independent cluster of Greek-only sequences, including the sole previously available sequence, suggesting the prolonged circulation of this species in Greece. On the contrary, FAdV-D strains were more heterogeneous and closely related to strains sampled in other European countries, testifying the occurrence of multiple introduction events. The evaluation of phylogenetic relationships, geographic clustering, age of infection, and origin of the broiler breeder flocks suggests that both vertical and horizontal transmission are important in FAdV epidemiology in Greece and highlights the limited efficacy of currently implemented control measures. Of note, a significantly higher mortality was observed in precociously infected flocks, likely because of the higher susceptibility of younger animals. This evidence stresses the need of preventing vertical and/or early infection to limit the economic impact of adenovirus-induced diseases.

Hematochezia and thrombocytopenia in a 3-day-old infant: Congenital adenoviral infection

Neonatal adenovirus infection is infrequent, but in most cases the outcome of the infection is fatal. In this case report we describe the hospital course of a 3 day old newborn patient presenting with bloody stools and thrombocytopenia that remained clinically stable and had a benign course following Adenovirus 40/41 infection detected in stool. Neonatal adenovirus infection should be considered in the differential diagnosis of neonatal sepsis and pneumonia but also in patients that present with hematochezia, thrombocytopenia and/or other less specific signs and symptoms of viral illness.

Triple infection with agamid adenovirus 1, Encephaliton cuniculi-like microsporidium and enteric coccidia in a bearded dragon (Pogona vitticeps)

A 2-month-old juvenile central bearded dragon was presented for anorexia and cachexia. Another specimen from the same cage had died suddenly 2 weeks prior. Fecal analysis revealed a high quantity of Isospora amphiboluri and a few pinworm eggs. Other examinations were not performed and the animal died a few days later despite supportive care. A third individual from the same cage presented with anorexia and a distended cœlom and was euthanized. In this third dragon, histological examination revealed intestinal coccidiosis, basophilic intranuclear inclusions compatible with adenovirus infection, acute hepatic necrosis with intrahepatocytic and intraenteritic organisms typical of microsporidia and renal gout. A PCR confirmed the diagnosis of adenovirosis. Sequencing showed that the PCR product was 100% identical to the corresponding portion of the agamid adenovirus 1 genome. A PCR for the detection of Encephalitozoon (E.) cuniculi was positive. Partial sequencing revealed 100% identity to an E. cuniculi-like organism previously found in bearded dragons. In cases where environmental factors such as poor hygiene or stress can be excluded, the presence of opportunistic pathogens in high numbers can be due to a systemic (viral) infection with temporary immunosuppression.

Sheep lung segmental delivery strategy demonstrates adenovirus priming of local lung responses to bacterial LPS and the role of elafin as a response modulator

Viral lung infections increase susceptibility to subsequent bacterial infection. We questioned whether local lung administration of recombinant adenoviral vectors in the sheep would alter the susceptibility of the lung to subsequent challenge with bacterial lipopolysaccharide (LPS). We further questioned whether local lung expression of elafin, a locally produced alarm anti-LPS/anti-bacterial molecule, would modulate the challenge response. We established that adenoviral vector treatment primed the lung for an enhanced response to bacterial LPS. Whereas this local effect appeared to be independent of the transgene used (Ad-o-elafin or Ad-GFP), Ad-o-elafin treated sheep demonstrated a more profound lymphopenia in response to local lung administration of LPS. The local influence of elafin in modulating the response to LPS was restricted to maintaining neutrophil myeloperoxidase activity, and levels of alveolar macrophage and neutrophil phagocytosis at higher levels post-LPS. Adenoviral vector-bacterial synergism exists in the ovine lung and elafin expression modulates such synergism both locally and systemically.

[Mixed infection and risk factors in children with severe adenovirus pneumonia]

OBJECTIVE

To investigate the mixed infection and analyze risk factors in children with severe adenovirus pneumonia.

METHODS

A retrospective analysis was performed on the clinical data of 756 children with adenovirus pneumonia between June 2009 and June 2011. Pathogens and risk factors were studied in 216 severe cases.

RESULTS

Of the 216 severe cases, 138 (63.9%) were aged from 6 months to 2 years, and 161 (74.5%) developed the disease in the winter and spring; 177 (81.9%) were affected by 1-4 pathogens besides adenovirus, including 74 cases (34.3%) infected with one pathogen as an addition. A total of 334 pathogen strains were identified from the respiratory secretions and sera of the 216 cases. Of them, 163 (48.8%) were bacterial strains, dominated by Gram-negative bacteria (124 strains), 108 (32.3%) were viral strains, and 40 (12.0%) were fungal strains. Multivariate logistic regression analysis indicated that congenital heart disease, congenital airway abnormalities, nutritional anemia, recurrent pulmonary infection, and surgical history were the independent risk factors for severe adenovirus pneumonia in children, with odds ratios of 3.3, 11.1, 7.2, 14.3 and 12.9 respectively (P<0.05).

