title: An outbreak of acute respiratory disease in China caused by human adenovirus type B55 in a physical training facility.
abstract: OBJECTIVE
  To investigate the cause of an acute respiratory tract infection (ARTI) outbreak.
  
  
  METHODS
  Thirty-eight clinical samples were collected from 19 patients in an ARTI outbreak that occurred in a physical training facility in January 2013; patient demographic information was also collected. In addition, 60 influenza virus-negative samples from febrile respiratory patients were collected from the same community at the same time to determine whether these were the same infections. Multiplex PCR (multi-PCR) was used to detect the possible pathogen in these samples. All human adenovirus (HAdV)-positive samples were inoculated onto Hep-2 cells for isolation. HAdV isolates were typed by hexon gene, fiber gene, and whole genome sequencing using primers designed in-house and compared to different type/serotype HAdVs downloaded from GenBank. Phylogenetic analysis was used to determine the type of the HAdV.
  
  
  RESULTS
  Of the 38 samples, 34 from 17 cases were HAdV-positive; two of them were co-infected, one with respiratory syncytial virus A and the other with human rhinovirus. The hexon gene open reading frame (ORF; 2841 nucleotides (nt)) and fiber gene ORF (978 nt) were obtained from four HAdV strains (TJ-2013-92, TJ-2013-94, TJ-2013-100, TJ-2013-122) from three upper respiratory infection cases and one pneumonia case. They were all completely identical. One HAdV isolate, TJ-2013-90, was selected for whole genome sequencing; 34238 nt were obtained. Phylogenetic analysis showed the whole genome of TJ-2013-90 to be clustered together with HAdV-B55/HAdV-B11a. Three of 60 influenza virus-negative specimens were HAdV-positive, but hexon and fiber gene analysis showed that they were grouped in different branches to the HAdV isolates from this outbreak.
  
  
  CONCLUSIONS
  The cause of this ARTI outbreak was HAdV-B55. This was another outbreak caused by this re-emerging virus. Continuous surveillance of respiratory adenovirus is necessary for disease control.
authors.affiliation: Tianjin Centers for Disease Control and Prevention, No. 6, Huayue Road, Hedong District, Tianjin, 300011, China. Electronic address: xiaoyanli1291@163.com.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Li
authors.affiliation: Tianjin Centers for Disease Control and Prevention, No. 6, Huayue Road, Hedong District, Tianjin, 300011, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Kong
authors.affiliation: Tianjin Centers for Disease Control and Prevention, No. 6, Huayue Road, Hedong District, Tianjin, 300011, China. Electronic address: suxu@cdctj.gov.cn.
authors.forename: Xu
authors.initials: X
authors.lastname: Su
authors.affiliation: Tianjin Centers for Disease Control and Prevention, No. 6, Huayue Road, Hedong District, Tianjin, 300011, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zou
authors.affiliation: Tianjin Centers for Disease Control and Prevention, No. 6, Huayue Road, Hedong District, Tianjin, 300011, China.
authors.forename: Liru
authors.initials: L
authors.lastname: Guo
authors.affiliation: Tianjin Centers for Disease Control and Prevention, No. 6, Huayue Road, Hedong District, Tianjin, 300011, China.
authors.forename: Xiaochun
authors.initials: X
authors.lastname: Dong
authors.affiliation: Tianjin Centers for Disease Control and Prevention, No. 6, Huayue Road, Hedong District, Tianjin, 300011, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.affiliation: Tianjin Centers for Disease Control and Prevention, No. 6, Huayue Road, Hedong District, Tianjin, 300011, China. Electronic address: gqing_1964@163.com.
authors.forename: Qing
authors.initials: Q
authors.lastname: Gu
mesh_terms: D000208:Acute Disease; D000258:Adenovirus Infections, Human / Q000453:epidemiology* / Q000821:virology*; D000260:Adenoviruses, Human / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D004196:Disease Outbreaks; D005334:Fever / Q000453:epidemiology; D006801:Humans; D008297:Male; D010802:Phylogeny; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology*; D055815:Young Adult
keywords: Human adenovirus-B55; Phylogenetic analysis; Respiratory infection outbreak; Whole genome sequence