Outbreak of human adenovirus type 3 infection in a pediatric long-term care facility - Illinois, 2005
Outbreak of human adenovirus type 3 infection in a pediatric long-term care facility - Illinois, 2005
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DOI：
10.1086/519938
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发表时间：
2007-08-15
影响因子：
11.8
通讯作者：
Gerber, Susan I.
中科院分区：
文献类型：
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作者：
James, Lyn;Vernon, Michael O.;Gerber, Susan I.
背景人类3型腺病毒（HAdV-3）可导致儿童严重呼吸道疾病，但长期护理设施中的疫情尚未经常报告。我们描述了HAdV-3感染的爆发，在长期护理机构的儿童有严重的神经功能障碍，其中只有3的63名居民是走动。HAdV-3的临床病例被定义为发热（体温>= 38.0 ℃）和居民呼吸道症状恶化或结膜炎，发病时间为2005年6月至8月。我们查阅了医疗记录;监测发烧、结膜炎和呼吸道症状，并从有症状的居民中收集鼻咽和结膜样本。标本在HAdV允许的细胞系中培养或通过HAdV特异性聚合酶链反应分析。63名居民中有35名（56%）患有符合病例定义的疾病; 17名患者（49%）入住重症监护室，2名（6%）死亡。患者在重症监护室住院，共233患者日。发病日期为2005年6月1日至8月24日。呼吸道感染32例（91%），结膜炎3例（9%）。20例患者经培养或PCR鉴定为HAdV。9株HAdV-3为a2型。考虑到居民的流动性有限以及他们对呼吸道护理的依赖，此次疫情期间HAdV-3感染的传播可能是通过工作人员提供的呼吸道护理发生的。在易感基础疾病患者居住的环境中，当患者被确定患有恶化的呼吸道疾病时，应考虑HAdV感染，并且HAdV感染的快速诊断测试应随时可用，以帮助识别和减少这种病原体的传播。
Background. Human adenovirus type 3 (HAdV-3) causes severe respiratory illness in children, but outbreaks in long-term care facilities have not been frequently reported. We describe an outbreak of HAdV-3 infection in a long-term care facility for children with severe neurologic impairment, where only 3 of 63 residents were ambulatory.Methods. A clinical case of HAdV-3 was defined as fever (temperature, >= 38.0 degrees C) and either a worsening of respiratory symptoms or conjunctivitis in a resident, with illness onset from June through August 2005. We reviewed medical records; conducted surveillance for fever, conjunctivitis, and respiratory symptoms; and collected nasopharyngeal and conjunctival specimens from symptomatic residents. Specimens were cultured in HAdV-permissive cell lines or were analyzed by HAdV-specific polymerase chain reaction assay.Results. Thirty-five (56%) of 63 residents had illnesses that met the case definition; 17 patients (49%) were admitted to intensive care units, and 2 (6%) died. Patients were hospitalized in the intensive care unit for a total of 233 patient-days. Illness onset dates ranged from 1 June through 24 August 2005. Thirty-two patients (91%) had respiratory infection, and 3 (9%) had conjunctivitis. HAdV was identified by culture or PCR in 20 patients. Nine isolates were characterized as HAdV-3 genome type a2.Conclusions. Considering the limited mobility of residents and their reliance on respiratory care, transmission of HAdV-3 infection during this outbreak likely occurred through respiratory care provided by staff. In environments where patients with susceptible underlying conditions reside, HAdV infection should be considered when patients are identified with worsening respiratory disease, and rapid diagnostic tests for HAdV infection should be readily available to help identify and curtail the spread of this pathogen.