Health care transmission of a newly emergent adenovirus serotype in health care personnel at a military hospital in Texas, 2007.
BACKGROUND
Adenoviruses can cause outbreaks of febrile respiratory illness in military trainees, but until 2007, adenovirus serotype 14 (Ad14) was never associated with such outbreaks. From April through June 2007, 15 trainees at one base were hospitalized for pneumonia due to Ad14. Subsequent reports of febrile respiratory illness among health care personnel suggested nosocomial transmission.


METHODS
Health care personnel participants completed a questionnaire and provided blood and nasal wash specimens for Ad14 diagnostic testing. We defined a confirmed case of Ad14 infection as one with titers > or = 1:80 or nasal wash specimens positive for Ad14 by polymerase chain reaction, whereas a possible case was defined by titers of 1:20 or 1:40. We also collected environmental samples.


RESULTS
Among 218 tested health care personnel, 35 (16%) had titers > or = 1:20; of these, 7 had possible cases and 28 had confirmed cases of infection. Confirmed case patients were more likely to report febrile respiratory illness (57% vs 11%; P< .001) and to have had direct contact with patients with Ad14 infection (82% vs 62%; P.04 ). Of the 23 confirmed case patients with direct contact with Ad14-infected patients, 52% reported that patients were not in contact and droplet precautions at the time of exposure. Ad14 was recovered from several hospital surfaces.


CONCLUSIONS
Our findings of possible nosocomial transmission of Ad14 highlight the need to reinforce infection control guidelines.
Division of Healthcare Quality Promotion, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. flessa@cdc.gov
Fernanda C
FC
Lessa
Philip L
PL
Gould
Neil
N
Pascoe
Dean D
DD
Erdman
Xiaoyan
X
Lu
Michel L
ML
Bunning
Vincent C
VC
Marconi
Lisa
L
Lott
Marc-Alain
MA
Widdowson
Larry J
LJ
Anderson
Arjun
A
Srinivasan
D000258:Adenovirus Infections, Human / Q000453:epidemiology / Q000635:transmission* / Q000821:virology; D000260:Adenoviruses, Human / Q000235:genetics / Q000302:isolation & purification*; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003428:Cross Infection / Q000635:transmission* / Q000821:virology; D004196:Disease Outbreaks; D004783:Environmental Microbiology; D005260:Female; D006282:Health Personnel; D006772:Hospitals, Military; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D008297:Male; D008875:Middle Aged; D011024:Pneumonia, Viral / Q000635:transmission / Q000821:virology; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology