title: First reported outbreak of diarrhea due to adenovirus infection in a hematology unit for adults.
abstract: Numerous outbreaks of adenovirus infection from different types of health care settings, except a hematology unit, have been reported. This is the first report describing an outbreak of adenovirus infection causing diarrhea among adult hematopoietic stem cell transplant recipients. Six of 21 patients from the outbreak cohort were affected with diarrhea. Electron microscopy, cell culture, and direct DNA sequencing of amplicons generated from stool and blood samples were used to investigate this outbreak. Electron microscopy and cell culture detected adenovirus in stools from symptomatic patients. DNA sequencing of amplicons generated from stool samples confirmed nosocomial transmission of infection from a single index case. The outbreak strain was also detected in plasma of four of these patients, suggesting systemic infection. The outbreak strain was identified as type 12. Standard infection control measures were effective to control this outbreak.
authors.affiliation: Clinical Microbiology & Public Health Laboratory, Addenbrooke's Hospital, Cambridge, Hills Road, Cambridge CB2 2QW, United Kingdom. hamid.Jalal@addenbrookes.nhs.uk
authors.forename: Hamid
authors.initials: H
authors.lastname: Jalal
authors.forename: David F
authors.initials: DF
authors.lastname: Bibby
authors.forename: Julian W
authors.initials: JW
authors.lastname: Tang
authors.forename: Julie
authors.initials: J
authors.lastname: Bennett
authors.forename: Chara
authors.initials: C
authors.lastname: Kyriakou
authors.forename: Karl
authors.initials: K
authors.lastname: Peggs
authors.forename: David
authors.initials: D
authors.lastname: Cubitt
authors.forename: Nicola S
authors.initials: NS
authors.lastname: Brink
authors.forename: Kate N
authors.initials: KN
authors.lastname: Ward
authors.forename: Richard S
authors.initials: RS
authors.lastname: Tedder
mesh_terms: D000258:Adenovirus Infections, Human / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D000260:Adenoviruses, Human / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D000328:Adult; D000818:Animals; D001483:Base Sequence; D036022:Capsid Proteins / Q000737:chemistry / Q000235:genetics; D002460:Cell Line; D003428:Cross Infection / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D003967:Diarrhea / Q000453:epidemiology* / Q000821:virology; D004196:Disease Outbreaks; D005260:Female; D006405:Hematology; D006757:Hospital Units; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction / Q000379:methods; D017422:Sequence Analysis, DNA
chemical_list: D036022:Capsid Proteins; C018315:hexon capsid protein, Adenovirus