Outbreak of acute respiratory disease caused by human adenovirus type 7 and human coronavirus‐229E in Zhejiang Province, China

Abstract

In 2019, an outbreak of pharyngoconjunctival fever (PCF) occurred at a swimming center in Zhejiang Province, China. A total of 97 (13.55%) of the 716 amateur swimmers had illnesses, with 24 patients (24.74%) hospitalized in the pediatric ward. Human adenovirus serotype 7 (HAdV‐7) was isolated from one concentrated water from the swimming pool, and 20 of 97 positive cases without liver damage. This outbreak led to a nosocomial outbreak in the pediatric ward, in which 1 nurse had a fever and was confirmed to be adenovirus positive. The hexon, fiber, and penton genes from 20 outbreak cases, 1 water sample, and 1 nurse had 100% homology. Furthermore, 2 cases admitted to the pediatric ward, 2 parents, and 1 doctor were confirmed to be human coronaviruses (HCoV‐229E) positive. Finally, all outbreak cases had fully recovered, regardless of a single infection (adenovirus or HCoV‐229E) or coinfection of these two viruses simultaneously. Thus, PCF and acute respiratory disease outbreaks in Zhejiang were caused by the completely homologous type 7 adenovirus and HCoV‐229E, respectively. The swimming pool water contaminated with HAdV‐7 was most likely the source of the PCF outbreak, whereas nosocomial transmission might be the source of HCoV‐229E outbreak.

The clinical and virological features of two children's coinfections with human adenovirus type 7 and human coronavirus-229E virus

“…As a result, most of population has no immunity to these two viruses ( 24 ). Thirdly, adenoviruses are non-enveloped viruses that are unusually resistant to physical and chemical agents, which gives them prolonged survival capacity in various environments ( 25 ). The incubation period for mono- or coinfection was 2–3 days, which aligns with previous estimates of adenovirus incubation periods ( 26 ).…”

Human adenovirus lung disease: outbreaks, models of immune-response-driven acute lung injury and pandemic potential

“…Like the Guangdong outbreak, HAdV-7 was responsible for nearly all of the severe cases of infection and was more common than HAdV-3 in severe cases of infection than nonsevere cases overall [13]. HAdV-7 was responsible for an outbreak of pharyngoconjunctival fever at a swimming center in Zhejiang Province, China in the summer of 2019 [14 ▪▪ ]. A total of 97 of 716 swimmers developed illness, with 24 requiring hospitalization that resulted in nosocomial transmission in the pediatric ward.…”