CONCLUSIONS

Severe adenovirus pneumonia is mostly seen in children aged from 6 months to 2 years and occurs frequently in the winter and spring. Many cases are also infected with other pathogens, most commonly Gram-negative bacteria. Congenital heart disease, congenital airway abnormalities, nutritional anemia, recurrent pulmonary infection and surgical history are the independent risk factors for severe adenovirus pneumonia in children.

Proanthocyanidin-enriched extract from Myrothamnus flabellifolia Welw. exerts antiviral activity against herpes simplex virus type 1 by inhibition of viral adsorption and penetration

AIM OF THE STUDY

Extracts from the aerial parts of the South African resurrection plant Myrothamnus flabellifolia Welw. have been used traditionally against infections of the upper respiratory tract and skin diseases. A polyphenol-enriched extract was investigated for potential antiviral effects against herpes simplex virus type 1 (HSV-1) and adenovirus, and the underlying mode of action was to be studied.

MATERIALS AND METHODS

Antiviral effects of an acetone-water extract (MF) from Myrothamnus flabellifolia on HSV-1 and adenovirus type 3 were tested in infected Vero cells by plaque reduction assay, MTT test and immunofluorescence. The influence of the extract on the HSV-1 envelope glycoprotein D was shown by Western blot. Organotypic full thickness skin models consisting of multilayer skin equivalents were used for the investigation of MF effects on HSV-1 replication.

RESULTS

MF exhibited strong antiviral activity against HSV-1. The HSV-1-specific inhibitory concentration (IC(50)) was determined as 0.4 μg/mL and the cytotoxic concentration (CC(50)) against Vero cells as 50 μg/mL. A selectivity index (SI) (ratio of CC(50) to IC(50)) of approximately 120 was calculated when MF was added to the virus inoculum for 1h at 37°C prior to infection. The replication of adenovirus 3 was not affected by MF. MF abolished virus entry into the host cell by blocking viral attachment to the cell surface. When added after attachment at a concentration of >6 μg/mL, the extract also inhibited penetration of HSV-1 into the host cell. Polyphenolic compounds from MF directly interacted with viral particles, leading to the oligomerisation of envelope proteins as demonstrated for the essential viral glycoprotein D (gD). Using organotypic full thickness tissue cultures, it was shown that treatment of HSV-1 infected cultures with the MF resulted in reduced viral spread.

CONCLUSIONS

A polyphenol-enriched extract from Myrothamnus flabellifolia strongly acts against HSV-1 by blocking viral entry into the cells.

Viral cytopathic changes in urine cytology of ileal conduit attributed to adenovirus: Report of a case

Urine cytology from ureteral diversions utilizing intestinal segment as reservoir or conduit, constructed during cystectomy performed usually for advanced bladder neoplasia, differs from bladder urine cytology in that the presence of abundant intestinal mucosal cells with degenerative and inflammatory changes interferes with the recognition of other important cellular changes, particularly of recurrent neoplasia in the upper urinary tract, not to mention other less frequent yet note worthy pathologic changes, such as viral type indigenous to the urinary tract. When confronted with diseases involving the intestinal segment, such as viral enteritides, the diagnostic problem becomes more complex and special effort is needed to recognize and characterize them correctly, differentiating them from other pathologies or artifacts seen in such specimens. We report one such case in which viral changes affecting columnar intestinal epithelium were identified and by immunocytochemistry characterized as adenoviral involving primarily cells of the intestinal conduit. We discuss the significance of such infection in comparison to other viral changes indigenous to the urinary tract, which could also occur in such specimens.

Detection of microorganisms in the tracheal aspirates of preterm infants by polymerase chain reaction: association of adenovirus infection with bronchopulmonary dysplasia

Bronchopulmonary dysplasia (BPD) is recognized as an important cause of morbidity and mortality in preterm infants. Because the role of congenital infections in BPD has been debated, the purpose of this study was to test the hypothesis that detection of infectious agents in tracheal aspirate samples was associated with the development of BPD. Tracheal aspirate samples were obtained within the 1st week of life and screened by polymerase chain reaction for adenovirus, cytomegalovirus, parvovirus, enteroviruses, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma pneumoniae, and Chlamydia species. BPD was defined as persistent oxygen dependence at 28 d of age and 36 wk postconceptional age (PCA). Infants that expired before these time points were excluded from statistical analysis. Out of 89 infants studied, at 28 d of life, 13 had expired, 45 had BPD, and 31 had no BPD (controls). At 36 wk PCA, 15 infants expired, 39 still had BPD, and 35 did not. A significant increase in the frequency of adenovirus genome was identified in BPD patients compared with controls, both at 28 d of life (12/45 = 27% versus 1/31 = 3%: p< or =0.01) and at 36 wk PCA (10/39 = 29% versus 2/35 = 6%: p = 0.01). Other microorganisms were rarely detected and not associated with the development of BPD. This is the first study reporting the frequency of detection of adenovirus DNA in tracheal aspirate samples obtained during the 1st week of life from infants with BPD and suggests that prenatal acquisition may be important in the development of BPD.

