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Tracking Emerging Diseases
New Adenoviral Serotype Identified

"It's that canary in the mine - something is going on differently here that hasn't happened before. It turns out that across the United States, this particular adenovirus serotype, Ad14, seems to be emerging as a new respiratory threat."

CHORI clinical researcher Ann Petru, MD, in collaboration with Janice K. Louie, MD at the California Department of Public Health, and Dr. Petru's colleagues at CHRCO, Ms. Lilly Guardia-LaBar, RN, CIC, and Brian Lee, MD, reports in the February issue of Clinical Infectious Diseases on the identification of a new adenovirus (Ad) serotype not previously associated with severe clinical disease.

“This is a collection of clinical cases that happened to be caused by a serotype of a common germ that hasn’t been previously reported,” says Dr. Petru.

Human viruses have been around for hundreds of years, causing ailments as common as the cold, or as life threatening as meningitis.

"An adenovirus is a very commonly encountered germ that can cause a variety of illnesses in people, many of whom have no symptoms, and some of whom have mild, moderate or very severe complications," Dr. Petru explains. "Chickenpox, the common cold, herpes, they're all viruses."

In this case, 3 different patients at 2 different hospitals presented with the same life-threatening respiratory complications within a 2 month period. All 3 patients' severe illnesses, and in 1 case, death, were attributable to the Ad14 serotype. Further restriction enzyme analysis identified the strain as a novel genotype that the authors are labeling Ad14a.

"In medicine, we try to be more specific than just calling a virus a virus," says Dr. Petru. "Certain viruses act differently than other viruses, and if we can be specific enough, we can then look at how people respond."

In fact, these 3 case studies reveal important clues about Ad14.

"All three patients had significantly underlying lung disease," Dr. Petru points out. "One had chronic obstructive pulmonary disease, one was a premature baby who had a lot of the chronic lung complications associated with premature delivery, and one had restrictive lung disease."

This suggests that like many illnesses, Ad14 might not be a problem if a relatively healthy person is exposed to it, but that in someone who has chronic lung problems, Ad14 could cause real trouble.
"It's a warning to physicians to be aware that there are new bugs out, and we have to be looking for them."
In addition, it points to the importance of making a significant effort to identify the pathogens causing problems in kids who have severe lung disease.

"With the help of the newer techniques used by the Viral and Rickettsial Disease Lab at the California State Health Lab," says Dr. Petru, "we can."

In the Dr. Petru's case, CHRCO has a long-standing relationship with the California State Department of Health,
which takes a significant interest in tracking lung disease, and can provide the most up-to-date technologies.

“It’s all new, being able to tie in  emerging understanding of viral diseases and new pathogens with the clinical work that’s ongoing,” says Dr. Petru. “I love the clinical work that I do, but I also really appreciate what’s done on the research side, because it helps us understand what’s happening with our patients, so that we can treat them better. That’s the fun of medicine.”


Tuesday, May 17, 2011 8:19 AM

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