title: Virology and epidemiology analyses of global adenovirus-associated conjunctivitis outbreaks, 1953-2013.
abstract: This study aimed to compare the virology and epidemiology of epidemic keratoconjunctivitis (EKC), pharyngoconjunctival fever (PCF) and acute haemorrhagic conjunctivitis (AHC) outbreaks worldwide caused by the human adenovirus (HAdV) from 1953 to 2013. Eighty-three hexon sequences from 76 conjunctivitis outbreaks were analysed and subtyped using Mega 5.05, Clustal X and SimPlot software. Epidemiology was performed for the area, age and seasonal distribution. A phylogenetic analysis indicated that all the isolates could be divided into three subgenetic lineages, without a common ancestor. The major causes of the outbreaks were Ad8, Ad7 and Ad2 co-infection with enterovirus 70 (EV70) in EKC, PCF and AHC, respectively. The epidemiological findings suggested that EKC and AHC were circulating predominantly in Asia during the early winter and spring, whereas PCF was circulating mainly in China, Australia and the United States during the summer. This study suggests that EKC, AHC and PCF outbreaks have different circulating patterns throughout the world and are caused by different adenovirus serotypes. A global surveillance system should be established to monitor conjunctivitis outbreaks in the future.
authors.affiliation: Eye Center,Second Affiliated Hospital,Medical School of Zhejiang University,Hangzhou,Zhejiang Province,China.
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.affiliation: National Research Center for Wildlife Born Diseases,Institute of Zoology,Chinese Academy of Sciences,Beijing,China.
authors.forename: N
authors.initials: N
authors.lastname: Zhao
authors.affiliation: Department of Gastroenterology,The 421 Hospital of Chinese People's Liberation Army,Guangzhou,Guangdong Province,China.
authors.forename: J
authors.initials: J
authors.lastname: Sha
authors.affiliation: National Research Center for Wildlife Born Diseases,Institute of Zoology,Chinese Academy of Sciences,Beijing,China.
authors.forename: C
authors.initials: C
authors.lastname: Wang
authors.affiliation: Eye Center,Second Affiliated Hospital,Medical School of Zhejiang University,Hangzhou,Zhejiang Province,China.
authors.forename: X
authors.initials: X
authors.lastname: Jin
authors.affiliation: Department of Zoology,Faculty of Science,Kafr El Sheikh University,Kafr El Sheikh,Egypt.
authors.forename: S
authors.initials: S
authors.lastname: Amer
authors.affiliation: Department of Infectious Diseases,Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou,Zhejiang Province,China.
authors.forename: S
authors.initials: S
authors.lastname: Liu
mesh_terms: D000257:Adenoviridae Infections / Q000453:epidemiology* / Q000821:virology*; D000260:Adenoviruses, Human / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D000367:Age Factors; D036022:Capsid Proteins / Q000235:genetics; D003236:Conjunctivitis, Viral / Q000453:epidemiology* / Q000821:virology*; D004196:Disease Outbreaks; D005838:Genotype; D014943:Global Health; D006801:Humans; D017720:Molecular Epidemiology; D010802:Phylogeny; D012621:Seasons; D019371:Topography, Medical
chemical_list: D036022:Capsid Proteins; C018315:hexon capsid protein, Adenovirus
keywords: Adenovirus; conjunctivitis; ocular infection; outbreak; virology