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Jacqueline E. Tate, Michel L. Bunning, Lisa Lott, Xiaoyan Lu, John Su, David Metzgar, Lorie Brosch, Catherine A. Panozzo, Vincent C. Marconi, Dennis J. Faix, Mila Prill, Brian Johnson, Dean D. Erdman, Vincent Fonseca, Larry J. Anderson, Marc-Alain Widdowson, Outbreak of Severe Respiratory Disease Associated with Emergent Human Adenovirus Serotype 14 at a US Air Force Training Facility in 2007, The Journal of Infectious Diseases, Volume 199, Issue 10, 15 May 2009, Pages 1419–1426, https://doi.org/10.1086/598520
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Abstract
BackgroundIn 2007, a US Air Force training facility reported a cluster of severe respiratory illnesses associated with a rare human adenovirus (Ad) serotype, Ad14. We investigated this outbreak to better understand its epidemiology, clinical spectrum, and associated risk factors
MethodsData were collected from ongoing febrile respiratory illness (FRI) surveillance and from a retrospective cohort investigation. Because an Ad7 vaccine is in development, Ad7 antibody titers in pretraining serum samples from trainees with mild and those with severe Ad14 illness were compared
ResultsDuring 2007, an estimated 551 (48%) of 1147 trainees with FRI were infected with Ad14; 23 were hospitalized with pneumonia, 4 required admission to an intensive care unit, and 1 died. Among cohort members (n=173), the Ad14 infection rate was high (50%). Of those infected, 40% experienced FRI. No cohort members were hospitalized. Male sex (risk ratio [RR], 4.7 [95% confidence interval {CI}, 2.2–10.1]) and an ill close contact (RR, 1.6 [95% CI, 1.2–2.2]) were associated with infection. Preexisting Ad7 neutralizing antibodies were found in 7 (37%) of 19 Ad14-positive trainees with mild illness but in 0 of 16 trainees with Ad14 pneumonia (P=.007)
ConclusionsEmergence of Ad14, a rare Ad serotype, caused a protracted outbreak of respiratory illness among military recruits. Most infected recruits experienced FRI or milder illnesses. Some required hospitalization, and 1 died. Natural Ad7 infection may protect against severe Ad14 illness