Friday, November 09, 2018

NJ DOH: Update On Two Adenovirus Clusters In Nursing Facilities


In late summer and early fall, before flu season, we typically see an increase in non-influenza respiratory viruses. Most common are rhinoviruses, enteroviruses, and adenoviruses.
While enteroviruses - like EV-D68 and EV-71 - have been getting the bulk of our attention this fall, due primarily to their possible link to a spike in a polio-like paralysis around the country (see CDC Acute Flaccid Myelitis (AFM) Update - Nov 5th), we've also been following several adenovirus outbreaks as well. 

On November 1st, the NJ DOH reported a 2nd NJ Facility Reporting Adenovirus Outbreak & 10th Fatality At Wanaque Center. While the first outbreak was identified as Adenovirus 7, testing was in progress on the second outbreak.

Yesterday the NJ DOH updated both outbreaks, where we learn the second outbreak has been identified as Adenovirus 3, and that no additional fatalities have been reported over the past week.

Adenoviruses are common viruses that can cause a range of illnesses. They can cause cold-like symptoms, sore throat, bronchitis, pneumonia, diarrhea, and pink eye (conjunctivitis). You can get an adenovirus infection at any age. People with weakened immune systems or existing respiratory or cardiac disease are more likely than others to get very sick from an adenovirus infection.

The New Jersey Department of Health is actively investigating two outbreaks at the Wanaque Center for Nursing and Rehabilitation in Haskell and Voorhees Pediatric Facility that appear to be unrelated at this time.

Strain typing has confirmed the adenovirus cases at Voorhees are Type 3. This is a different strain from the one that caused a severe outbreak at the Wanaque Center (Type 7). Type 3 is typically associated with a milder illness than Type 7, however it is still sometimes associated with severe illness and even death.

We've looked at severe adenovirus outbreaks in the past, including a multi-state outbreak of virulent serotype Ad14 a dozen years ago (see 2007 MMWR Acute Respiratory Disease Associated with Adenovirus Serotype 14 --- Four States, 2006—2007) and in 2012, China: Hebei Outbreak Identified As Adenovirus 55.

In 2016, we looked at a report in the EID Journal: Human Adenovirus Associated with Severe Respiratory Infection, Oregon, USA, 2013–2014, that described a relatively large outbreak in the Pacific Northwest.

All reasons why we should be practicing good flu hygiene (washing hands, covering coughs, & staying home if sick) as a year-round habit, even if you've had your flu shot.

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