Quantitative colorimetric microneutralization assay for characterization of adenoviruses

A microneutralization assay that automates the reading and interpretation of viral infectivity and neutralization data was developed for the characterization of adenoviruses (AV). Virus, serum, and cells were added to 96-well plates, incubated for 7 days, and stained with vital stain. The A550 of solubilized dye was read in a plate reader interfaced to a personal computer which analyzed the results. Correlation of A550 values with visual observation of cytopathic effect was extremely good (r = 0.977625). Clinical isolates of 17 AV from 11 patients were characterized by colorimetric neutralization assay. Prototype AV titers tested were comparable to those determined by tube methods. Prototype homotypic antiserum titers were comparable to or greater than those determined by standard tube neutralization.

Genome analysis of South American adenovirus strains of serotype 7 collected over a 7-year period

DNA restriction analysis was carried out on a sample of 212 epidemiologically unrelated adenovirus (Ad) strains of serotype 7 isolated in Chile, Uruguay, and Argentina from nasopharyngeal aspirates of children with acute lower respiratory disease between 1984 and 1990. The identified genome types were Ad7b (n = 12), Ad7c (n = 21), and Ad7h (n = 179). The analysis of the occurrence of the three genome types throughout the study period revealed that Ad7c was the predominant virulent variant in 1984 and indicated that a shift to genome type 7h took place in 1986. Ad7b cocirculated with the other genomic variants at a relatively low frequence.

Inclusion body hepatitis in Gambel's quail (Callipepla gambelii)

An acute necrotizing hepatitis in 1- to 3-wk-old Gambel's quail (Callipepla gambelii) caused by an adenovirus is described. The infection caused high mortality in captive raised, orphan chicks at two wildlife rehabilitation facilities in Arizona (USA). Gross lesions varied from pale livers to multiple, pinpoint, white foci scattered throughout the livers. Microscopically, scattered foci of hepatocellular necrosis were present. Intact hepatocytes at teh periphery of necrotic foci had eosinophilic and basophilic intranuclear inclusion bodies.

Bacterial flora of Tasmanian SIDS infants with special reference to pathogenic strains of Escherichia coli

The general bacterial flora of 38 Tasmanian SIDS infants was examined together with faecal flora of 134 comparison infants ranging in age from birth to 6 months. The microflora of all specimens received was investigated with special emphasis on the toxigenic Escherichia coli (TEC). Samples were examined for verocytotoxigenic E. coli, free faecal verocytotoxin (FVT), heat labile toxin (LT) and heat stable toxin (ST) producers with the use of a Vero cell assay and commercial kits. The findings of this study revealed a high isolation rate (39%) of TEC from SIDS infants as compared to 1.5% from the healthy comparison infants. Atypical E. coli strains were also identified during the study, including E. coli A-D. An analysis of the same specimens for rotaviral and adenoviral antigens indicated that 30% of the SIDS cases were positive as compared to 20% in the comparison group.

Histochemical/histoenzymic studies in broiler chicks fed aflatoxin, ochratoxin and inoculated with inclusion body hepatitis virus singly and in concurrence

The effect of feeding mycotoxins, i.e. aflatoxin B1 (1.25 ppm from 3 to 38 days of age) and ochratoxin A (0.5 ppm from 3 to 38 days of age) along with inclusion body hepatitis virus (IBHV) inoculation (at 10 days of age) singly and in combination was studied in broiler chicks. Birds in combined treatment groups, i.e. aflatoxin fed and virus inoculated and ochratoxin fed and virus inoculated, showed more changes in activities of phosphatases (AKPase, ATPase, G-6-Pase and ACPase) in liver and kidney tissues than their respective individual treatment groups with a few exceptions. Reduction in the activities of oxido-reductases in liver and kidney tissues were almost comparable in different treatment groups. The increase in muco-polysaccharides reaction was more marked in both the combined treatment groups than the single treatment groups. Intensity of lipid reaction was more in ochratoxin virus combination group than either alone.

Laboratory testing in patients with morbilliform viral eruptions

The explosion of immunologic testing capabilities over the past 20 years has enabled clinicians to accurately diagnose many conditions that previously were very difficult to identify solely on a clinical basis. Among these disorders are the viral exanthems. Infections with some of these viruses are of relatively little import (erythema infectiosum), whereas others have more significant consequences (HIV, cytomegalovirus). Clinical suspicions may be pursued more fully now, sometimes even in an office setting.

