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1 February 2008

Volume 46, Number 3
Clinical Infectious Diseases 2008;46:421–425
© 2008 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2008/4603-0010$15.00
DOI: 10.1086/525261
MAJOR ARTICLE

Severe Pneumonia Due to Adenovirus Serotype 14: A New Respiratory Threat?

Janice K. Louie,1

Adriana E. Kajon,5,6

Mark Holodniy,2,3

Lilly Guardia‐LaBar,4

Brian Lee,4

Ann M. Petru,4

Jill K. Hacker,1 and

David P. Schnurr1

1Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, 2Veterans Affairs Palo Alto Health Care System and 3Division of Infectious Diseases & Geographic Medicine, Stanford University, Stanford, 4Pediatric Infectious Diseases, Children’s Hospital & Research Center Oakland, California; and 5Infectious Disease Program, Lovelace Respiratory Research Institute, and 6Infectious Diseases and Inflammation Program, University of New Mexico Health Sciences Center, Albuquerque, NM

Background.Adenoviruses are associated with sporadic infection and community and institutional outbreaks; they can cause especially severe disease in infants, young children, immunocompromised persons, and transplant recipients. Fifty‐two adenovirus serotypes have been recognized and classified within 7 subgroups or species (A–G), with limited data available on associated clinical syndromes and disease severity in more than one‐half of the known serotypes.

Methods.We describe the clinical presentation and virologic characterization of 1 adult and 2 pediatric patients admitted to 2 separate hospitals during April–May 2006 with severe acute respiratory tract infection. All patients had underlying chronic pulmonary disease; none were severely immunocompromised. All 3 experienced serious chronic sequelae or died.

Results.Adenovirus was isolated from all 3 case patients. Adenovirus serotype 14, a subspecies B2 serotype not previously associated with severe clinical illness, was confirmed by neutralization assay and sequencing of the hexon gene. Restriction enzyme analysis with BamHI, BglII, HindIII, and SmaI showed all 3 viruses to be identical and to belong to a new genome type that we have designated “Ad14a.”

Conclusions.Our identification of severe respiratory illness due to a previously rarely reported adenovirus serotype may signify the emergence in the United States of a new genomic variant that has the potential to spread globally and cause epidemics. These case reports highlight the need for rapid diagnosis and improved surveillance, with serotyping and molecular characterization, to identify emerging variants of adenovirus, which may assist with targeted development of antiviral agents or type‐specific vaccines.

Received 13 July 2007; accepted 24 September 2007; electronically published 3 January 2008.

Reprints or correspondence: Dr. Janice K. Louie, California Dept. of Public Health Viral and Rickettsial Disease Laboratory, 850 Marina Bay Pkwy., Richmond, CA 94804 ().

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