Molecular and clinical characteristics of adenoviral infections in Taiwanese children in 2004-2005.
This study clinically and molecularly characterizes an adenovirus epidemic that broke out in Taiwan in April 2004. Clinical data on 325 children diagnosed with acute illness were collected between April 2004 and April 2005, and a diagnosis of adenovirus was confirmed by viral isolation. Polymerase chain reaction and restriction fragment length polymorphism were used to identify the adenovirus genotypes in 267 patients. There was a seasonal variation, with a peak incidence between November 2004 and January 2005 (p < 0.001). The median age was 52 months, range 1-210 months. Most cases (90.8%) were younger than 7 years old. Male-to-female ratio was 1.56:1. The most common clinical diagnosis was exudative tonsillitis (50.8%), followed by bronchitis/bronchiolitis (29.9%), conjunctivitis or pharyngoconjunctival fever (22.5%), and acute otitis media (16.3%). Adenovirus type 3 was found in 215 patients (80.5%). The other 52 patients had other genotypes: type 2 (10.1%), type 1 (6.0%), type 5 (1.9%), type 7 (0.7%), type 4 (0.4%), and type 6 (0.4%). Patients with type 3 were significantly older [age >52 months, adjusted odds ratio (OR) 8.55, 95% confidence interval (CI) 1.84-40, p = 0.006), their family members had a higher incidence of illness (adjusted OR 8.77, 95% CI 1.55-50, p = 0.01), they coughed (adjusted OR 6.37, 95% CI 1.54-26.3, p = 0.01), and they had a higher C-reactive protein (CRP) level (>2.87 mg/dL, adjusted OR 3.64, 95% CI 1.06-12.3, p = 0.04) than the 52 cases with other genotypes. In conclusion, this adenovirus outbreak, from late autumn to winter, was predominately caused by adenovirus type 3. Patients with this genotype were significantly older, had a higher incidence of cough and family transmission, and had higher CRP levels than those with other genotypes.
Cheng
Chia-Chi
CC
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, No 7. Chung-Shan South Road, Taipei, Taiwan, Republic of China.
Huang
Li-Min
LM
Kao
Chuan-Liang
CL
Lee
Ping-Ing
PI
Chen
Jong-Min
JM
Lu
Chun-Yi
CY
Lee
Chin-Yun
CY
Chang
Sui-Yuan
SY
Chang
Luan-Yin
LY
D000258:Adenovirus Infections, Human / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D000260:Adenoviruses, Human / Q000235:genetics* / Q000302:isolation & purification*; D000293:Adolescent; D000956:Antigens, Viral; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis / Q000302:isolation & purification; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008499:Medical Records; D017720:Molecular Epidemiology; D015999:Multivariate Analysis; D010614:Pharynx / Q000821:virology; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D015995:Prevalence; D013624:Taiwan / Q000453:epidemiology
D000956:Antigens, Viral; D004279:DNA, Viral