title: A human adenovirus species B subtype 21a associated with severe pneumonia.
abstract: Between 2005 and 2013 six severe pneumonia cases (all requiring mechanical ventilation, two fatal outcomes) caused by human adenovirus type 21 (HAdV-B21) were observed in Germany. So far, HAdV-B21 was mainly associated with non-severe upper and lower respiratory tract infections. However, a few highly virulent HAdV types, e.g. HAdV-B14p1, were previously associated with severe, fatal pneumonia. Complete genomic sequences of the German HAdV-B21 pneumonia isolates formed a single phylogenetic cluster with very high sequence identity (≥ 99.897%). Compared to the HAdV-B21 prototype (only 99.319% identity), all isolates had a unique 15 amino acid deletion and a 2 amino acid insertion in the RGD loop of the penton base which may affect binding to the secondary receptor on the host cells. Moreover, a recombinant E4 gene region derived of HAdV-B3 was identified by bootscan analysis. Thus, the highly virulent, pneumotropic HAdV-B21 was denominated as subtype 21a. Surprisingly, there was 99.963% identity with agent Y/SIBU97 (only 13.4 kb available in GenBank of the 35.4 kb genome) which was associated with 10 fatalities due to cardiopulmonary failure in Sarawak, Malaysia, in 1997. In conclusion, a HAdV-B21 subtype (21a) associated with severe pneumonia in Germany was phylogenetically linked to an adenovirus isolated in Malaysia.
authors: Institut für Virologie, Medizinische Hochschule, Hannover, Germany.
authors: Elias
authors: E
authors: Hage
authors: Institut für Virologie, Albert-Ludwigs-Universität, Freiburg, Germany.
authors: Daniela
authors: D
authors: Huzly
authors: Institut für Virologie, Medizinische Hochschule, Hannover, Germany.
authors: Tina
authors: T
authors: Ganzenmueller
authors: Institut für Medizinische Virologie, Universitätsklinikum Tübingen, Germany.
authors: Robert
authors: R
authors: Beck
authors: Institut für Virologie, Medizinische Hochschule, Hannover, Germany; Deutsches Zentrum Infektionsforschung, Hannover und Braunschweig, Germany.
authors: Thomas F
authors: TF
authors: Schulz
authors: Institut für Virologie, Medizinische Hochschule, Hannover, Germany; Netzwerk Atemwegsinfektionen des Robert-Koch-Institutes, Adenovirus Konsiliarlabor, Germany. Electronic address: heim.albert@mh-hannover.de.
authors: Albert
authors: A
authors: Heim
mesh_terms: D000260:Adenoviruses, Human / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D000328:Adult; D000595:Amino Acid Sequence; D002675:Child, Preschool; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005858:Germany; D006801:Humans; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D010802:Phylogeny; D011024:Pneumonia, Viral / Q000821:virology*; D012141:Respiratory Tract Infections / Q000821:virology; D014764:Viral Proteins / Q000235:genetics
chemical_list: D004279:DNA, Viral; D014764:Viral Proteins
keywords: Adenovirus infections; Communicable diseases; Emerging; Genetic; Human; Pneumonia; Recombination; Viral