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

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

Research output: Contribution to journalArticle

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.

Original languageEnglish
JournalJournal of Infectious Diseases
Volume199
Issue number10
Pages (from-to)1419-26
Number of pages8
ISSN0022-1899
DOIs
Publication statusPublished - 2009

Keywords

  • Adenovirus Infections, Human/epidemiology
  • Adenoviruses, Human/classification
  • Cross Infection/epidemiology
  • Cross Reactions
  • Disease Outbreaks/statistics & numerical data
  • Humans
  • Military Personnel
  • Retrospective Studies
  • Risk Factors
  • Serotyping
  • Time Factors
  • United States/epidemiology

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