Tweet
Re: Adenovirus 14 - CDC: New Respiratory Bug Has Killed 10
Adenovirus 14 page
Adenovirus 14 page
-
-
Re: Adenovirus 14 - CDC: New Respiratory Bug Has Killed 10
Doctors: Killer cold strain no cause for alarm
BY DELTHIA RICKS
delthia.ricks@newsday.com
November 17, 2007
A mutant common cold virus that killed a 12-day-old Manhattan infant and nine other people nationwide is a re-emergent strain that circulated in the 1950s and '60s before seeming to almost vanish.
Now that it's back, scientists are trying to learn about the genetic changes that adenovirus 14 -- Ad14 -- developed during the four decades since it dropped off their radar.
"Adenovirus 14 has been seen only with rare exceptions since the 1960s," said Dr. Larry Anderson, director of viral illnesses in the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention in Atlanta.
Even though the virus is essentially new to 21st century medicine, Anderson said it is not likely to be a source of outbreaks or serious public concern.
"First of all, there is no reason to be alarmed," he said. "This is an uncommon infection. You have a much greater chance of being infected with influenza or a rhinovirus," he said of another pathogen that can cause the common cold. Colds, he said, also are caused by another family of infectious agents known as coronaviruses.
All told, there are 51 known adenoviruses, Anderson said, which in addition to causing the common cold are also linked to pneumonia and bronchitis. The CDC, aided by state health departments in New York, Texas, Oregon and Washington, have documented 140 infections triggered by the variant strain over the past 18 months.
Dr. Ken Steier, director of patient safety at Nassau University Medical Center in East Meadow, said Ad14 should be put into perspective. With only 140 cases, infections linked to the variant come nowhere near the prevalence of influenza, he said, which affects millions of people each year -- and sometimes carries a death sentence. Influenza causes 36,000 deaths annually in the United States and more than 200,000 hospitalizations.
"There's no specific treatment for any adenovirus infection," Steier said. "Usually we recommend aspirin, fluids and bed rest. But it's also important to cover your cough, wash your hands, and don't rub your eyes after touching things because that's how it's spread."
The Manhattan baby's infection was identified as Ad14 by the New York State Health Department's Wadsworth Center laboratory. The CDC further confirmed the rare pathogen as the infant's cause of death. Identified only as a baby girl who was sickened when 3 days old, her case was probed because all childhood respiratory deaths are investigated by local and state health authorities in New York. She died in May 2006, and her plight came to light in a CDC report this week.
"The confirmed case of Ad14 is the only seen in New York," said Jeffrey Hammond, spokesman for the state Health Department. "It's important to note that our surveillance database goes back to 1986."
Other cases have involved military recruits elsewhere in the country, Anderson said. One recruit died after a three-week illness.
Comment
-
Re: Adenovirus 14 - CDC: New Respiratory Bug Has Killed 10
Adenovirus 14 Recombination and EmergenceOriginally posted by niman View Post
Papers and commentaries related to Adenovirus serotype 14 recombination and emergence are linked below
<SMALL>Adenovirus Serotype 14 Hexon Sequences Released (Commentary 11/16/07)
Adenovirus Serotype 14 Fatal Colds Due To Recombinant? (Commentary 11/16/07)
Acute Respiratory Disease Associated with Adenovirus Serotype 14 --- Four States, 2006--2007. (MMWR 11/16/07)
<SMALL style="COLOR: rgb(0,0,0)"><SMALL><SMALL><SMALL><SMALL>Abrupt<SUP> </SUP>Emergence<SUP> </SUP>of<SUP> </SUP>Diverse<SUP> </SUP>Species<SUP> </SUP>B<SUP> </SUP>Adenoviruses<SUP> </SUP>at<SUP> </SUP>US<SUP> </SUP>Military<SUP> </SUP>Recruit<SUP> </SUP>Training<SUP> </SUP>Centers. J Infec Dis 196: 1465 (Nov 2007)
Emergence of Adenovirus Type 14 in US Military Recruits - A New Challenge. J Infec Dis 196: 1437 (Nov 2007)
Co-infection of Adenovirus Species in Previously Vaccinated Patients. Emerg Infec Dis 12 (June 2006)
</SMALL></SMALL></SMALL></SMALL></SMALL></SMALL><SMALL>PCR analysis of egyptian respiratory adenovirus isolates, including identification of species, serotypes, and coinfections. J Clin Microbiol 43: 5743 (Nov 2005)</SMALL>
."The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller FoundationComment
-
Re: Adenovirus 14 - CDC: New Respiratory Bug Has Killed 10
Ohio Airman Among Deadly Cold Virus Victims
<TABLE cellSpacing=0 cellPadding=0 border=0><TBODY><TR><TD vAlign=top><!--- photo ---><TABLE cellSpacing=0 cellPadding=0 width=570 border=0><TBODY><TR><TD rowSpan=3><!-- photo and caption -->
</TD><TD vAlign=top>Maureen Kyle
Created: 11/17/2007 11:21:25 PM
Updated:11/18/2007 5:04:27 AM
</TD></TR></TBODY></TABLE><!--- end headline, photo --->(Norton) -- Its a rare but severe virus strain and the CDC says its popping up in clusters across the country. The adenovirus is a common cause of upper respiratory illness.
