title: An outbreak of adenovirus type 7 in a residential facility for severely disabled children.
abstract: BACKGROUND
  Adenoviruses cause a variety of clinical symptoms, involving the respiratory, gastrointestinal, urogenital, and neurologic systems. Only a few of the 55 known serotypes of adenovirus that affect humans can cause outbreaks of respiratory tract infection.
  
  
  OBJECTIVE
  To describe the characteristics and clinical manifestations of severe respiratory disease contracted by 8 physically and cognitively disabled children during a very short outbreak of adenovirus serotype 7 infection in a residential facility.
  
  
  METHODS
  The clinical, imaging, and laboratory findings of the patients who were hospitalized with severe respiratory symptoms were retrospectively reviewed. Molecular typing of the adenovirus was performed.
  
  
  RESULTS
  During 10 days in February 2010, 8 severely disabled children, 9 months to 5 years of age (median 22.5 months), from the same residential facility, were hospitalized due to severe acute respiratory disease with hypoxemia. Four of them (50%) needed mechanical ventilation for 2 to 8 days and one developed multisystem failure, including acute renal failure. Adenovirus serotype 7 was detected in the respiratory specimens of all 8 children. Two patients were treated with intravenous cidofovir. All 8 patients survived and were discharged after hospitalization of 6 to 15 (median: 11.5) days. The epidemiologic investigation revealed that all the 8 affected children shared a playroom and a caregiver worked with them while suffering fever, sore throat, and conjunctivitis before the onset of the outbreak.
  
  
  CONCLUSIONS
  Adenovirus type 7 may cause short outbreaks of infection in institutions, causing children to develop life-threatening disease. Early detection of pathogens causing respiratory infections in institutions, isolation, and other preventive precautions are advocated. Moreover, vaccination of health care providers in institutions with the currently available live, oral adenovirus vaccine for types 4 and 7 should be considered.
authors.affiliation: Department of Pediatrics, Hadassah University Hospital, Jerusalem, Israel.
authors.forename: Hammam
authors.initials: H
authors.lastname: Ghanaiem
authors.forename: Diana
authors.initials: D
authors.lastname: Averbuch
authors.forename: Benjamin Z
authors.initials: BZ
authors.lastname: Koplewitz
authors.forename: Ido
authors.initials: I
authors.lastname: Yatsiv
authors.forename: Jackues
authors.initials: J
authors.lastname: Braun
authors.forename: Natali
authors.initials: N
authors.lastname: Dehtyar
authors.forename: Dana G
authors.initials: DG
authors.lastname: Wolf
authors.forename: Michal
authors.initials: M
authors.lastname: Mandelboim
authors.forename: Dan
authors.initials: D
authors.lastname: Engelhard
mesh_terms: D000256:Adenoviridae / Q000187:drug effects / Q000502:physiology*; D000258:Adenovirus Infections, Human / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology*; D000998:Antiviral Agents / Q000008:administration & dosage; D002675:Child, Preschool; D000077404:Cidofovir; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D019988:Children with Disabilities; D004196:Disease Outbreaks / Q000517:prevention & control*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D058889:Molecular Typing; D063065:Organophosphonates / Q000008:administration & dosage*; D012112:Residential Facilities; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology*; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir