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Adenovirus Infection in Hospitalized Children with Acute Respiratory Infection in Jordan
Varvara Probst1, Danielle A Rankin1,2, Zaid Haddadin1
1Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN.
Insights
Adenovirus (AdV) causes acute respiratory illness (ARI) in children. This study identified Adenovirus-C as the most common type in Jordan, with distinct clinical features when detected alone versus with other viruses.
Area of Science:
- Virology
- Pediatric Infectious Diseases
- Public Health
Background:
- Adenovirus (AdV) is a common cause of acute respiratory illness (ARI).
- The specific AdV species linked to ARI hospitalizations in the Middle East remain poorly understood.
- Understanding AdV epidemiology is crucial for public health interventions.
Purpose of the Study:
- To identify AdV species causing ARI in hospitalized children in Amman, Jordan.
- To compare clinical features of AdV infections based on single vs. co-detection with other viruses.
- To differentiate clinical and epidemiological characteristics between AdV-B and AdV-C species.
Main Methods:
- A viral surveillance study was conducted on children under 2 years old hospitalized with ARI in Amman, Jordan (March 2010-March 2013).
- Nasal and throat specimens were tested for viruses using real-time reverse-transcription quantitative polymerase chain reaction.
- AdV-positive specimens were typed using partial hexon gene sequencing, and clinical data were analyzed.
Main Results:
- Adenovirus (AdV) was detected in 15% of hospitalized children with ARI.
- Adenovirus-C was the predominant species (65%), identified in 216 typed specimens.
- Children with single AdV detection showed more fever, diarrhea, and seizures compared to those with co-infections. AdV-C infections were more likely to be co-detected with other viruses.
Conclusions:
- Clinical differences exist between single and co-detected AdV infections, and between AdV-B and AdV-C species.
- Adenovirus-C is a significant cause of ARI in young children in Jordan.
- Further research with larger sample sizes and AdV typing is necessary to fully elucidate epidemiological and clinical differences between AdV species.
Background:
The most common clinical manifestation of adenovirus (AdV) infection is acute respiratory illness (ARI). Specific AdV species associated with ARI hospitalizations are not well defined in the Middle East.
Methods:
A viral surveillance study was conducted among children <2 years hospitalized in Amman, Jordan, from March 2010 to March 2013. Nasal and throat respiratory specimens were obtained from enrolled children and tested for viruses using a real-time reverse-transcription quantitative polymerase chain reaction. AdV-positive specimens were typed by partial hexon gene sequencing. Demographic and clinical features were compared between AdV detected as single pathogen versus co-detected with other respiratory viruses, and between AdV-B and AdV-C species.
Results:
AdV was detected in 475/3168 (15%) children hospitalized with ARI; of these, 216 (45%) specimens were successfully typed with AdV-C as the most common species detected (140/216; 65%). Children with AdV-single detection (88/475; 19%) had a higher frequency of fever (71% vs. 56%; P=0.015), diarrhea (18% vs. 11%; p=0.048), and/or seizures/abnormal movements (14% vs. 5%; p=0.003). Children with AdV co-detected with other viruses more likely required oxygen support [adjusted odds ratio (aOR) 1.91 (95% CI: 1.08, 3.39), P = 0.027] than those with AdV-single detection. Children with AdV-C had higher odds of co-detections with other viruses compared with those with AdV-B [aOR 4.00 (95% CI: 1.91, 8.44), P < 0.001].
Conclusion:
Clinical differences were identified between AdV-single and AdV co-detected with other viruses, and between AdV-B and AdV-C. Larger studies with AdV typing are needed to determine additional epidemiological and clinical differences between specific AdV species and types.
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