B J Parcell1, P G McIntyre1, D L Yirrell1, A Fraser2, M Quinn3, K Templeton4, S Christie5, F Romanes6. 1. Department of Medical Microbiology, Ninewells Hospital and Medical School, NHS Tayside, Dundee DD1 9SY, UK. 2. NHS Health Scotland, Lothian EH10 4SG, UK. 3. Department of Public Health, Cameron House, NHS Fife, Leven KY8 5RG, UK. 4. Edinburgh Specialist Virology Centre, Royal Infirmary Edinburgh, Edinburgh,EH16 4SA, UK. 5. Intensive Care, Ninewells Hospital and Medical School, NHS Tayside, Dundee DD1 9SY, UK. 6. Directorate of Public Health, Kings Cross, Clepington Road, Dundee, DD3 8EA, UK.
Abstract
BACKGROUND: This report describes the investigation and public health management of a community-based outbreak of severe adenovirus serotype 14p1 respiratory infection affecting the Tayside area during 2011. It is the first report of an adenovirus outbreak involving prisons. METHODS: An outbreak-based/incident management approach was carried out. Alerts were sent out to local doctors, general practitioners, prison healthcare staff and consultants so that cases could be identified prospectively. Sequencing of hexon, fibre and E1A regions of adenovirus were carried out to genotype the viruses. RESULTS: Fifteen cases were identified in total, including 13 confirmed cases and 2 possible cases. There were 3 deaths amongst the 13 confirmed cases, with a case fatality rate of 23%. Eight of the cases had a direct association with one of the two prisons in the area. CONCLUSIONS: We advise that surveillance measures for adenovirus infection and guidelines for the management of critically ill patients should be developed in order to identify outbreaks at an early stage and allow patients to receive appropriate treatment. Adenovirus infection should be borne in mind as a cause of severe pneumonia in closed settings such as prisons.
BACKGROUND: This report describes the investigation and public health management of a community-based outbreak of severe adenovirus serotype 14p1 respiratory infection affecting the Tayside area during 2011. It is the first report of an adenovirus outbreak involving prisons. METHODS: An outbreak-based/incident management approach was carried out. Alerts were sent out to local doctors, general practitioners, prison healthcare staff and consultants so that cases could be identified prospectively. Sequencing of hexon, fibre and E1A regions of adenovirus were carried out to genotype the viruses. RESULTS: Fifteen cases were identified in total, including 13 confirmed cases and 2 possible cases. There were 3 deaths amongst the 13 confirmed cases, with a case fatality rate of 23%. Eight of the cases had a direct association with one of the two prisons in the area. CONCLUSIONS: We advise that surveillance measures for adenovirus infection and guidelines for the management of critically illpatients should be developed in order to identify outbreaks at an early stage and allow patients to receive appropriate treatment. Adenovirus infection should be borne in mind as a cause of severe pneumonia in closed settings such as prisons.
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