Outbreak of severe respiratory disease associated with emergent human adenovirus serotype 14 at a US air force training facility in 2007.

Abstract

BACKGROUND:

In 2007, a US Air Force training facility reported a cluster of severe respiratory illnesses associated with a rare human adenovirus (Ad) serotype, Ad14. We investigated this outbreak to better understand its epidemiology, clinical spectrum, and associated risk factors.

METHODS:

Data were collected from ongoing febrile respiratory illness (FRI) surveillance and from a retrospective cohort investigation. Because an Ad7 vaccine is in development, Ad7 antibody titers in pretraining serum samples from trainees with mild and those with severe Ad14 illness were compared.

RESULTS:

During 2007, an estimated 551 (48%) of 1147 trainees with FRI were infected with Ad14; 23 were hospitalized with pneumonia, 4 required admission to an intensive care unit, and 1 died. Among cohort members (n = 173), the Ad14 infection rate was high (50%). Of those infected, 40% experienced FRI. No cohort members were hospitalized. Male sex (risk ratio [RR], 4.7 [95% confidence interval {CI}, 2.2-10.1]) and an ill close contact (RR, 1.6 [95% CI, 1.2-2.2]) were associated with infection. Preexisting Ad7 neutralizing antibodies were found in 7 (37%) of 19 Ad14-positive trainees with mild illness but in 0 of 16 trainees with Ad14 pneumonia (P = .007).

CONCLUSIONS:

Emergence of Ad14, a rare Ad serotype, caused a protracted outbreak of respiratory illness among military recruits. Most infected recruits experienced FRI or milder illnesses. Some required hospitalization, and 1 died. Natural Ad7 infection may protect against severe Ad14 illness.

• Authors: Jacqueline E Tate, Michel L Bunning, Lisa Lott, Xiaoyan Lu, John Su, David Metzgar, Lorie Brosch, Catherine A Panozzo, Vincent C Marconi, Dennis J Faix, Mila Prill, Brian Johnson, Dean D Erdman, Vincent Fonseca, Larry J Anderson, Marc-Alain Widdowson
• Journal: The Journal of infectious diseases (J Infect Dis) Vol. 199 Issue 10 Pg. 1419-26 (May 15 2009) ISSN: 0022-1899 [Print] United States
• PMID: 19351260 (Publication Type: Journal Article)

Topics

• Adenovirus Infections, Human (epidemiology, prevention & control, transmission)
• Adenoviruses, Human (classification, genetics)
• Cross Infection (epidemiology, prevention & control, virology)
• Cross Reactions
• Disease Outbreaks (statistics & numerical data)
• Humans
• Military Personnel
• Retrospective Studies
• Risk Factors
• Serotyping
• Time Factors
• United States (epidemiology)