710. Deaths Attributed to Adenovirus Disease in US Military Members, 1998-2009
Session: Abstracts: Virology
Friday, October 22, 2010

Background:

Adenoviral respiratory disease (AdRD) has long imposed significant morbidity on the US active duty (AD) military population, particularly at basic (initial entry) training installations. Since cessation of routine type 4 and 7 adenovirus (Adv) vaccinations in 1996, AdRD has resurged. The Armed Forces Medical Examiner System (AFMES) tracks all AD deaths and obtains perimortem records for risk factor analyses. We studied the burden of mortality from Adv on the US AD military population and assessed available risk data for 1998-2009.

Methods:

Data were obtained from the AFMES database.  All recorded cases where adenovirus was a contributor to the cause of death in AD members were studied.

Results:

During the study period, just over 17,000 AD service member deaths were recorded; approximately 0.5% were due to known infectious agents. Eight deaths attributable to AdRD were identified (age range 18-32 years; 7/8 male). Six were in basic trainees, with all Military Services represented. No clustering in time or geography was observed. Adv types were determined for six cases: Adv 4 (2), Adv 14 (2) and Adv 4 and 7 (2). Counts were too low for time trend analysis or other statistical testing but were similar to deaths from other virulent community acquired pathogens during the same time period (Streptococcus pneumoniae 13, Streptococcus pyogenes group A  11, and Neisseria meningitidis 7). In two additional deaths an Adv was identified in postmortem lung tissue. However, these deaths were attributed to sudden unexpected cardiac death and eosinophilic pneumonia, not AdRD.

Conclusion:

Adv infections accounted for a small number of deaths in AD military members for 1998-2009. However, AdRD did account for a large proportion of all deaths due to virulent community acquired pathogens for which effective preventive measures are feasible, to include vaccines and antibiotic prophylaxis. Basic trainees had a disproportionate amount of the Adv mortality burden. Reinstitution of Adv vaccinations in trainees should reduce the associated morbidity and mortality.

 


Subject Category: I. Adult and Pediatric Vaccines

Speakers:
Robert N. Potter, DVM , Office of the Armed Forces Medical Examiner, Armed Forces Institute of Pathology, Rockville, MD
Joyce A. Cantrell, MD , Office of the Armed Forces Medical Examiner, Armed Forces Institute of Pathology, Rockville, MD
Craig T. Mallak, MD , Office of the Armed Forces Medical Examiner, Armed Forces Institute of Pathology, Rockville, MD
Joel Gaydos, MD , Walter Reed Army Institute of Research, DoD Emerging Infections, Silver Spring, MD

Disclosures:

R. N. Potter, None

J. A. Cantrell, None

C. T. Mallak, None

J. Gaydos, None

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