Large Epidemic of Respiratory Illness Due to Adenovirus Types 7 and 3 in Healthy Young Adults

Abstract

After 25 years of successful control through immunization, respiratory infections due to adenoviruses have reemerged to threaten the health of young adults in the military. Shortly after the loss of adenovirus vaccine supplies, a large outbreak of respiratory illness was observed at the United States Navy's sole basic training center. Laboratory testing confirmed 541 cases of adenovirus infection, including 378 cases due to serotype 7 and 132 cases due to serotype 3. This outbreak was remarkable because of its unique serotype distribution and the large amount of data available to describe demographic factors associated with infection. This was the largest outbreak of respiratory illness due to adenovirus types 7 and 3 documented in recent history, and it portends even greater challenges for young adults in the military in the postvaccine era.

Molecular epidemiology and clinical presentation of human adenovirus infections in Kansas City children

“…Similar reports on severe outcomes due to disseminated adenoviral infection with HAdV-3 or -7 among children and adults have been published earlier. 15,34 Other adenovirus HAdV serotypes (2,4,5,6,14,19,37, and 41) were also detected in small numbers in our study population and the majority of them were from respiratory specimens followed by stool, eye and throat. Although these serotypes appear to have low prevalence in our area, severe clinical disease and even fatal outcome were reported with HAdV serotypes 4, 11, 14 and 41 worldwide.…”

Respiratory tract infections in a military recruit setting: A prospective cohort study

“…The high impact of respiratory tract infections in military personnel has been well described previously [1][2][3][4]. Recruits are thought to be at high risk due to the crowded living conditions and the stressful environment of military training.…”

“…Thus, large epidemics of infectious diseases -especially of viral etiology -are common. However, few studies in the past examined the determinants of infectious diseases in this setting [1,3,5,7]. We conducted this prospective, observational study of young recruits joining the Hellenic Army for their basic military training to further investigate this issue.…”

“…The crowded living conditions and the physically demanding basic mil- itary training may often lead to epidemics of respiratory infections [1][2][3]. Outbreaks of viral respiratory infections are common in the military training and sometimes may precede outbreaks of much more serious diseases such as meningococcal disease [4].…”

Emergence of a new human adenovirus type 4 (Ad4) genotype: Identification of a novel inverted terminal repeated (ITR) sequence from majority of Ad4 isolates from US military recruits

“…Since 1971, the Ad vaccines were in continuous use to reduce the incidence of Ad associated ARD in recruits by 80-90% (Gaydos and Gaydos, 1995;Lee and Hung, 1993). The recent abrupt termination of Ad vaccines production and administration has resulted in a resumption of Ad-associated ARD outbreaks, caused predominantly by Ad4 at several Army and Navy basic training installations during the period of 1997-2000 (Gray et al, 1999;McNeill et al, 1999McNeill et al, , 2000Ryan et al, 2002;Faix et al, 2004).…”