National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
J Infect Dis. 2022 Jan 5;225(1):55-64. doi: 10.1093/infdis/jiab322.
Although a human adenovirus (HAdV) vaccine is available for military use, officers-in-training are not routinely vaccinated. We describe an HAdV-associated respiratory outbreak among unvaccinated cadets at the US Coast Guard Academy and its impact on cadet training.
We defined a case as a cadet with new onset cough or sore throat during August 1-October 4, 2019. We reviewed medical records and distributed a questionnaire to identify cases and to estimate impact on cadet training. We performed real-time polymerase chain reaction testing on patient and environmental samples and whole genome sequencing on a subset of positive patient samples.
Among the 1072 cadets, 378 (35%) cases were identified by medical records (n = 230) or additionally by the questionnaire (n = 148). Of the 230 cases identified from medical records, 138 (60%) were male and 226 (98%) had no underlying conditions. From questionnaire responses, 113 of 228 (50%) cases reported duty restrictions. Of cases with respiratory specimens, 36 of 50 (72%) were HAdV positive; all 14 sequenced specimens were HAdV-4a1. Sixteen (89%) of 18 environmental specimens from the cadet dormitory were HAdV-positive.
The HAdV-4-associated outbreak infected a substantial number of cadets and significantly impacted cadet training. Routine vaccination could prevent HAdV respiratory outbreaks in this population.
尽管有一种人腺病毒（HAdV）疫苗可用于军事用途，但受训军官并未常规接种疫苗。我们描述了美国海岸警卫队学院未接种疫苗的学员中腺病毒相关呼吸道暴发的情况及其对学员训练的影响。
我们将病例定义为在 2019 年 8 月 1 日至 10 月 4 日期间新出现咳嗽或喉咙痛的学员。我们审查了医疗记录并分发了一份问卷，以确定病例并估计对学员训练的影响。我们对患者和环境样本进行了实时聚合酶链反应检测，并对部分阳性患者样本进行了全基因组测序。
在 1072 名学员中，通过医疗记录（n=230）或通过问卷（n=148）确定了 378 例（35%）病例。从医疗记录中确定的 230 例病例中，有 138 例（60%）为男性，226 例（98%）无潜在疾病。根据问卷答复，228 例病例中有 113 例（50%）报告了职责限制。有呼吸道标本的病例中，50 例中有 36 例（72%）为 HAdV 阳性；所有 14 个测序标本均为 HAdV-4a1。学员宿舍的 18 个环境标本中有 16 个（89%）为 HAdV 阳性。
HAdV-4 相关暴发感染了大量学员，并严重影响了学员训练。在该人群中常规接种疫苗可以预防 HAdV 呼吸道暴发。
