Outbreak of Pneumonia Associated with Emergent Human Adenovirus Serotype 14-Southeast Alaska, 2008
Outbreak of Pneumonia Associated with Emergent Human Adenovirus Serotype 14-Southeast Alaska, 2008
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DOI：
10.1086/653498
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发表时间：
2010-07-15
影响因子：
6.4
通讯作者：
Anderson, Larry J.
中科院分区：
文献类型：
--
作者：
Esposito, Douglas H.;Gardner, Tracie J.;Anderson, Larry J.
背景2008年9月，在阿拉斯加东南部的一个乡村岛屿上发生了与新出现的人类腺病毒（人类腺病毒血清型14 [HAdV-14]）相关的肺炎爆发。9例患者需要住院治疗，1例患者死亡。为了调查疫情，根据年龄、性别和居住社区将肺炎病例患者与对照参与者进行匹配。对调查对象及其家庭接触者进行了访谈，并采集了血清样本和呼吸道标本。通过条件Logistic回归分析评估危险因素。在32例肺炎病例中，21例（65%）已确诊或可能感染HAdV-14。32名匹配的对照参与者中没有HAdV-14感染的证据（差异P <0.001）。与肺炎独立相关的因素包括与已知的HAdV-14感染病例患者接触（比值比[OR]，18.3 [95%置信区间{CI}，>= 2.0]），目前吸烟（OR，6.7 [95%CI，>= 0.9]），并且从未出岛旅行或参加大型公众集会（OR，14.7 [95%CI，>= 2.0]）。21例HAdV-14阳性病例中有14例（67%）属于一个单一的社交网络，经常一起吸烟，很少离开岛屿。HAdV-14感染发生在43%的病例-患者家庭接触者中，而对照参与者家庭接触者为5%（P = .005）。在阿拉斯加的一次社区爆发期间，HAdV-14似乎主要在密切接触者中传播，而不是在社区中广泛传播。病例患者的人口统计学特征和疾病模式与最近在美国其他HAdV-14感染暴发中观察到的相似。
Background. In September 2008, an outbreak of pneumonia associated with an emerging human adenovirus (human adenovirus serotype 14 [HAdV-14]) occurred on a rural Southeast Alaska island. Nine patients required hospitalization, and 1 patient died.Methods. To investigate the outbreak, pneumonia case patients were matched to control participants on the basis of age, sex, and community of residence. Participants in the investigation and their household contacts were interviewed, and serum samples and respiratory tract specimens were collected. Risk factors were evaluated by means of conditional logistic regression.Results. Among 32 pneumonia case patients, 21 (65%) had confirmed or probable HAdV-14 infection. None of 32 matched control participants had evidence of HAdV-14 infection (P < .001 for the difference). Factors independently associated with pneumonia included contact with a known HAdV-14-infected case patient (odds ratio [OR], 18.3 [95% confidence interval {CI}, >= 2.0]), current smoking (OR, 6.7 [95% CI, >= 0.9]), and having neither traveled off the island nor attended a large public gathering (OR, 14.7 [95% CI, >= 2.0]). Fourteen (67%) of 21 HAdV-14-positive case patients belonged to a single network of people who socialized and often smoked together and infrequently traveled off the island. HAdV-14 infection occurred in 43% of case-patient household contacts, compared with 5% of control-participant household contacts (P = .005)Conclusions. During a community outbreak in Alaska, HAdV-14 appeared to have spread mostly among close contacts and not widely in the community. Demographic characteristics and illness patterns among the case patients were similar to those observed in other recent outbreaks of HAdV-14 infection in the United States.