Biological characterisation of an Indian isolate of egg drop syndrome-76 virus

An isolate of egg drop syndrome-76 virus replicated best in primary chicken embryo liver cells and less well in duck embryo liver cells, duck embryo fibroblast cells and chicken embryo kidney cells. The cytopathic effect in chicken embryo liver cells was marked by the presence of round and refractile cells and detachment of cells from the glass surface. The intranuclear eosinophilic inclusion bodies were observed by 24 to 48 hours after infection. No virus multiplication was observed in primary quail embryo fibroblast cells, chicken embryo fibroblast cells or mammalian cells like Vero, BHK-21 and MDBK. Duck embryos supported the maximum growth of the virus, with allantoic fluid having the highest haemagglutinin titre, followed in order by chorioallantoic membrane, skin and internal organs. Chicken and quail embryos did not support the growth of the virus.

Immunohistological detection of human herpes virus 6 in formalin-fixed, paraffin-embedded lung tissues

Human herpes virus type 6 (HHV-6) infection is widespread in healthy individuals. The only definite disease association is with exanthem subitum in infants though the virus has been linked with a variety of other diseases including interstitial pneumonitis in bone marrow allograft recipients. In order to investigate the role of HHV-6 in the latter disease we have developed an optimised staining method for the demonstration of specific antigen in routinely processed post-mortem tissues. Formalin-fixed, paraffin-embedded lung tissue from 8 immunocompromised patients who died from interstitial pneumonitis was subjected to immunoperoxidase staining with monoclonal antibodies against HHV-6, cytomegalovirus (CMV), and adenovirus, using a modified avidin-biotin complex (ABC) method. Staining for HHV-6 was obtained in 6 of the 8 patients studied and was present in pneumocytes and macrophages. CMV and adenovirus antigens were identified in 4 and 6 patients, respectively. Whilst the lung tissue of 6 patients contained more than one virus, there was no evidence of cross-reactivity between the monoclonal antibodies. We demonstrated that accurate localisation of HHV-6 using monoclonal antibodies is possible in post-mortem lung tissue and conclude that either HHV-6 alone or in combination with other viruses may play a role in the development of interstitial pneumonitis following bone marrow transplantation or chemotherapy.

Evaluation of the interaction of Eimeria meleagrimitis with hemorrhagic enteritis virus or marble spleen disease virus in turkeys

The interaction of Eimeria meleagrimitis with hemorrhagic enteritis virus (HEV) or marble spleen disease virus (MSDV) was studied in 4-week-old female turkeys. Birds given either virus in combination with the coccidia showed greater weight gain than did birds given HEV alone. A combination of MSDV and E. meleagrimitis resulted in significantly lower oocyst production when oocysts were counted from individual birds. Levels of serum glucose, serum albumin, and total protein were reduced in birds given HEV either alone or in combination with E. meleagrimitis. Birds receiving E. meleagrimitis alone or in combination with either MSDV or HEV exhibited higher blood urea nitrogen (BUN) levels than birds in all other treatments. Birds receiving HEV or the combination of E. meleagrimitis and either HEV or MSDV had significantly lower serum triglycerides and cholesterol. Serum amylase was lower in poults receiving HEV alone or combined with E. meleagrimitis, and serum alkaline phosphatase was lower in the HEV-only treatment.

[Mycoplasma sp. in the respiratory tract of hospitalized children]

Mycoplasma pneumoniae is one of the most common bacteria causing respiratory diseases in other countries, specially in older children, adolescents and young adults and less frequently in the age group studied here, nevertheless the determination of its presence in this group was considered important. Two hundred and fifty throat swabs were taken from children, under five years of age, hospitalized with a diagnosis of acute respiratory infections (ARI) and to 50 children, same age, with no ARI (controls). The samples were placed in transport media and were incubated at 37 degrees C during 7 to 15 days. They were reinoculated in PPLO agar and typical colonies were looked for, 5 to 8 days later. The organisms were identified by biochemical tests. Eight Mycoplasma sp (3.2%) were obtained, five of them were M. pneumoniae (2.0%) and three M. hominis (1.2%). Only in 2 cases adenoviruses with M. hominis were found in the absence of other pathogens. It was shown that M. pneumoniae also infects children under five years old, so its present should be suspected, specially when the patient's health does not improve with the installed treatment. Some important suggestions for the isolation of mycoplasma are given.

Monitoring foreign gene expression by a human adenovirus-based vector using the firefly luciferase gene as a reporter

We have constructed a helper-independent adenovirus type 5-luciferase recombinant (Ad5-Luc 3) containing the firefly luciferase gene flanked by simian virus 40 (SV40) regulatory sequences inserted in the early region 3 (E3) of the Ad5 genome. Expression of luciferase in cells infected with Ad5-Luc3 was relatively efficient. In HeLa cells approximately 20 micrograms luciferase per 10(6) cells was made by 36 h post-infection and a 62 kilo-Dalton (kDa) luciferase band was clearly visible in a [35S]methionine-labeled Ad5-Luc 3-infected cell extract analyzed directly by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). The results of experiments in which cultured cells were infected with Ad5-Luc 3 in the presence or absence of 1-beta-D-arabinofuranosyl cytosine (AraC) showed that the majority of luciferase expression was dependent on viral DNA replication. This suggested that the enzyme was probably translated primarily from mRNA derived from transcripts expressed from the major late promoter of Ad5. An anti-luciferase antibody was raised in a rabbit and used to further characterize the luciferase expressed in HeLa cells infected with Ad5-Luc 3 by immunoprecipitations and Western blot analyses. The half-life of luciferase expressed in HeLa cells infected with Ad5-Luc 3 was calculated to be approximately 6-8 h by pulse chase analysis. Luciferase is likely to be a useful marker for monitoring virus dissemination and gene expression in experimental animals because assays for enzymatic activity are extremely sensitive and backgrounds are low in all tissues. In mice inoculated intraperitoneally (i.p.) with Ad5-Luc 3, luciferase activity was detected in the liver, spleen, kidney, and lung. A single i.p. inoculation of mice with Ad5-Luc 3 was sufficient to raise anti-luciferase antibody and Ad5 neutralizing antibody which persisted for at least 8 weeks. Even in the presence of circulating anti-luciferase and Ad5 neutralizing antibodies, luciferase activity could be detected in the livers, spleens, and kidneys of mice inoculated i.p. a second time with Ad5-Luc 3.

Necrotizing pancreatitis and gizzard erosion associated with adenovirus infection in chickens

Cases of focal necrotic pancreatitis and gizzard erosion in chickens are reported. Intranuclear inclusion bodies were seen in necrotic pancreatic acinar cells and necrotic epithelial cells of the gizzard, and electron microscopy demonstrated virus particles in affected gizzard epithelium. Adenovirus antigens were detected immunohistochemically in these intranuclear inclusion bodies. These findings suggest that the necrotizing pancreatitis and gizzard erosion were associated with adenovirus infection.

Experimental infection of weaned calves and lambs with two strains of bovine adenovirus type 2

The pathogenicity of two genetically different strains of bovine adenovirus type 2 (BAV-2) was tested in a double cross experimental infection of weaned lambs and calves. One of the virus strains was isolated from cattle and represented BAV-2 subgroup "A", while the other was isolated from sheep and belonged to subgroup "B" (Belák et al., 1983). The two virus strains caused infection both in lambs and calves; the viruses were repeatedly reisolated and definite seroconversion was found in all four groups. However, remarkable differences were observed in the pathogenicity: the most intensive virus multiplication and shedding, the most severe clinical symptoms and histopathological lesions were observed in the lamb group infected with the ovine isolate.

Physical mapping and homology studies of egg drop syndrome (EDS-76) adenovirus DNA

Homologous sequences between EDS-76 adenovirus strain 127 DNA and bovine adenovirus DNA were found by the Southern blotting technique and no homology with CELO virus DNA could be detected. These data suggest a genetic similarity between EDS-76 virus and bovine adenoviruses. The fragments generated form EDS-76 adenovirus DNA by eight restriction endonucleases were physically mapped.

Serological relationships within the group E fowl adenoviruses

Antisera were raised in chickens to six group E fowl adenoviruses (FAV) which have been divided into a highly virulent (hypervirulent) and a mildly virulent subgroup using restriction endonuclease analysis. Virus neutralisations showed that these two distinct restriction endonuclease groups were distinguishable serologically, and indicated a possible vaccine candidate for use against the hypervirulent FAV. The suitability of this candidate was established in challenge experiments where vaccination with this virus protected against challenge from another hypervirulent virus as well as one of the mildly virulent FAV.

Reptilian viruses: adenovirus-like agent isolated from royal python (Python regius)

An adenovirus-like agent was isolated from a moribund royal python (Python regius). The DNA containing virus replicated in IgH2-cells at 30 degrees C forming eosinophilic intranuclear inclusion bodies. The virus proved to be stabile to treatment with chloroform, pH3 und pH 12 but it was labile to heat (56 degrees C). Infected IgH2 cells revealed symmetric hexagonal virus particles measuring 67-79 nm in the nucleus. The isolate shared characteristics with the viruses of the family Adenoviridae.

Pretreatment with topical 0.1% (S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine inhibits adenovirus type 5 replication in the New Zealand rabbit ocular model

Currently there is no clinically effective antiviral agent for the prevention or treatment of ocular adenoviral infections. Using a paired-eye, masked design, we tested the antiviral efficacy of topical 0.1% (S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine in the New Zealand rabbit ocular model after topical and intrastromal inoculation with 100 microliters (4 x 10(5) plaque-forming units per eye) of adenovirus type 5 McEwen, a clinical isolate. Prevention studies involved pretreatment (six times a day) 1 day before inoculation and continuing for 4 additional days. Compared with the control eyes, the pretreated eyes showed a significant reduction in the peak viral eye titers on days 3, 4, 5, and 7 after treatment (p < 0.03-0.005), and a reduction in the duration of viral sheeding (p < 0.02). Rebound increase in adenoviral titers was detected in five of 20 eyes (25%) after cessation of treatment, suggesting a therapeutic effect and a need for further studies to optimize the treatment regimen.

[Gastroenteritis caused by adenoviruses 40/41: epidemiological and clinical aspects]

The 40/41 adenovirus plays an important role as the productive agent of gastroenteritis at a pediatric age according to recent studies. With the aim of evaluating the clinical-epidemiological importance of this agent in our medium a prospective study of the 40/41 adenovirus was carried out in 1,697 stools of children of under 14 years of age over a period of 2 years. An enzyme immunoassay technique with specific monoclonal antibodies was used for detection. The 40/41 adenovirus was the third cause of gastroenteritis following Salmonella sp. and rotavirus with a percentage of infection of 2.1%. In 87.1% of the patients in which it was detected the patients had an age of less than 24 months. A clear peak of infection was found in the months of September of the two years studied. The infection was of intrahospital origin in 46.2% of the patients. Most of the children presented a self-limited diarrheic picture. The evolution of the patients was good with adequate rehydration measures. The study of the 40/41 adenovirus is of indubitable interest with the aim of obtaining greater knowledge of its importance in the epidemiology and clinical manifestations of gastroenteritis.

Replication of adeno-associated virus type 2 in human lymphocytic cells and interaction with HIV-1

Adeno-associated virus (AAV) is a nonpathogenic parvovirus which normally requires helper adenovirus or herpes-virus for replication. We examined the growth of AAV type 2 in human lymphocytes and its possible interaction with HIV-1. Three B cell lines (CK-B, HS-2, and UC729) and four T cell lines (Molt-4, Jurkat, HUT78, and HUT78+HIV, which is persistently infected with HIV-1) were infected with AAV either in the presence or in the absence of adenovirus. AAV DNA was found in cells of all the lines following incubation with the virus, indicating absorption. AAV DNA replication occurred in most cell lines without particular preference for B or T cells, but only in the presence of helper virus, either adenovirus or Epstein-Barr virus. Expression of AAV proteins was examined by immunoblotting and ELISA, using sera specific for AAV Rep or capsid proteins. The level of AAV protein synthesis correlated with the efficiency of AAV DNA replication, and both varied between cell lines. The yield of infectious AAV was low in most cases, except in one T4 line (Jurkat), where AAV replication and protein synthesis in the presence of adenovirus were very extensive. In HUT78+HIV cells both adenovirus and AAV (in the presence of Ad2) replicated efficiently. The effects of adenovirus plus AAV coinfections on HIV-1 replication, measured by reverse-transcriptase (RT) activity, were mild. Infection with adenovirus or AAV alone resulted in a 60-70% increase in RT activity, while infection with AAV plus adenovirus resulted in a 20% decrease in RT activity. The yield of infectious AAV in this cell line was very low.

Detection of type II avian adenoviral antigen in tissue sections using immunohistochemical staining

An immunohistochemical staining technique for the detection of marble spleen disease (MSD) viral antigens and other type II avian adenoviral antigens was developed using a mixture of monoclonal antibodies produced against hemorrhagic enteritis (HE) virus and a commercial streptavidin-biotin peroxidase indicator system. This technique was applied to both frozen and formalin-fixed paraffin-embedded tissue sections. The immunohistochemical staining technique was used on tissues from pheasants with experimental MSD, on tissues from a pheasant with natural MSD, and on tissues from turkeys with natural HE. Staining results were compared with routine hematoxylin-and-eosin (H&E) staining. Additional viral inclusions, not detected with H&E, were found in the liver, lung, bone marrow, and kidney sections using the immunohistochemical technique. The immunohistochemical technique was highly specific and sensitive for the detection of type II adenoviral antigen, and it appears to be useful for studying the pathogenesis of these diseases and for retrospective evaluation of routinely processed diagnostic tissue samples.

Inclusion bodies containing adenovirus-like particles in the intestine of a psittacine bird affected by inclusion body hepatitis

This paper reports a case of inclusion body hepatitis with intranuclear inclusion bodies in the liver and the intestine of a Yellow-naped Amazon parrot (Amazona ochrocephala). Structurally, basophilic intranuclear inclusion bodies were found in hepatic cells and enterocytes. Ultrastructurally, icosahedral adenovirus-like particles, 60-75 nm in diameter, were found in the same cells.

An ocular model of adenovirus type 5 infection in the NZ rabbit

Ocular adenoviral infections occur worldwide, and currently, there is no ocular animal model for evaluating new antivirals or studying pathogenesis. With a paired-eye design, an ocular model was developed in 32 New Zealand rabbits following topical and intrastromal inoculation with a clinical isolate of adenovirus type 5 (Ad5 McEwen). Clinical signs of infection--conjunctivitis, corneal edema, subepithelial infiltrates, and iritis--and seroconversion were evaluated. Replicating virus on the ocular surface was determined by serial ocular titers. Reproducible acute ocular infection was demonstrated in 32 of 32 infected eyes (100%), with mean viral replication lasting for 8.3 days. Peak ocular viral titers (10(3) plaque forming units/ml) were achieved on day three after inoculation and represented a 2 log increase (100 times) over day one. Ocular viral replication was associated with acute conjunctivitis (24/34 eyes, 75%), and delayed-onset presumed immune-mediated clinical disease was associated with: blepharoconjunctivitis (21/32 eyes, 66%), iritis (29/32 eyes, 91%), corneal edema (32/32 eyes, 100%), and subepithelial corneal infiltrates (30/32 eyes, 94%). Seroconversion was demonstrated in 26 of 31 rabbits (84%). The study concludes that a potentially useful animal model of adenoviral ocular infection can be attained.

Viral tracheitis in goslings in Saskatchewan

Up to 12% mortality occurred in goslings between 4 and 11 days of age in two sequential hatches from a single breeder flock. Respiratory signs were noted before the birds died. The most consistent necropsy finding was a white opaque plug of fibrin and cellular debris in the trachea. The tracheal epithelium was hyperplastic and metaplastic with intranuclear inclusion bodies present in superficial cells. An adenovirus was isolated in both chicken and goose embryo liver cells.

Isolation and identification of adenovirus 127, the causative agent of egg drop syndrome (EDS), from commercial laying hens in South Africa

A drop in egg production associated with loss of pigment and soft-shelled eggs was experienced on a farm in the Western Cape. Investigations revealed high levels of antibodies against adenovirus 127, the causative agent of egg drop syndrome (EDS) in chickens which were not vaccinated against EDS. A cytopathic agent was subsequently isolated in chicken embryo liver cell cultures and identified as EDS virus by haemagglutination inhibition and neutralization tests.

Development of an immunocytochemical procedure to detect adenoviral antigens in chicken tissues

An immunocytochemical technique utilizing an avidin-biotin peroxidase complex was developed to detect viral antigens in various tissues following oral administration of a locally isolated serotype 8 avian adenovirus (AAV) in specific pathogen-free (SPF) chickens. A strong color reaction was obtained with tissues from infected birds that contained a minimal amount of AAV antigens as determined by an indirect enzyme-linked immunosorbent assay. No reaction was detected in sections of tissues obtained from SPF chickens, and the reactivity with infected tissues could be removed by prior absorption of the primary antibody with purified AAV. A group-specific antigen common to the 12 serotypes of AAV was demonstrated by this technique. Because of the high sensitivity and broad-spectrum reactivity, this technique could be useful for studying the pathogenesis and laboratory diagnosis of inclusion body hepatitis caused by several serotypes of AAV.

Respiratory adenovirus-like infection in a rose-ringed parakeet (Psittacula krameri)

Intranuclear inclusions were observed under light microscopy in the bronchial epithelial cells of a recently purchased female rose-ringed parakeet that died of chlamydiosis. Transmission electron microscopy revealed the presence of numerous particles of adenovirus morphology. A latent adenovirus infection may have become more severe following chlamydiosis and the stress of handling.

[Isolation of an adenovirus responsible for a case of pancreatitis in guinea fowl]

Necrotizing pancreatitis is observed in 2 to 4 week-old guinea poult. Virus isolation was attempted from the pancreata of naturally affected birds. The isolate was identified as a type 1 adenovirus, and it reproduced the disease when inoculated to sensible guinea fowl.

Cooperative binding of EF-1A to the E1A enhancer region mediates synergistic effects on E1A transcription during adenovirus infection

A cellular nuclear factor, EF-1A, binds to a sequence motif which is repeated in the adenovirus type 5 E1A transcriptional control region. Previous genetic analyses demonstrated that two of these binding sites are predominant functional elements of the E1A enhancer region in vivo. In this report, we demonstrate that the cooperative binding of EF-1A to neighboring sites in the E1A enhancer region results in a synergistic activation of E1A transcription in infected cells.

[An adenovirus epidemic in patients with kidney transplantation]

During weekly routine virological screening of kidney transplant patients 12 out of 15 patients within a period of four months were found to be infected with adenovirus. All isolates were of the same serotype, type AdII + 35/HII. However, DNA restriction enzyme analyses showed the presence of two different DNA variants which were associated with three different epidemiological episodes. The epidemic probably started with reactivation of latent virus in a limited number of patients, after which it spread nosocomially. None of the patients showed signs or symptoms clearly attributable to adenoviruses, although adenovirus could not be excluded as a cofactor in the fatal outcome of hepatitis in one of the patients. Adenovirus apparently can easily spread nosocomially. Since literature data suggest that adenovirus infections of transplant patients may result in serious complications, adenovirus should not be neglected in virological screening protocols for kidney transplant patients.

Isolation of adenovirus from lambs with upper respiratory syndrome

The role of viruses in the etiology of recurrent upper respiratory disease in newly weaned lambs was studied during 1984-1985 at the North Dakota Sheep Experiment Station. Serum samples collected from lambs at weaning, from lambs with signs of respiratory disease, and 3 weeks following the onset of clinical signs were tested for antibodies to ovine adenovirus (OAV), respiratory syncytial virus (RSV), and parainfluenza type-3 virus (PI-3). Virus isolation studies were performed on nasal secretions samples taken at the same time. Parainfluenza type-3 was isolated from 1 of 275 lambs tested, and there was 2.5% overall 4-fold increase in antibody titer to PI-3 during the 2-year study. An adenovirus with a different restriction endonuclease digestion pattern from that previously reported adenovirus strains in the United States was isolated from 13 of 275 nasal secretions collected from lambs at the time of weaning. There was a 17.6% overall 4-fold increase in seroconversion to the adenovirus isolated from the lambs with clinical disease.

Identification and characterization of viral polypeptides from type-II avian adenoviruses

The polypeptides of serologically related viruses of hemorrhagic enteritis (HE) in turkeys, marble spleen disease (MSD) in pheasants, and splenomegaly in chickens (SMC) were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and analyzed by protein immunoblotting with polyclonal antibodies to HE virus (HEV). The viral polypeptides II, III, IV, V, VI, and VII were detected on SDS-PAGE with the size range from 18 to 97 kDa in HEV. Viral polypeptides II, III, V, VI, and VII were detected in MSD virus and virus of SMC. Protein immunoblotting of viral proteins with anti-HEV serum revealed antigenic differences between the 3 viruses of avian adenovirus type-II examined. The differences were that the polypeptides II, III, IV, V, VI, and VII were identified in HEV and the polypeptides II, V, VI, and VII were identified in MSD virus and virus of SMC. The bands of penton base (polypeptide III) and fiber (polypeptide IV) were seen in HEV only by protein immunoblotting.

The causes of hospital-treated acute lower respiratory tract infection in children

OBJECTIVE

To determine the etiologic agents in children with acute lower respiratory infection.

DESIGN

A survey of a series of patients.

SETTING

General pediatric hospital serving an urban population with and without referrals in Helsinki, Finland.

PARTICIPANTS

135 Finnish children aged 2 months to 15 years (mean, 1.75 years), with clinically defined acute lower respiratory infection (with difficulty of breathing), or found to have fever and a pneumonic infiltrate on chest roentgenogram.

SELECTION PROCEDURES

Consecutive sample on voluntary basis.

INTERVENTIONS

None.

MAIN RESULTS

Of 121 children with adequate samples, an etiologic diagnosis could be established in 84 (70%): 30 (25%) had bacterial, 30 (25%) viral, and 24 (20%) mixed infections. Antibody assays alone identified the agent in 91% of positive cases.

CONCLUSIONS

Bacterial infections are common but generally underestimated in acute lower respiratory infection; serologic methods add significantly to their detection.

Pathogenesis of an acute viral hepatitis: inclusion body hepatitis in the chicken

The pathogenesis of inclusion body hepatitis was studied following the oral administration of a serotype 8 strain of avian adenovirus into 2-day-old specific pathogen free chickens. Viral antigens were detected in tissues at various times post inoculation (pi) by enzyme-linked immunosorbent assay and by immunocytochemistry. Viral antigens were detected in intestinal epithelium from 12h to 13 days pi and in the plasma fraction of blood by 24 h pi. A biphasic, cell-free viremia with peaks at 2 and 7 days pi was recorded. Antigens were first detected in the liver from 2 days and reached peak levels at 6 days pi. The second peak of viral antigens in blood plasma was probably due to release of virus from damaged hepatic cells. Initially, viral antigens in the liver were restricted to cells lining the sinusoids but increasing involvement of hepatocytes occurred with time. Small amounts of viral antigens were detected in other tissues. Following the appearance of neutralizing antibodies in serum from 7 days pi, the levels of viral antigens in all tissues decreased and were undetectable by 15 days pi. This viral hepatitis of chickens is possibly a useful model for other viral infections where a cell-free viremic phase is important for spread of virus from primary sites to target organs, such as the liver.