martes, 9 de junio de 2015

Ahead of Print -Severe Pediatric Adenovirus 7 Disease in Singapore Linked to Recent Outbreaks across Asia - Volume 21, Number 7—July 2015 - Emerging Infectious Disease journal - CDC


Ahead of Print -Severe Pediatric Adenovirus 7 Disease in Singapore Linked to Recent Outbreaks across Asia - Volume 21, Number 7—July 2015 - Emerging Infectious Disease journal - CDC

CDC. Centers for Disease Control and Prevention. CDC 24/7: Saving Lives. Protecting People.

Volume 21, Number 7—July 2015


Severe Pediatric Adenovirus 7 Disease in Singapore Linked to Recent Outbreaks across Asia

Natalie Woon Hui TanComments to Author , Koh Cheng Thoon, and Hui Ying Chua
Author affiliations: Tan Tock Seng Hospital, Singapore (O.T. Ng, H.Y. Chua, L. Cui, P.U. Krishnan, W.X. Khong)KK Women’s and Children’s Hospital, Singapore (K.C. Thoon, N.W.H. Tan, C.Y. Chong, N.W.S. Tee)Duke–National University of Singapore Graduate Medical School, Singapore (K.C. Thoon, N.W.H. Tan, C.Y. Chong, N.W.S. Tee);Yong Loo Lin School of Medicine, Singapore (N.W.H. Tan); Ministry of Health, Singapore (R.T.P. Lin)National Public Health Laboratory, Singapore (R.T.P. Lin, L. Cui, S. Maurer-Stroh)National University Hospital, Singapore (I. Venkatachalam, P.A. Tambyah, J. Chew)Changi General Hospital, Singapore (R.K.C. Fong, H.M.L. Oh)Ministry of Defence, Singapore (V.J.M. Lee)DSO National Laboratories, Singapore (B.H. Tan, S.H. Ng, P.J. Ting);Bioinformatics Institute, Agency for Science, Technology & Research, Singapore (S. Maurer-Stroh, V. Gunalan);School of Biological Sciences, Nanyang Technological University, Singapore (S. Maurer-Stroh)


During November 2012–July 2013, a marked increase of adenovirus type 7 (Ad7) infections associated with severe disease was documented among pediatric patients in Singapore. Phylogenetic analysis revealed close genetic links with severe Ad7 outbreaks in China, Taiwan, and other parts of Asia.
Human adenoviruses (HAdVs) are classified into >50 types and are associated with clinical manifestations that include respiratory, gastrointestinal, ocular, genitourinary, and neurologic disease (1). HAdV infections have been estimated to cause 5%–10% of acute respiratory illnesses in children <5 years of age. Although most infections are subclinical or result in mild upper respiratory tract illnesses, HAdVs can also cause severe pneumonia. Among the HAdV types, type 7 (Ad7) has most often been associated with severe respiratory disease (2).
Recent reports have noted increased incidence of severe Ad7 disease in Asia: among the general population and pediatric inpatients in Taiwan; among persons in a military training camp in Shaanxi, China; and among those in a police training center in Kuala Lumpur, Malaysia (24). During January–June 2013, physicians in Singapore noted an increase in HAdV pediatric inpatients. Here we characterize the clinical and molecular epidemiology of this outbreak by reviewing data from government hospitals, the military, and a nationwide influenza-like illness (ILI) laboratory surveillance network in Singapore.

Dr. Ng is an Infectious Disease Consultant at Tan Tock Seng Hospital. His primary research interests are pathogen molecular epidemiology, emerging infectious diseases, and HIV.


We thank the staff of all participating institutions who contributed to patient care and data collection for this analysis.
This study was supported by the Transition Award (NMRC/TA/0009/2012) grant, the Singapore National University Health System H7N9 grant (NUHSRO/2013/144/H7N9/06), and the NHG Small Innovative Grant (SIG/14015). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.


  1. Lynch JP IIIFishbein MEchavarria MAdenovirus. Semin Respir Crit Care Med2011;32:494511DOIPubMed
  2. Tsou TPTan BFChang HYChen WCHuang YPLai CYCommunity outbreak of adenovirus, Taiwan, 2011. Emerg Infect Dis.2012;18:182532.PubMed
  3. Yu PMa CNawaz MHan LZhang JDu QOutbreak of acute respiratory disease caused by human adenovirus type 7 in a military training camp in Shaanxi, China. Microbiol Immunol2013;57:55360DOIPubMed
  4. Yusof MARashid TRThayan ROthman KAHasan NAAdnan NHuman adenovirus type 7 outbreak in police training center, Malaysia, 2011.Emerg Infect Dis2012;18:8524DOIPubMed
  5. Tan XQZhao XLee VJLoh JPTan BHKoh WHRespiratory viral pathogens among Singapore military servicemen 2009–2012: epidemiology and clinical characteristics. BMC Infect Dis2014;14:204DOIPubMed
  6. Lee VJChen MIYap JOng JLim WYLin RTComparability of different methods for estimating influenza infection rates over a single epidemic wave. Am J Epidemiol2011;174:46878DOIPubMed
  7. Lu XErdman DDMolecular typing of human adenoviruses by PCR and sequencing of a partial region of the hexon gene. Arch Virol.2006;151:1587602DOIPubMed
  8. Tamura KNei MEstimation of the number of nucleotide substitutions in the control region of mitochondrial DNA in humans and chimpanzees. Mol Biol Evol1993;10:51226 .PubMed
  9. Tamura KStecher GPeterson DFilipski AKumar SMEGA6: Molecular Evolutionary Genetics Analysis version 6.0. Mol Biol Evol.2013;30:27259DOIPubMed
  10. Tang LWang LTan XXu WAdenovirus serotype 7 associated with a severe lower respiratory tract disease outbreak in infants in Shaanxi Province, China. Virol J2011;8:23DOIPubMed
  11. Erdman DDXu WGerber SIGray GCSchnurr DKajon AEMolecular epidemiology of adenovirus type 7 in the United States, 1966–2000. Emerg Infect Dis2002;8:26977 . DOIPubMed
  12. Li QGZheng QJLiu YHWadell GMolecular epidemiology of adenovirus types 3 and 7 isolated from children with pneumonia in Beijing. J Med Virol1996;49:1707DOIPubMed
  13. Kim YJHong JYLee HJShin SHKim YKInada TGenome type analysis of adenovirus types 3 and 7 isolated during successive outbreaks of lower respiratory tract infections in children. J Clin Microbiol2003;41:45949DOIPubMed
  14. Gray GCSetterquist SFJirsa SJDesJardin LEErdman DDEmergent strain of human adenovirus endemic in Iowa. Emerg Infect Dis.2005;11:1278DOIPubMed
  15. Noda MYoshida TSakaguchi TIkeda YYamaoka KOgino TMolecular and epidemiological analyses of human adenovirus type 7 strains isolated from the 1995 nationwide outbreak in Japan. J Clin Microbiol2002;40:1405DOIPubMed
Suggested citation for this article: Ng OT, Thoon KC, Chua HY, Tan NWH, Chong CY, Tee NWS, et al. Severe pediatric adenovirus 7 disease in Singapore linked to recent outbreaks across Asia. Emerg Infect Dis. 2015 Jul [date cited].
DOI: 10.3201/eid2107.141443

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