Description of an adenovirus A31 outbreak in a paediatric haematology unit

M Leruez-Ville1, M Chardin-Ouachée, B Neven

  • 1Laboratoire de Virologie, EA 3620 Université Paris V, Hôpital Necker-Enfants Malades AP-HP, Paris, France. marianne.leruez@nck.ap-hop-paris.fr

Insights

Adenovirus A31 caused an epidemic in pediatric stem cell transplant patients. This study highlights the need to assess the burden of this specific adenovirus genotype in this vulnerable population.

Area of Science:

  • Virology
  • Pediatric Hematology
  • Infectious Diseases

Background:

  • Allogeneic haematopoietic stem cell transplantation (hSCT) in children carries a high risk of adenovirus infections, leading to significant morbidity and mortality.
  • While species C and B adenoviruses are most common post-hSCT, adenovirus A31 has emerged as a growing concern.

Purpose of the Study:

  • To investigate an outbreak of adenovirus A31 infections in pediatric hSCT patients.
  • To characterize the clinical features and epidemiological spread of adenovirus A31 genotype.

Main Methods:

  • Quantitative real-time PCR was used to screen blood samples from 58 hSCT children for adenovirus species A-C over three years.
  • Phylogenetic analysis, including hexon gene amplification and sequencing, was performed on detected adenovirus strains.

Main Results:

  • Fifteen cases of adenovirus viraemia were identified in the study period.
  • Seven cases occurring in spring/summer 2003 were identified as adenovirus species A, specifically genotype A31, with 100% hexon gene homology.
  • Clinical data for these seven patients with A31 adenovirus viraemia were documented.

Conclusions:

  • An epidemic spread of adenovirus genotype A31 was observed in a pediatric hematology unit.
  • Epidemiological data strongly suggest a nosocomial (hospital-acquired) origin for this A31 adenovirus outbreak.
  • Further assessment of the burden of adenovirus A31 infection in hSCT recipients is warranted.

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