Epidemiology of severe pediatric adenovirus lower respiratory tract infections in Manitoba, Canada, 1991-2005

Abstract

Background Most pediatric adenovirus respiratory infections are mild and indistinguishable from other viral causes. However, in a few children, the disease can be severe and result in substantial morbidity. We describe the epidemiologic, clinical, radiologic features and outcome of adenovirus lower respiratory tract infections (LRTI) in Aboriginal and Non-Aboriginal children in Manitoba, Canada during the years 1991 and 2005. Methods This was a retrospective study of 193 children who presented to the department of pediatrics at Winnipeg Children's Hospital, Manitoba, Canada with LRTI and had a positive respiratory culture for adenovirus. Patients' demographics, clinical and radiologic features and outcomes were collected. Adenovirus serotype distributions and temporal associations were described. Approximate incidence comparisons (detection rates) of adenovirus LRTI among Aboriginal and Non-Aboriginal children were estimated with 95% confidence intervals. Results Adenovirus infections occurred throughout the year with clusters in the fall and winter. Serotypes 1 to 3 were the predominant isolates (two thirds of the cases). The infection was more frequent among Canadian Aboriginals, as illustrated in 2004, where its incidence in children 0-4 years old was 5.6 fold higher in Aboriginals (13.51 vs. 2.39 per 10,000, p < 0.000). There were no significant differences in length of hospitalization and use of ventilator assistance between the two groups ( p > 0.185 and p > 0.624, respectively) nor across serotypes ( p > 0.10 and p > 0.05, respectively). The disease primarily affected infants (median age, 9.5 months). Most children presented with bronchiolitis or pneumonia, with multi-lobar consolidations on the chest x-ray. Chronic (residual) changes were documented in 16 patients, with eight patients showing bronchiectasis on the chest computerized tomography scan. Conclusions Adenovirus infection is associated with significant respiratory morbidities, especially in young infants. The infection appears to be more frequent in Aboriginal children. These results justify a careful follow-up for children with adenovirus LRTI.

Genotyping of human adenoviruses circulating in Southwest India

“…Serotype 1-3 have shown predominance in pediatric adenovirus lower respiratory tract infection in Canada [2] and in our study, 2 pediatric cases of LRTI were found to be associated HAdV-3. Fig.…”

Impact of Human Adenovirus Serotype 7 in Hospitalized Children with Severe Fatal Pneumonia in the Philippines

“…Therefore, it is of great importance to decipher the clinical and molecular characteristics of HAdV. Although many studies have been published (2,5,18), data on the molecular epidemiology of HAdV in tropi- Table 1 : Synonymous mutation was observed.…”

“…Furthermore, a variety of genome types can be identified by the restriction fragment length polymorphism (RFLP) technique (6). Temporal and geographical distributions of serotypes and genome types have been reported (2,5,(7)(8)(9)(10)(11)(12). It has also been indicated that the emergence or switching of serotypes and genome types can cause HAdV outbreaks (8).…”

“…The HAdV subspecies B1 includes serotypes 3, 7, and 21, which can cause lower respiratory infections (1,2).…”

Bronquiolitis obliterante post-infecciosa: características y seguimiento a mediano plazo de 21 casos en Bogotá-Colombia a 2640 m de altura

“…A pesar de esta limitación el dato coincide con lo reportado en la literatura, especialmente con relación a la relevancia del adenovirus en la causalidad de la bronquiolitis obliterante post-infecciosa. 15,16 En cuanto al pronóstico de la enfermedad y con un seguimiento promedio de 5.6 años, obser-vamos una evolución global desfavorable en el 71% de los casos. Nuestros pacientes tuvieron consultas y hospitalizaciones frecuentes (a veces con necesidad de ventilación mecánica) y requirieron numerosos estudios paraclínicos entre ellos tomografía de tórax, gammagrafías pulmonares, estudios inmunológicos, electrolitos en sudor, ecocardiogramas y polisomnografías.…”