And in some cases - including one of an Ohio airman - it can be deadly.
"She changed so many people's lives," says Don Villers about his daughter.
Paige Villers was a determined 19 year old, just starting her life in the Air Force.
"The whole time she was down there - her whole main goal was to graduate the Air Force."
But in April - one month into her training - Paige came down with what's known as "boot camp flu", or the adenovirus.
There was an outbreak among this year's recruits. Over one hundred cases between February and June at Lackland Air Force base.
"She never really got better and kept getting sicker and they put her in intensive care and found out she had the adenovirus."
After months of struggling with a strain called AD-14, Paige passed away in august, just after her Air Force graduation.
Paige is one of 10 people to die from the virus since May last year.
"More and more people are getting exposed to it, it kind of makes you wonder what's changed that - why it's becoming this deadly again," says Don Villers.
The CDC says it's a new strain of an old virus. The last deadly AD-14 outbreak was in 1955.
Villers wasn't aware the virus that killed his daughter is now a nationwide concern until the c-d-c released more information Thursday.
"Sitting down to watch the morning news with a cup of coffee and Paige's picture popped up."
He's hoping the young woman who changed so many lives while she was alive will inspire medical professionals to focus on prevention.
<!--- existing content --->
</TD></TR></TBODY></TABLE>
Comment
-
Re: Adenovirus 14 - CDC: New Respiratory Bug Has Killed 10
could someone post up what the symptoms of this virus are please,many thanks.Comment
-
Re: Adenovirus 14 - CDC: New Respiratory Bug Has Killed 10
Sore throat and fever - it is a (seldom detected) cold virus.Originally posted by vinny View PostComment
-
Re: Adenovirus 14 - CDC: New Respiratory Bug Has Killed 10
The Naval Health Research Center reported that for the week ending 11 August:
Adenovirus remains the predominant cause of febrile respiratory illness among recruits. Type 21 adenovirus was responsible for recent increased FRI rates at CGTC Cape May starting in July. Emergence of type 14 adenovirus (Ad14) is responsible for recently increased FRI rates and pneumonia cases at Lackland AFB and MCRD Parris Island. Four other training centers had recent Ad14 activity at lower levels.
Comment
-
Re: Adenovirus 14 - CDC: New Respiratory Bug Has Killed 10
NHRC Febrile Respiratory Illness Surveillance Update
For the week ending 27 October:
? Adenovirus remains the predominant cause of febrile respiratory illness among recruits. Type 21 adenovirus was responsible for elevated FRI rates at CGTC Cape May that began in July and continue to date. Emergence of type 14 adenovirus (Ad14) was responsible for increased FRI rates and pneumonia cases at Lackland AFB and MCRD Parris Island. Four other training centers had recent Ad14 activity at lower levels; however, Ad14 activity at these 4 sites stopped by late August.
? FRI surveillance at eight U.S. military basic training centers indicated moderately elevated FRI rates at Ft. Benning, and Ft. Leonard Wood and substantially elevated FRI rates at Naval Recruit Training Command, Great Lakes; and Coast Guard Training Center.
? Influenza - Laboratory testing during the past week identified zero new influenza cases.
