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Epidemiological Investigation of the Outbreak of Acute Respiratory Infection caused by Adenovirus Type B55 in a Physical Education School in 2017.
Infect Chemother 2019; 51(2):119-129IC

Abstract

BACKGROUND

On May 19, 2017, the cluster of 6 acute respiratory infections due to adenovirus in the swimming department of a physical education school (School J) was reported to Korea Centers for Disease Control and Prevention. An epidemiological investigation was conducted to identify the transmission route of the infection and to control the outbreak.

MATERIALS AND METHODS

A retrospective cohort study (Study 1) was conducted on students and teachers of the athletic departments using the swimming pool, and a prospective surveillance (Study 2) was conducted on all students and teachers of the School J. A case was defined as any student and school personnel who developed more than two of the following symptoms from April 10 to July 2, 2017: fever, sore throat, cough, rhinorrhea, or headache. Relative risks (RRs) were calculated to compare the attack rates according to potential risk factors. Multivariable logistic regression was performed to identify the risk factors for infection in the outbreak.

RESULTS

47 cases were identified: 33 (55.9%) cases occurred among 59 students and teachers in Study 1 and 14 (3.9%) among 362 students and school personnel in Study 2. There were 18 laboratory confirmed adenovirus infection cases. The common symptoms were headache (71.7%), fever (69.6%), rhinorrhea (63.0%), sputum (56.5%), and sore throat (54.3%). 23.9% of the cases were accompanied with diarrhea and 19.6% with eye congestion. None of the cases developed pneumonia. 32.6% of the cases were hospitalized. In Study 1, attack rate in the swimming department was higher than that in others (RR: 1.90; 95% confidence interval [CI]: 1.01-3.60). In Study 2, being a member of the shooting department (RR: 20.70; 95% CI: 4.90-87.47) and being a first year high school student (RR: 10.95; 95% CI: 2.90-41.33) were identified as risk factors for the infections. Genetic analyses of the adenoviruses showed 100% identical sequence in homology and confirmed the human adenovirus B55 (HAdV-B55). No adenovirus was detected at examining the water and environment of the swimming pool and dormitory.

CONCLUSION

The outbreak is inferred to be occurred via propagated transmission among the students in the same athletic department, while the students with symptoms of respiratory infection continued performing school activities without any restrictions. Infection control measures such as early detection of symptoms of respiratory infection and restriction of group activity are necessary to prevent respiratory infection outbreak in the communal living setting.

Authors+Show Affiliations

Division of Infectious Disease Control, Korea Centers for Disease control and Prevention, Cheongju, Korea.Division of Infectious Disease Control, Korea Centers for Disease control and Prevention, Cheongju, Korea.Division of Control for Zoonotic and vector borne Disease, Korea Centers for Disease control and Prevention, Cheongju, Korea. cho6404@korea.kr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31270991

Citation

Song, Jeongsuk, et al. "Epidemiological Investigation of the Outbreak of Acute Respiratory Infection Caused By Adenovirus Type B55 in a Physical Education School in 2017." Infection & Chemotherapy, vol. 51, no. 2, 2019, pp. 119-129.
Song J, Lee H, Cho E. Epidemiological Investigation of the Outbreak of Acute Respiratory Infection caused by Adenovirus Type B55 in a Physical Education School in 2017. Infect Chemother. 2019;51(2):119-129.
Song, J., Lee, H., & Cho, E. (2019). Epidemiological Investigation of the Outbreak of Acute Respiratory Infection caused by Adenovirus Type B55 in a Physical Education School in 2017. Infection & Chemotherapy, 51(2), pp. 119-129. doi:10.3947/ic.2019.51.2.119.
Song J, Lee H, Cho E. Epidemiological Investigation of the Outbreak of Acute Respiratory Infection Caused By Adenovirus Type B55 in a Physical Education School in 2017. Infect Chemother. 2019;51(2):119-129. PubMed PMID: 31270991.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiological Investigation of the Outbreak of Acute Respiratory Infection caused by Adenovirus Type B55 in a Physical Education School in 2017. AU - Song,Jeongsuk, AU - Lee,Hyerim, AU - Cho,Enhi, PY - 2019/01/16/received PY - 2019/02/21/accepted PY - 2019/7/5/entrez PY - 2019/7/5/pubmed PY - 2019/7/5/medline KW - Acute respiratory infection KW - Human adenovirus KW - Outbreak KW - School SP - 119 EP - 129 JF - Infection & chemotherapy JO - Infect Chemother VL - 51 IS - 2 N2 - BACKGROUND: On May 19, 2017, the cluster of 6 acute respiratory infections due to adenovirus in the swimming department of a physical education school (School J) was reported to Korea Centers for Disease Control and Prevention. An epidemiological investigation was conducted to identify the transmission route of the infection and to control the outbreak. MATERIALS AND METHODS: A retrospective cohort study (Study 1) was conducted on students and teachers of the athletic departments using the swimming pool, and a prospective surveillance (Study 2) was conducted on all students and teachers of the School J. A case was defined as any student and school personnel who developed more than two of the following symptoms from April 10 to July 2, 2017: fever, sore throat, cough, rhinorrhea, or headache. Relative risks (RRs) were calculated to compare the attack rates according to potential risk factors. Multivariable logistic regression was performed to identify the risk factors for infection in the outbreak. RESULTS: 47 cases were identified: 33 (55.9%) cases occurred among 59 students and teachers in Study 1 and 14 (3.9%) among 362 students and school personnel in Study 2. There were 18 laboratory confirmed adenovirus infection cases. The common symptoms were headache (71.7%), fever (69.6%), rhinorrhea (63.0%), sputum (56.5%), and sore throat (54.3%). 23.9% of the cases were accompanied with diarrhea and 19.6% with eye congestion. None of the cases developed pneumonia. 32.6% of the cases were hospitalized. In Study 1, attack rate in the swimming department was higher than that in others (RR: 1.90; 95% confidence interval [CI]: 1.01-3.60). In Study 2, being a member of the shooting department (RR: 20.70; 95% CI: 4.90-87.47) and being a first year high school student (RR: 10.95; 95% CI: 2.90-41.33) were identified as risk factors for the infections. Genetic analyses of the adenoviruses showed 100% identical sequence in homology and confirmed the human adenovirus B55 (HAdV-B55). No adenovirus was detected at examining the water and environment of the swimming pool and dormitory. CONCLUSION: The outbreak is inferred to be occurred via propagated transmission among the students in the same athletic department, while the students with symptoms of respiratory infection continued performing school activities without any restrictions. Infection control measures such as early detection of symptoms of respiratory infection and restriction of group activity are necessary to prevent respiratory infection outbreak in the communal living setting. SN - 2093-2340 UR - https://www.unboundmedicine.com/medline/citation/31270991/Epidemiological_Investigation_of_the_Outbreak_of_Acute_Respiratory_Infection_caused_by_Adenovirus_Type_B55_in_a_Physical_Education_School_in_2017 L2 - https://www.icjournal.org/DOIx.php?id=10.3947/ic.2019.51.2.119 DB - PRIME DP - Unbound Medicine ER -
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