title: Prison and community outbreak of severe respiratory infection due to adenovirus type 14p1 in Tayside, UK.
abstract: BACKGROUND
  This report describes the investigation and public health management of a community-based outbreak of severe adenovirus serotype 14p1 respiratory infection affecting the Tayside area during 2011. It is the first report of an adenovirus outbreak involving prisons.
  
  
  METHODS
  An outbreak-based/incident management approach was carried out. Alerts were sent out to local doctors, general practitioners, prison healthcare staff and consultants so that cases could be identified prospectively. Sequencing of hexon, fibre and E1A regions of adenovirus were carried out to genotype the viruses.
  
  
  RESULTS
  Fifteen cases were identified in total, including 13 confirmed cases and 2 possible cases. There were 3 deaths amongst the 13 confirmed cases, with a case fatality rate of 23%. Eight of the cases had a direct association with one of the two prisons in the area.
  
  
  CONCLUSIONS
  We advise that surveillance measures for adenovirus infection and guidelines for the management of critically ill patients should be developed in order to identify outbreaks at an early stage and allow patients to receive appropriate treatment. Adenovirus infection should be borne in mind as a cause of severe pneumonia in closed settings such as prisons.
authors.affiliation: Department of Medical Microbiology, Ninewells Hospital and Medical School, NHS Tayside, Dundee DD1 9SY, UK.
authors.forename: B J
authors.initials: BJ
authors.lastname: Parcell
authors.affiliation: Department of Medical Microbiology, Ninewells Hospital and Medical School, NHS Tayside, Dundee DD1 9SY, UK.
authors.forename: P G
authors.initials: PG
authors.lastname: McIntyre
authors.affiliation: Department of Medical Microbiology, Ninewells Hospital and Medical School, NHS Tayside, Dundee DD1 9SY, UK.
authors.forename: D L
authors.initials: DL
authors.lastname: Yirrell
authors.affiliation: NHS Health Scotland, Lothian EH10 4SG, UK.
authors.forename: A
authors.initials: A
authors.lastname: Fraser
authors.affiliation: Department of Public Health, Cameron House, NHS Fife, Leven KY8 5RG, UK.
authors.forename: M
authors.initials: M
authors.lastname: Quinn
authors.affiliation: Edinburgh Specialist Virology Centre, Royal Infirmary Edinburgh, Edinburgh,EH16 4SA, UK.
authors.forename: K
authors.initials: K
authors.lastname: Templeton
authors.affiliation: Intensive Care, Ninewells Hospital and Medical School, NHS Tayside, Dundee DD1 9SY, UK.
authors.forename: S
authors.initials: S
authors.lastname: Christie
authors.affiliation: Directorate of Public Health, Kings Cross, Clepington Road, Dundee, DD3 8EA, UK.
authors.forename: F
authors.initials: F
authors.lastname: Romanes
mesh_terms: D000256:Adenoviridae / Q000145:classification; D000258:Adenovirus Infections, Human / Q000453:epidemiology* / Q000821:virology; D000328:Adult; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011330:Prisons / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology; D012703:Serotyping; D006113:United Kingdom
keywords: adenovirus; outbreak; pneumonia; prison; sequencing