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Heather C. Yun, Vidhya Prakash, Transmission of Adenovirus Serotype 14 in the Health Care Setting, Clinical Infectious Diseases, Volume 46, Issue 12, 15 June 2008, Pages 1935–1936, https://doi.org/10.1086/588558
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Tothe Editor—In the 1 February 2008 issue of Clinical Infectious Diseases, Louie et al. [1] described a cluster of severe respiratory illnesses caused by adenovirus serotype 14 (Ad14). Two children, both requiring high-frequency oscillatory ventilation (HFOV), were admitted to adjacent beds in the intensive care unit; Ad14 infection was diagnosed during the course of hospitalization for both patients. Louie et al. [1] speculated that 1 of these cases may have been acquired nosocomially. We describe a cluster of health care workers (HCWs) infected with adenovirus in association with caring for a critically ill patient with Ad14 infection, to highlight the possibility of transmission of this pathogen and the need for precautions against airborne pathogen transmission that are associated with the use of high-risk respiratory procedures in patient care.
An outbreak of Ad14 infection among military trainees at Lackland Air Force Base, Texas, that started in February 2007 has been described elsewhere [2]. In April and May 2007, 4 trainees required admission to the intensive care unit, including 1 who presented in severe respiratory distress and required immediate intubation, prolonged bag-mask ventilation, and subsequent transition to HFOV. Many HCWs were involved in the patient's resuscitation and initial care in the intensive care unit; within a week, 7 HCWs reported respiratory illness and/or conjunctivitis. As part of our facility's outbreak investigation, active surveillance for respiratory symptoms among this patient's HCWs was undertaken, and 23 reported symptoms. Eight were tested for adenovirus by respiratory viral culture or PCR, and 6 had positive results. Although these specimens were not serotyped, given the exposure to this patient with Ad14 and the high proportion of Ad14 respiratory illnesses among trainees at the time (60 [92.3%] of 65 serotyped isolates [3]), it is most likely that the 8 adenoviruses were Ad14 as well.
