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Journal of Clinical Microbiology, March 2009, p. 697-703, Vol. 47, No. 3
0095-1137/09/$08.00+0 doi:10.1128/JCM.01769-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
Outbreak of Acute Respiratory Disease in China Caused by B2 Species of Adenovirus Type 11
Zhen Zhu,1,
Yong Zhang,1,
Songtao Xu,1
Pengbo Yu,2
Xiaoping Tian,2
Li Wang,2
Zhonghua Liu,1
Liuying Tang,1
Naiying Mao,1
Yixin Ji,1
Chongshan Li,1
Zhaohui Yang,1,3
Shiwen Wang,1
Jingjun Wang,2
Dexin Li,1 and
Wenbo Xu1*
WHO WPRO Regional Reference Measles Laboratory and State Key Laboratory for Molecular Virology & Genetic Engineering, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China,1 Shanxi Center for Disease Control and Prevention, Xian, China,2 School of Basic Medical Science, Lanzhou University, Lanzhou, China3
Received 13 September 2008/ Returned for modification 3 November 2008/ Accepted 15 December 2008
An outbreak of acute respiratory tract infection occurred in Shanxi Province, China, from March to April 2006. Of the 254 patients affected by this outbreak, 247 patients were students of a senior high school; 1 of these patients died during the outbreak. Serological tests and blood culture revealed no evidence of bacterial infection. The results of direct reverse transcription-PCR or PCR performed with clinical specimens collected from the patients, including the sole patient who died, were positive for human adenoviruses (HAdVs) but negative for influenza virus, measles virus, rubella virus, mumps virus, parainfluenza virus, respiratory syncytial virus, and human enteroviruses. These findings were confirmed by enzyme-linked immunosorbent assay for HAdV immunoglobulin A, the conventional neutralization test, and viral isolation and identification. Sequencing of the entire hexon gene revealed that HdAV type 11a (HAdV-11a) belonging to the B2 species of HAdV was the etiological agent responsible for the outbreak. However, both the analysis of the phylogenetic relationship and the similarity plot indicated that the sequence of the 3' end of the hexon gene outside the hypervariable regions the HAdV-11a strain isolated in this outbreak may be a recombinant with the sequence of the HAdV-14 strain of species B2. Although isolates of HAdV species B2 seldom cause respiratory infections, they may pose a new global challenge with regard to acute respiratory diseases; this possibility cannot be overlooked and should be carefully considered. Hence, the need to establish and improve both epidemiological and virological surveillance of HAdV infections in China should be emphasized.
* Corresponding author. Mailing address: National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27, Nanwei Road, Room 505, Xuanwu District, Beijing 100050, People's Republic of China. Phone and fax: 0086-10-63028480. E-mail: wenbo_xu1{at}yahoo.com.cn
Published ahead of print on 24 December 2008.
These authors made equal contributions to this study.
Journal of Clinical Microbiology, March 2009, p. 697-703, Vol. 47, No. 3
0095-1137/09/$08.00+0 doi:10.1128/JCM.01769-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
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