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Health advisory: Advisory: Adenovirus and Severe Respiratory Infection in Oregon and Clark County, Washington
April 30, 2007 |
ACTION REQUESTED:
- Consider adenovirus in any patient with severe respiratory infection of unknown etiology
- Report cases of severe respiratory infection of unknown etiology and suspected outbreaks of adenoviral illness to Public Health at 206-296-4774
- Clinical laboratories are asked to submit adenovirus isolates or the original clinical sample from patients with severe respiratory infection of unknown etiology to the WAPHL after consultation with Public Health
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Background
Today, Oregon Public Health and the Washington Department of Health notified local public health departments of 15 cases of severe respiratory infections due to adenovirus type 14, a rare serotype not previously recognized as a cause of severe community-acquired pneumonia. Fifteen of the 16 persons have been hospitalized. Patients are residents of Multnomah, Washington, and Clackamas Counties in Oregon, and Clark County, Washington. An epidemiologic investigation is under way.
Multiple serotypes of adenovirus cause a spectrum of illness in both normal and immunocompromised hosts. Common manifestations include URI, pharyngitis, otitis media, and pharyngoconjunctival fever. Severe disseminated infection, severe pneumonia, meningitis, and encephalitis occasionally occur especially among young infants and immunocompromised hosts. Unusual manifestations of adenovirus infection include hemorrhagic conjunctivitis, croup, bronchiolitis, hemorrhagic cystitis, and gastroenteritis.
Adenoviral infections are not notifiable in Washington. However, any suspected outbreak of an unusual infectious disease is considered notifiable, as is any case of severe respiratory infection of unknown etiology. Testing of respiratory secretions for adenoviruses by antigen testing and/or viral culture is available at many reference laboratories. Viral culture and rapid shell vial culture are available at the King County Public Health Laboratory. In addition to these tests, polymerase chain reaction (PCR) assay of respiratory secretions is available from the Washington State Department of Health Public Health Laboratories (WAPHL).
Adenovirus isolates or the original clinical sample from patients with severe respiratory infection of unknown etiology should be submited to the WAPHL after consultation with Public Health’s Communicable Disease Section (call 206-296-4774). Preferred samples are nasopharyngeal swab or aspirate, or oropharyngeal swabs in viral transport medium; fluid obtained by bronchoalveolar lavage is also acceptable. The chance of identifying the virus is best within the first three days of onset of illness.
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