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Adenovirus 7a: a community-acquired outbreak in a children's hospital
L S Mitchell1, B Taylor, W Reimels
1Department of Pediatrics, University of Tennessee, Memphis 38103, USA.
Insights
Adenovirus 7a caused a significant epidemic in hospitalized children, primarily leading to respiratory illness. This community-acquired infection highlights the severity and potential fatality of adenovirus 7a in pediatric populations.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Epidemiology
Background:
- Adenoviruses are common causes of pediatric respiratory and gastrointestinal illnesses.
- Adenovirus types 1, 2, 3, and 5 are frequent culprits in childhood respiratory infections.
- Rapid spread in closed environments leads to epidemic adenoviral disease, with serotype 7a noted for outbreaks in children.
Purpose of the Study:
- To describe a large community-acquired adenovirus 7a epidemic in hospitalized children.
- To characterize the clinical presentation and outcomes of adenovirus 7a infections in pediatric patients.
Main Methods:
- Retrospective review of patients with adenovirus-positive cultures during a recognized outbreak.
- Typing of adenovirus isolates to identify serotypes.
- Detailed medical record review for patients with adenovirus 7a infection.
Main Results:
- 47 children hospitalized with adenovirus infection between March and July 1997.
- Adenovirus 7a accounted for 26 (55%) of cases, with 92% community-acquired.
- Respiratory symptoms (84%) and fever (81%) were most common; one fatality occurred.
Conclusions:
- Adenovirus 7a can precipitate substantial community epidemics in children.
- The predominant manifestation of adenovirus 7a in children is respiratory tract disease.
- Adenovirus 7a infections can be severe and potentially fatal in pediatric cases.
Background:
Adenoviruses produce many illnesses in children, particularly respiratory and gastrointestinal disease. The most common adenoviral respiratory infections in children are caused by types 1, 2, 3 and 5. Adenoviruses spread rapidly in closed environments often causing epidemic disease. Serotype 7a has been responsible for outbreaks of respiratory disease in children living in close proximity with one another. This report describes a large community-acquired adenovirus 7a epidemic in hospitalized children.
Methods:
Evaluation of all patients with cultures positive for adenovirus from a children's hospital-based virology laboratory during a recognized adenovirus outbreak. All such adenovirus isolates were typed, and patients with adenovirus 7a are described by review of medical records.
Results:
Between March 1 and July 26, 1997, 47 children admitted to the hospital were identified as infected with adenovirus. Of these 47 patients 26 (55%) were infected with adenovirus 7a. Twenty-four (92%) infections were community-acquired. The age range was 11 days to 10 years with a median of 9.5 months. Twenty-two patients (84%) had respiratory symptoms, and 21 (8%) had fever, making these the most common symptoms. The mean durations of fever and hospitalization were 5.5 and 7 days, respectively. One of 26 patients died.
Conclusions:
Adenovirus 7a can cause large community epidemics affecting children. The disease produced by adenovirus 7a in children is almost exclusively of the respiratory tract, and in some individuals it may be very severe and possibly fatal.