Comment
-
Re: Adenovirus 14 - CDC: New Respiratory Bug Has Killed 10
NHRC Febrile Respiratory Illness Surveillance Update
For the week ending 10 November:
? Adenovirus remains the predominant cause of febrile respiratory illness among recruits. Type 21 adenovirus was responsible for elevated FRI rates at CGTC Cape May that began in July and continue to date. Emergence of type 14 adenovirus (Ad14) was responsible for increased FRI rates and pneumonia cases at Lackland AFB and MCRD Parris Island. Four other training centers had recent Ad14 activity at lower levels; however, Ad14 activity at these 4 sites stopped by late August.
? FRI surveillance at eight U.S. military basic training centers indicated substantially elevated FRI rates at Naval Recruit Training Command, Great Lakes; and Coast Guard Training Center, Cape May.
? Influenza - Laboratory testing during the past week identified zero new influenza cases.
More information
Comment
-
Re: Adenovirus 14 - CDC: New Respiratory Bug Has Killed 10
Parris Island Adeno Cases
Comment
-
Re: Adenovirus 14 - CDC: New Respiratory Bug Has Killed 10
Lackland at 100% Ad14
Comment
-
Re: Adenovirus 14 - CDC: New Respiratory Bug Has Killed 10
USA (Oregon): Adenovirus 14-associated pneumonia
A potentially deadly form of community acquired pneumonia linked to adenovirus type 14 has emerged in the Pacific Northwest. First encountered in 2005 in Oregon, the viral pneumonia frequently leads to hospitalization and has a 20 per cent fatality rate, Paul Lewis of the Oregon State Public Health Department said at the Infectious Diseases Society of America (IDSA) meeting. "We recommend obtaining a viral culture in pneumonia patients who lack a specific etiology, especially those with severe disease," said Dr Lewis. Recognition of the adenoviral pneumonia began with 4 patients hospitalized simultaneously at a Portland hospital. Upon comparing notes with physicians at area hospitals, Dr Lewis and colleagues "almost fell out of our chairs because every hospital we called had recent severe and fatal cases of adenovirus disease." Investigators followed up the communication with a systematic review of all cases of adenovirus disease identified by Oregon clinical laboratories from Nov 2006 to Apr 2007. 6 months of active surveillance revealed what appeared to be a winter-spring predominant adenovirus disease, as the number of reported cases increased from Jan through Apr. Isolates from the sickest patients were sent to CDC, which found that almost all the cases involved adenovirus 14, a serotype identified more than 50 years ago but rarely detected since then and never in association with outbreaks.
Lewis et al. at the state health department reviewed specimens dating back to 1993 and found a few cases of adenoviral disease almost every year. Beginning in 2005, adenovirus 14 was the predominant serotype identified. Comparison of 31 patients with adenovirus 14 disease and 14 patients with other adenovirus serotypes showed that adenovirus 14 tended to infect older men (median age 52.9), and almost half the cases involved smokers. Most strikingly, adenovirus 14 was associated with a hospitalization odds ratio of 15.9 compared with other adenovirus serotypes. Chest x-rays were abnormal in 23 of 24 cases. All patients received broad spectrum antibiotics. Dr Lewis said 22 of the 31 patients with adenovirus 14 disease were hospitalized, and 16 required ICU (intensive care unit) care. 7 patients (22 per cent) died.
(Promed 10/10/07)
Comment
-
Re: Adenovirus 14 - CDC: New Respiratory Bug Has Killed 10
Volume 17 | Number 2 | Summer 2007
EIN Members Reporting Unusual Adenovirus Pneumonia Activity
Four cases of adenovirus pneumonia requiring mechanical ventilation, including one death, have been reported by a member of IDSA?s Emerging Infections Network (EIN) in Oregon. The member asks, ?Is our experience unique or is there an outbreak of adenovirus pneumonia??
For background, the member wrote, ?Pneumonia due to adenovirus is/has been a big problem in neonatal intensive care units (ICUs), transplant patients, and other immunocompromised patients. In 2001,two fatal cases of adenovirus in previously healthy adults were reported (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5026a1.htm). ?The latest patient required prone ventilation and appears to slowly be getting better with cidofovir therapy.?
Members responded:
Utah: ?In our children?s hospital, virtually all patients with pneumonia are tested for respiratory viruses with a 6-(now 7-) valent direct fluorescent assay with culture back-up. We typically see adenovirus pneumonia in healthy kids every year, some severe. We have a moderate increase this year with about 15-20 isolates per week compared to the usual 6-10.
?We pulled together the clinical experience a few years back (Pediatrics 2004;113:51-56- http://pediatrics.aappublications.org/cgi/content/full/113/1/e51).?
Iowa: ?You are not alone in your experience. We are helping a number of U.S. clinicians and laboratorians investigate recent unusual morbidity due to adenovirus infections. We have received recent typing requests from a number of states:MO, IL, CT, NY, and MN. We are working to identify the distribution of strains associated with severe disease.?
Atlanta: ?We have seen a number of outbreaks in chronic care facilities that may provide some insight. We suspect that these outbreaks are related to feeding tubes or intubation that provides a route to inoculate virus directly into the lungs.
Studies from the ?50s demonstrated that the route of administration for some serotypes can determine disease outcome, i.e., oral is asymptomatic and small particle aerosol is associated with lower respiratory tract disease.?
Puerto Rico: ?Adenovirus serotypes 4, 7, and 3 infections causing acute respiratory disease, including fatal pneumonias, among healthy military recruits have been well-described. Any underlying immunologic deficiency in this population has been unexplored. Stress and crowding have been invoked as the explanation.?
Thread originator: ?If there is a military connection, it seems unlikely that cases will be limited to Oregon. Testing of specimens revealed that all are adenovirus type 14. This is an unexpected finding, as it is a very rare serotype.?
For more about EIN, visit the IDSA website, www.idsociety.org, and click on the ?EIN? icon on the right side of the page.
Comment
-
Re: Adenovirus 14 - CDC: New Respiratory Bug Has Killed 10
IDSA: Outbreak of Severe Pneumonia Traced to Adenovirus 14
<TABLE cellSpacing=0 cellPadding=0 border=0><TBODY><TR><TD class=credit vAlign=top>By Charles Bankhead, Staff Writer, MedPage Today
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
October 09, 2007
</TD></TR><TR><TD></TD></TR></TBODY></TABLE><TABLE cellSpacing=0 cellPadding=0 width=570 border=0><TBODY><TR><TD class=text vAlign=top>SAN DIEGO, Oct. 9 -- A potentially deadly form of community-acquired pneumonia linked to adenovirus type 14 has emerged in the Pacific northwest, according to a report presented here.<O p="#DEFAULT"></O> Action Points- <LI class=app>Explain to interested patients that a severe form of community-acquired pneumonia has been associated with a previously uncommon form of viral infection.<O p="#DEFAULT"></O>
<LI class=app>Note that most cases reported thus far have been in Oregon, but that does not exclude the possibility that the virus is infecting people in other parts of the country.<O p="#DEFAULT"></O> - Point out that the findings were reported at a medical conference and as a published abstract and should be considered preliminary until they have appeared in a peer-reviewed journal.<O p="#DEFAULT"></O>
<O p="#DEFAULT"></O>First encountered in 2005 in Oregon, the viral pneumonia frequently leads to hospitalization and has a 20% fatality rate, Paul Lewis, M.D., of the Oregon State Public Health Department, said at the Infectious Diseases Society of America meeting.<O p="#DEFAULT"></O>
<O p="#DEFAULT"></O>
"We recommend obtaining a viral culture in pneumonia patients who lack a specific etiology, especially those with severe disease," said Dr. Lewis. "If adenovirus 14 is detected, anticipate a stormy course. We encourage an infectious disease consultation to discuss the risks and benefits of any specific therapy that might be contemplated."<O p="#DEFAULT"></O>
<O p="#DEFAULT"></O>
