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National Burden of Human Adenovirus Infections in China: A Community-Based Multiplier Modeling Study
Qianqian Feng1, Anqi Dai1, Xiaofei Zhou1
1Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China.
Journal of Medical Virology
|July 30, 2026
Summary
Human adenovirus (HAdV) caused an estimated 44.21 million infections in China post-pandemic. Children under five experienced the highest burden, with significant regional and species variations in respiratory illness incidence.
Area of Science:
- * Epidemiology and Public Health
- * Virology and Infectious Diseases
Background:
- * Human adenovirus (HAdV) is a significant cause of respiratory infections globally.
- * Community-level burden estimates for HAdV, particularly post-pandemic, remain limited in many regions, including China.
Purpose of the Study:
- * To estimate the community-level burden of HAdV infections in China during the post-pandemic period (2023-2024).
- * To analyze HAdV incidence by age, viral species, and geographic location.
- * To provide data for informing HAdV surveillance and control strategies.
Main Methods:
- * Utilized nationwide respiratory pathogen surveillance data from China.
- * Employed a multiplier model to estimate HAdV infections, symptomatic illnesses (SI), and medically attended illnesses (MAI).
- * Conducted age-, species-, and province-specific analyses, with uncertainty assessed via Monte Carlo simulations.
Main Results:
- * Estimated 44.21 million HAdV infections over 19 months, with an annualized incidence of 18.96 per 1000 persons.
- * Annualized incidences for SI and MAI were 4.92 and 3.60 per 1000 persons, respectively.
- * Children aged 0-4 years exhibited the highest incidence (16.66 per 1000 persons monthly). HAdV species B showed higher incidence than species C in children aged 5-14 years. Highest rates were observed in Hunan, Guangxi, Hubei, Guangdong, and Yunnan provinces.
Conclusions:
- * HAdV imposes a substantial and previously under-recognized respiratory disease burden in China.
- * Children bear the highest burden of HAdV infections.
- * Significant species-specific and geographic heterogeneity in HAdV incidence necessitates targeted surveillance and control efforts.
