Outbreak of febrile respiratory illness associated with human adenovirus type 14p1 in Gansu Province, China

Huang, Guohong; Yu, Deshan; Zhu, Zhen; Zhao, Hai; Wang, Peng; Gray, Gregory C.; Meng, Lei; Xu, Wenbo

In recent decades, outbreaks of HAdV-associated FRI have been reported in various regions worldwide, 8, 9, 23, 24 including China. HAdV-3 and HAdV-7 have been most frequently implicated in Chinese FRI outbreaks. [16] [17] [18] [19] Here, we report the first outbreak of FRI associated with HAdV-14p1 at a primary and middle school in China and the first schoolbased HAdV-14p1 outbreak in the world. HAdV-14 was initially discovered in 1955 in the Netherlands, 25 and it was subsequently isolated in Great Britain in the same year, 26 Uzbekistan in 1962, 27 and Czechoslovakia in 1963. 28 Its detection was not reported for the next 40 years, with the only exception of the sporadic isolation in the Netherlands during 1974. HAdV subspecies B2 was found only in Eurasia before HAdV-14 was detected in North America in 2006. 15 Afterward, HAdV-14p1 spread widely and caused severe cases and deaths in adults in the United States. 29 Deaths associated with HAdV-14p1 infection were also recently reported in Europe. 30 This HAdV-14p1 outbreak produced a series of mild FRI symptoms among children of 8-15 years of age. The outbreak differed from that in the US HAdV-14p1 outbreak reports in that the US adults often suffered severe pneumonia and death. The age of the patients in China likely played an important role in attenuating the disease severity. 7 In our study, male patients accounted for 62Á8% (27/43) of the cases, which was similar to other observations. [30] [31] [32] The significance of gender as a risk factor for HAdV-14p1 infection was unknown. We hypothesized that it was due to the poor hygienic behaviors of school-aged boys.