1481. Adenovirus Illness in Hospitalized Children in Amman, Jordan
Session: Poster Abstract Session: Global Health
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background:

Adenovirus (ADV) is a common cause of fever without a source in children 2-36 months of age; however, the burden of respiratory disease attributable to ADV in Jordanian hospitalized children is unknown. 

Methods:

We conducted a prospective year-round viral surveillance study in children <2 years of age admitted with respiratory symptoms &/or fever at the government-run hospital, Al-Basheer.  Surveillance was conducted Sunday-Thursday from 3/16/2010-9/10/2012. Clinical and demographic data were collected. Nasal/throat swabs were collected, placed into lysis buffer, aliquoted, and frozen at -80°C. Specimen aliquots were shipped to Vanderbilt and tested by real-time RT-PCR for respiratory syncytial virus (RSV), metapneumovirus (HMPV), rhinovirus (HRV), influenza A and B, ADV, & parainfluenza viruses 1, 2, 3 (PIV1-3).

Results:

2429/2433(99.8%) of subjects enrolled had viral data available. The median age was 3.5 months, with 60% males, 10% had underlying medical conditions, 2% attended day care, 76% subjects had smoke exposure, and 7% were admitted to the ICU.  A total of 316 (13%) tested positive for ADV, co-detection with 124 HRV, 113 RSV, 35 HMPV, 15 PIV1-3, and 4 Influenza A.  The most common symptoms for ADV+ subjects were cough (75%), fever (62%), and shortness of breath (55%). The most common diagnoses were:  bronchopneumonia (41%) and rule out sepsis (18%). Table 1 compares ADV+ subjects to ADV negative subjects. 

Table 1.

 

ADV

Positive

N=316

ADV
Negative

N=2117

p-value

 

Median age (months)

7.2

3.2

<0.001

Gender = Male

193 (61%)

1275 (60%)

0.77

Cough

237 (75%)

1538 (73%)

0.38

Fever

197 (62%)

1195 (56%)

0.48

Poor appetite

46 (15%)

493 (23%)

<0.001

Shortness of Breath

174 (55%)

1215 (57%)

0.43

Seizure

6 (2%)

23 (1%)

0.21

Vomiting

59(19%)

362 (17%)

0.49

Diarrhea

45(14%)

216 (10%)

0.031

Bronchopneumonia

128 (41%)

678 (32%)

0.003

Pneumonia

39 (12%)

229 (11%)

0.42

Bronchiolitis

39 (12%)

373 (18%)

0.02

Rule out sepsis

57 (18%)

626 (30%)

<0.001

Conclusion:

ADV+ subjects were older, more likely to present with fever & diarrhea, and have the diagnosis of bronchopneumonia & rule out sepsis compared to ADV negative subjects.  In contrast, ADV negative subjects were more likely to present with poor appetite and a diagnosis of bronchiolitis compared to ADV + subjects.

Annabelle De St. Maurice, M.D., Pediatric Infectious Diseases, Vanderbilt University, Nashville, TN, Najwa Khuri-Bulos, MD, CIC, FIDSA, Division of Infectious Disease, Jordan University Hospital, Jordan, Samir Faouri, MD, Al-Basheer, Amman, Jordan, Asem Shehabi, DSC, Jordan University, Amman, Jordan, Li Wang, M.S., Vanderbilt University, Nashville, TN, John Williams, MD, Vanderbilt Univ. Med. Ctr., Nashville, TN and Natasha Halasa, MD MPH, Vanderbilt University Medical Center, Nashville, TN

Disclosures:

A. De St. Maurice, None

N. Khuri-Bulos, None

S. Faouri, None

A. Shehabi, None

L. Wang, None

J. Williams, Quidel: Scientific Advisor, Consulting fee

N. Halasa, None

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