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

The outbreak began on April 6, 2011 when a male student presented with fever (oral temperature of 38°C) and a series of FRI symptoms, including cough, sore throat, and headache. The student attended a school (grades 1-9; 11 classes, 28 teachers, and 487 students) located in Tongwei County, Gansu province, China. He continued to attend school and recovered from his symptoms after taking an unknown cold medication administered by the village health center for 3 days. Through a retrospective survey, we learned that the boy did not have contacts with patients exhibiting similar symptoms during 2 weeks prior the onset of the illness. He had also never travelled outside the town. After the index case, the outbreak peaked on April 10, 2011, with 10 cases detected. The last case was reported on April 19 ( Figure 1A ). During the outbreak, 43 students (8Á8%, 43/487 students) from the same school developed into FRI. The patients were 8-15 years old, and 53Á5% (23/43) of them were 12-13 years old. Children from seven classes were affected in this outbreak. Among them, 21 patients were from the fifth grade ( Figure 1B) , the same grade as the index patient. Twenty seven (62Á8%) of the 43 patients were boys. All the patients presented with fever (oral 38°C-40°C), sore throat, cough, headache, and fatigue, similar to influenza-like symptoms. Some of the patients experienced pharyngeal congestion, swollen tonsils, and submandibular lymphadenopathy, and a few patients were diagnosed with mild pneumonia. Given that no patient presented with severe symptoms, all the patients were treated at the village health center and continued to attend school without isolation. Many children presented with the same symptoms of a mild form of FRI. Public health officials at the local CDC office were engaged, and they undertook measures to prevent disease spread, such as morning temperature screening of children, ensuring ventilation through open doors and windows, and disinfecting school surfaces with 0Á2% peroxyacetic acid spray. On average, illnesses lasted for 4-5 days. There were no severe illnesses associated with this outbreak, and all the patients fully recovered. All the patients denied any history of travel in the 2 weeks prior to the onset of illness.