Recognition of the adenoviral pneumonia began with four patients hospitalized simultaneously at a Portland hospital. Upon comparing notes with physicians at area hospitals, Dr. Lewis and colleagues "almost fell out of our chairs because every hospital we called had recent severe and fatal cases of adenovirus disease."<O p="#DEFAULT"></O>
<O p="#DEFAULT"></O>
Investigators followed up the informal communication with a systematic review of all cases of adenovirus disease identified by Oregon clinical laboratories from November 2006 to April 2007. Six months of active surveillance revealed what appeared to be a winter-spring predominant adenovirus disease, as the number of reported cases increased from January through April.<O p="#DEFAULT"></O>
<O p="#DEFAULT"></O>
Isolates from the sickest patients were sent to the CDC, which found that almost all the cases involved adenovirus 14, a serotype identified more than 50 years ago but rarely detected since then and never in association with outbreaks.<O p="#DEFAULT"></O>
<O p="#DEFAULT"></O>
Dr. Lewis and colleagues at the state health department reviewed analyzed specimens dating back to 1993 and found a few cases of adenoviral disease almost every year. Beginning in 2005 adenovirus 14 was the predominant serotype identified.<O p="#DEFAULT"></O>
<O p="#DEFAULT"></O>
Comparison of 31 patients with adenovirus 14 disease and 14 patients with other adenovirus serotypes showed that adenovirus 14 tended to infect older men (median age 52.9), and almost half the cases involved smokers. Most strikingly, adenovirus 14 was associated with a hospitalization odds ratio of 15.9 compared with other adenovirus serotypes.<O p="#DEFAULT"></O>
<O p="#DEFAULT"></O>
The most common clinical features leading to diagnosis of adenovirus 14 disease were fever (~80%), tachypnea (75% to 80%), hypoxia (~50%), and hypotension (40% to 45%). Chest x-rays were abnormal in 23 of 24 cases. Radiographic progression was common, including single-lobe disease to multilobe in 55% of cases and lobar disease to adult respiratory distress syndrome in 45%.<O p="#DEFAULT"></O>
<O p="#DEFAULT"></O>
All patients received broad-spectrum antibiotics. Dr. Lewis said 22 of the 31 patients with adenovirus 14 disease were hospitalized, and 16 required ICU care. Median hospital and ICU length of stay was seven days. Of the patients treated in the ICU, 13 required ventilatory support and eight had severe hypotension requiring pressor drugs. Seven patients (22%) died.<O p="#DEFAULT"></O>
<O p="#DEFAULT"></O>
Risk factors for death or ICU care were a creatinine level greater than 1.2 mg/dL, lymphocyte count less than 100 ?L, and coinfection with another pathogen. None of those factors remained statistically significant in multivariate analysis.<O p="#DEFAULT"></O>
<O p="#DEFAULT"></O>
"This came out of nowhere in 2005 in Oregon," said Dr. Lewis. Acknowledging that almost all of the cases have involved severe illness, he agreed that the scope of the problem could be much larger and involve a broader spectrum of illness severity.<O p="#DEFAULT"></O>
<O p="#DEFAULT"></O>
<TABLE style="BORDER-RIGHT: #8dabbc 1px solid; PADDING-RIGHT: 5px; BORDER-TOP: #8dabbc 1px solid; PADDING-LEFT: 5px; FONT-SIZE: 12px; PADDING-BOTTOM: 5px; BORDER-LEFT: #8dabbc 1px solid; PADDING-TOP: 5px; BORDER-BOTTOM: #8dabbc 1px solid; FONT-FAMILY: arial; BACKGROUND-COLOR: #dbe9f2" cellSpacing=0 hspace="1"><TBODY><TR><TD>Dr. Lewis reported no conflicts. David Gilbert, M.D., an investigator in the study, disclosed consulting relationships with Schering-Plough and Pfizer and speaker fees from Merck, Wyeth, and GlaxoSmithKline.<O p="#DEFAULT"></O></TD></TR></TBODY></TABLE>
Primary source: Infectious Diseases Society of America
Source reference:
Lewis P, et al. "Adenovirus 14: a new cause of severe community-acquired pneumonia." Infectious Diseases Society of America 45<SUP>th</SUP> Annual Meeting. Oct. 4-7, 2007. San Diego. Final Program and Abstracts. Abstract LB-5.
</TD></TR></TBODY></TABLE>Comment
- <LI class=app>Explain to interested patients that a severe form of community-acquired pneumonia has been associated with a previously uncommon form of viral infection.<O p="#DEFAULT"></O>
-
Re: Adenovirus 14 - CDC: New Respiratory Bug Has Killed 10
Power point of Paul Lewis presentation
Comment
Comment