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April 19, 2021
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Adenovirus type 4 infections tripled among civilians in last decade

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Adenovirus type 4 infections among civilians have tripled in the last decade worldwide, according to study results published in Clinical Infectious Diseases.

Kristen K. Coleman, PhD, senior research fellow at Duke-NUS Medical School in Singapore, told Healio that adenovirus type 4 infections should be considered a cause of ocular and respiratory illness, and that “outbreaks can cause many hospitalizations and some deaths.”

adenovirus infographic
Source: Coleman KK, et al. Clin Infect Dis. 2021;doi:10.1093/cid/ciab146.

“It seems prudent for public health officials to consider seeking emergency use authorization for adenovirus vaccines [because they] might be available to control future outbreaks and spare high-risk civilian populations from disease,” Coleman said. “There is a safe and effective adenovirus vaccine produced by Teva Pharmaceuticals that could be considered. This vaccine is used to protect U.S. military personnel from adenovirus types 4 and 7. We also encourage the development of other adenovirus vaccines suitable for civilian populations.”

Coleman and colleagues performed a systematic review of 144 peer-reviewed articles published between 1960 and 2020 that reported adenovirus type 4 infections. They identified a more than 24,500 infections in military and civilian populations, including 27 associated deaths.

Kristen K. Coleman

Adenovirus type 4 infections tripled from less than 200 in the 1970s to more than 600 during the 2010s. Most infections were reported in North America (86.14%), with 7.05% coming from Asia, 5.37% from Europe and less than 1% coming from Africa, South America, Oceania and the Middle East.

“Clinical and public health laboratories should include adenoviruses in their routine screening of clinical respiratory and ocular specimens, and when a marked increase in cases is detected, perform molecular adenovirus genotyping tests on samples that test positive for adenovirus,” Coleman said. “In the United States, laboratories can report these adenovirus typing data to public health agencies like the CDC National Adenovirus Type Reporting System.”

Coleman said the study’s limitations included a lack of examination of large-scale serological studies related to adenovirus type 4 antibody detection, which may mean that the 24,500 infections identified in the study underrepresent the true global prevalence of the virus.

“Future serological studies could be useful for identifying civilian populations that are immunologically naive to this virus,” Coleman said.