Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-22T05:46:32.606Z Has data issue: false hasContentIssue false

An Epidemic of Adenovirus 7a Infection in a Neonatal Nursery: Course, Morbidity, and Management

Published online by Cambridge University Press:  21 June 2016

Adam Finn
Affiliation:
Division of Infectious Diseases, Children's Hospital of Philadelphia
Endla Anday
Affiliation:
Department of Neonatology, Hospital of the University of Pennsylvania, Philadelphia
George H. Talbot*
Affiliation:
Infection Control and Infectious Diseases Sections, Hospital of the University of Pennsylvania, Philadelphia
*
Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104

Abstract

An epidemic of adenovirus 7a in our neonatal intensive care nursery and intermediate care nursery in July and August 1987 caused the death of two patients. Significant symptomatic infection possibly due to the virus occurred in nine patients, ten staff, and three parents, of whom three patients, three staff, and one parent were positive by culture. As a direct consequence of the outbreak, 58 staff days of work were lost; the intensive care nursery had to be closed to admissions for 19 days and the intermediate care nursery for 14 days. Seventeen newborns were transferred to other hospitals and four mothers were sent elsewhere for delivery. Control measures, which included cohorting of patients, use of gloves, gowns and goggles, and exclusion of symptomatic staff from the unit, appeared effective. Rapid immunofluorescence testing of virological specimens was of little use in monitoring the outbreak, largely because of poor specimen quality. This outbreak further underlines the ease of transmission and high morbidity of neonatal adenovirus infection.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1988

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Spencer, MJ, Cherry, JD, in Feigin, RD Cherry, JD (eds): Textbook of Pediatric Infectious Diseases, ed 2. Philadelphia, WB Saunders Co, 1987, pp 16881701.Google Scholar
2. Herbert, FA. Wilkinson, D, Burchak, E. et al: Adenovirus type 3 pneumonia causing lung damage in childhood. Can Med Assoc J 1977; 116:274276.Google ScholarPubMed
3. Angella, JJ, Connor, JD: Neonatal infection caused by adenovirus type 7. J Pediatr 1968: 72:474478.CrossRefGoogle ScholarPubMed
4. Zahradnik, JM, Spencer, MJ, Porter, DD: Adenovirus infection in the immunocompromised patient. Am J Med 1980; 68:725732.CrossRefGoogle ScholarPubMed
5. Straube, RC. Thompson, MA, Van Dyke, RB, et al: Adenovirus type 7b in a children's hospital. J Infect Dis 1983: 147:814819.CrossRefGoogle ScholarPubMed
6. Alpert, G, Charney, E, Fee, M, et al: Outbreak of fatal adenoviral type 7a respiratory disease in a children's long-term care inpatient facility. Am J Infect Control 1986: 14:188190.CrossRefGoogle Scholar
7. Eichenwald, HF, Kotsevalov, O: Immunologic responses of premature and full-term infants to infection with certain viruses. Pediatrics 1960; 25:829839.CrossRefGoogle ScholarPubMed
8. St. Geme, JW, Prince, JT: Mixed, systemic virus infection: A postulate for alteration of host resistance to adenovirus infection. J Pediatr 1966; 69:653655.CrossRefGoogle ScholarPubMed
9. Odio, C, McCracken, GH, Nelson, JD: Disseminated adenovirus infection: A case report and review of the literature. Pediatr Infect Dis 1984; 3:4649.CrossRefGoogle ScholarPubMed
10. Levandowski, RA, Rubenis, M: Nosocomial conjunctivitis caused by adenovirus type 4. J Infect Dis 1981: 143:2831.CrossRefGoogle ScholarPubMed
11. Pingleton, SK, Pingleton, WW, Hill, RH. et al: Type 3 adenoviral pneumonia occurring in a respiratory intensive care unit. Chest 1978: 73:554555.CrossRefGoogle Scholar
12. Larsen, RA, Jacobson, JT, Jacobson, JA, et al: Hospital-associated epidemic of pharyngitis and conjunctivitis caused by adenovirus (21/1121+35). J Infect Dis 1986: 154:706709.CrossRefGoogle Scholar
13. Faden, H. Gallagher, M. Ogra, P, et al: Nosocomial outbreak of pharyngoconjunctival fever due to adenovirus type 4-New York. MMWR 1978; 27:49.Google Scholar
14. Barr, J, Kjellen, L, Svedmyr, A: Hospital outbreak of adenovirus type 3 infections. A clinical and virologic study on 38 patients partly involved in a nosocomial outbreak. Acta Paediatr (suppl) 1958; 47:365382.CrossRefGoogle Scholar
15. Harrison, HR. Howe, P, Minnich, L. et al: A cluster of adenovirus 19 infection with multiple clinical manifestations. J Pediatr 1979; 94:917919.CrossRefGoogle Scholar
16. Chany, C, Lepine, P, Lelong, M. et al: Severe and latal pneumonia in infants and young children associated with adenovirus infections. Am J Hyg 1958; 67:367378.Google Scholar
17. Hierholzer, JC. Phillips, DJ, Humphrey, DD, et al: Application of a solid-phase immunofluorometric assay to the selection of monoclonal antibody specific for the adenovirus group-reactive hexon antigen. Arch Virol 1969: 80:110.CrossRefGoogle Scholar
18. Friedman, HM, Koropchak, C: Comparison of WI-38, MRC-5 and IMR-90 cell strains for isolation of viruses from clinical specimens. J Clin Microbiol 1978; 7:368371.CrossRefGoogle ScholarPubMed
19. Couch, RB, Cate, TR, Fleet, WF, et al: Aerosol-induced adenoviral illness resembling the naturally occurring illness in military recruits. Am Rev Respir Dis 1966; 93:529535.Google ScholarPubMed
20. Gala, CL, Hall, CB, Schnabel, KG, et al: The use ol eye-nose goggles to control nosocomial respiratory syncytial virus infection. JAMA 1986: 256:27062708.CrossRefGoogle Scholar