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Influenza Other Respir Viruses. 2016 Sep;10(5):414-20. doi: 10.1111/irv.12392. Epub 2016 May 13.

Type-specific clinical characteristics of adenovirus-associated influenza-like illness at five US military medical centers, 2009-2014.

Author information

1
Walter Reed National Military Medical Center, Washington, DC, USA.
2
Naval Medical Center, San Diego, CA, USA.
3
Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
4
Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, MD, USA.
5
Madigan Army Medical Center, Fort Lewis, WA, USA.
6
Naval Medical Center, Portsmouth, VA, USA.
7
San Antonio Military Health System, San Antonio, TX, USA.
8
Naval Health Research Center, San Diego, CA, USA.
9
Children's National Medical Center, Washington, DC, USA.

Abstract

BACKGROUND:

Adenovirus is a recognized cause of influenza-like illness (ILI). The proportion of ILI attributable to adenovirus is not known. Moreover, knowledge gaps remain with respect to the epidemiologic, virologic, and clinical characteristics of adenovirus-associated ILI among otherwise healthy individuals.

METHODS:

An observational, longitudinal study of <65-year-old patients with febrile ILI at five medical centers was conducted from 2009 to 2014. Nasopharyngeal specimens obtained at enrollment were first tested by single-reaction PCR for adenovirus, then further evaluated by a multiplex PCR assay for other respiratory viral pathogens. Symptoms over a 28-day period were collected.

RESULTS:

We enrolled 1536 individuals, among whom 43 (2·8%) were positive for adenovirus. The median age of cases was 3·4 years (range: 4 months to 41 years). Three were hospitalized. Species and serotype information was available for 33 (76·7%) cases. Species C (n = 21) was the most common, followed by B3 (n = 9) and one each of E4a, D46, and A. Species C infections were more frequent in children (P < 0·01). Half of the cases were positive for at least one other respiratory viral pathogen. Symptoms were generally mild and most commonly included cough (90%), fatigue (79%), rhinorrhea (74%), loss of appetite (71%), and sore throat (64%). Children with non-C adenovirus infection were more likely to report sore throat (P = 0·05) and hoarseness (P = 0·06) than those with species C infection.

CONCLUSIONS:

Adenovirus is frequently detected with other respiratory viruses. Persons with non-C adenovirus infections reported more severe symptoms, suggesting there may be species-specific differences in virulence and/or host response to infection.

KEYWORDS:

Adenovirus; influenza-like illness; military

PMID:
27062998
PMCID:
PMC4947946
DOI:
10.1111/irv.12392
[Indexed for MEDLINE]
Free PMC Article

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