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Last month, I blogged about the surge in cases of adenovirus -- especially the type known as Ad14.  Today, Associated Press medical writer Mike Stobbe reports on the virus. 

New cold bug kills 10, scores sickened

Scores sickened as mutated virus becoming more common, CDC says

ATLANTA - A mutated version of a common cold virus has caused 10 deaths in the last 18 months, U.S. health officials said Thursday.

Adenoviruses usually cause respiratory infections that aren’t considered lethal. But a new variant has caused at least 140 illnesses in New York, Oregon, Washington and Texas, according to a report issued Thursday by the U.S. Centers for Disease Control and Prevention.

The illness made headlines in Texas earlier this year, when a so-called boot camp flu sickened hundreds at Lackland Air Force Base in San Antonio. The most serious cases were blamed on the emerging virus and one 19-year-old trainee died. (bold mine)

“What really got people’s attention is these are healthy young adults landing in the hospital and, in some cases, the ICU,” said Dr. John Su, an infectious diseases investigator with the CDC.

There are more than 50 distinct types of adenoviruses tied to human illnesses. They are one cause of the common cold, and also trigger pneumonia and bronchitis. Severe illnesses are more likely in people with weaker immune systems.

Some adenoviruses have also been blamed for gastroenteritis, conjunctivitis and cystitis.

There are no good antiviral medications for adenoviruses. Patients usually are treated with aspirin, liquids and bed rest.

In the CDC report, the earliest case of the mutated virus was found in an infant girl in New York City, who died last year. The child seemed healthy right after birth, but then became dehydrated and lost appetite. She died 12 days after she was born.

Tests found that she been infected with a form of adenovirus, called Ad14, but with some little differences, Su said.

More common
It’s not clear how the changes made it more lethal, said Linda Gooding, an Emory University researcher who specializes in adenoviruses.

Earlier this year, hundreds of trainees at Lackland became ill with respiratory infections. Tests showed a variety of adenoviruses in the trainees, but at least 106 — and probably more — had the mutated form of Ad14, including five who ended up in an intensive care unit. (bold mine)

In April, Oregon health officials learned of a cluster of cases at a Portland-area hospital. They ultimately counted 31 cases, including seven who died with severe pneumonia. The next month, Washington state officials reported four hospitalized patients had the same mutated virus. One, who also had AIDS, died.

The Ad14 form of adenovirus was first identified in 1955. In 1969, it was blamed for a rash of illnesses in military recruits stationed in Europe, but it’s been detected rarely since then.

But it seems to growing more common. The strain accounted for 6 percent of adenovirus samples collected in 22 medical facilities in 2006, while none was seen the previous two years, according to a study published this month in the medical journal Clinical Infectious Diseases.

My earlier blog can be found at: http://www.scottmcpherson.net/journal/2007/10/11/its-not-always-influenza-that-kills.html .  Stobbe's article can be found (among numerous other places) at: http://www.msnbc.msn.com/id/21820799/ . 

Adenovirus is but one member of the new vanguard of older diseases coming back for a remake in the Information Age.  last month, Reuters also picked up on the adenovirus outbreaks across the Americas.  The story is below and can be found at:http://www.msnbc.msn.com/id/21269732/

Old virus causing new disease in United States

WASHINGTON - A strain of virus best known for causing colds and "stomach flu" is becoming more common and more dangerous, U.S. researchers report.

They said that adenovirus 21 was surprisingly common and was causing an unexpected level of severe disease and deaths.

The researchers used a new test developed by the U.S. Centers for Disease Control and Prevention and said the wider use of such tests might help doctors and health officials better understand what diseases are making people sick.

"It makes the case that if you did survey regularly and routinely for adenoviruses you would get more information and a little advance information on where the bad ones are likely to pop up and to be ready," said Dr. Catherine Laughlin of the National Institute of Allergy and Infectious Diseases, which paid for the study.

Adenoviruses cause colds, bronchitis and stomach upsets, but can also cause chronic airway obstruction, a heart infection called myocarditis, a sometimes deadly bowel condition called intussusception and sudden infant death at birth.

Gregory Gray of the Center for Emerging Infectious Diseases at the University of Iowa and colleagues were trying to get a handle on which types of adenoviruses were most common and which were causing serious outbreaks of disease.

This had not been easy to do because the old diagnostic tests were slow and could not differentiate easily among the different strains of adenovirus. And doctors rarely test patients to see what infection they have. (bold mine)

"The new test is very elegant and specific," Laughlin said in a telephone interview.

Gray's team used the test on 2,200 samples from 22 U.S. medical facilities, including eight military sites. Military personnel are especially susceptible to outbreaks of all kinds of disease, including adenoviruses.

Adenovirus 21 was found in 1 percent of specimens in 2004, but in 2.4 percent in 2006. And it was making people much sicker than the other strains, killing 50 percent of bone marrow transplant patients, for instance.

These patients are at extra risk from infections as their entire immune systems are destroyed before they get transplants of new bone marrow tissue.

"For both populations, we observed a statistically significant increasing trend of adenovirus type 21 detection over time," Gray and colleagues wrote in their report.

And half of them were sick enough to be hospitalized.

"The high prevalence of hospitalization among the patients with adenovirus infection was surprising," Gray's team wrote in their report, published in the journal Clinical Infectious Diseases.

Laughlin said the test would need to be commercialized, but having it available might encourage companies to develop better drugs and vaccines against adenoviruses.

"I think there will also be more effort in drug and vaccine development, especially because the numbers of immunosuppressed people that we have around really has been increasing," she said -- including cancer patients, organ recipients and people infected with the AIDS virus.

The Department of Defense has also contracted for a new vaccine against adenovirus types 4 and 7.

Like MRSA, typing for adenovirus should become manadatory.  Too often tests are done and causes excluded; when will our testing include looking for certain re-emerging viruses?  And like H5N1 overseas, we can assume the numbers of people who actually suffer from adenovirus infections is much greater than was has been reported.  Recall that MRSA now kills more people in the United States than HIV/AIDS.  If we really knew the numbers of people suffering from MRSA, adenovirus and other maladies, we would have much better surveillance on these emerging diseases.