Secondary Logo

Journal Logo

Letters to the Editor

Species C is Predominant in Chinese Children with Acute Respiratory Adenovirus Infection

Ma, Guangyuan MS; Zhu, Yongzhang PhD; Xiao, Yong MS; Ji, Yayong BS; Wu, JiaLin MS; Bao, Jing MS; Sha, Dan MS; Guo, HongXiong PhD

Author Information
The Pediatric Infectious Disease Journal: September 2015 - Volume 34 - Issue 9 - p 1042
doi: 10.1097/INF.0000000000000791

To the Editors:

Human adenovirus (Hadv) is responsible for approximately 5–10% of acute respiratory tract infections (ARTIs) in infants and children less than 5 years old worldwide.1 Even in developed countries, severe ARTI with higher mortality and morbidity among children less than 5 years old impose a burden on society. More than 55 Hadvs serotypes are classified into 7 species (A–G). Serotypes C1, C2, C5, C6, B3, B7, B11, B14 and E4 mainly cause ARTI in humans. Recently, outbreaks of ARTI caused by Hadv species B occurred in many cities of China.2,3 Here, we report the species of HadVs circulating in children with ARTI in the east of China.

A total of 1035 outpatients with ARTI were evaluated at the Children’s Hospital of Wuxi City, China from June 2011 to May 2013. This study was approved by the Ethics Committee of Wuxi Center for Disease Control and Prevention (CDC). Wuxi City, located in the east of China, has more than 10 million residents including immigrants. Clinical confirmation of pediatric ARTI is mainly based on one or more of the respiratory symptoms as follows: (1) fever (>37°C); (2) cough, sore throat, wheeze, and chest pain and (3) dry rales. All nasopharyngeal aspirate specimens were collected within 72 hours after the onset of symptoms, and then transported to the Network Laboratory of Chinese National Influenza Surveillance in Wuxi CDC. Seven viruses were detected with real time PCR methods.4 All Hadv-positive nasopharyngeal aspirate specimens were inoculated into Hep-2 cells and were observed daily until an evident cytopathic effect was observed. Partial hexon genes were amplified and sequenced.4 Phylogenetic trees were inferred by the neighbor-joining methods with bootstrap test of 1000 replicates using software MEGA 6.0.

Among 1035 specimens, 343 were positive for at least 1 of the 7 common respiratory viruses. Influenza virus predominated, accounting for 36.7% (126/343), followed by parainfluenza virus (23.6%, 81/343), respiratory syncytial viruses (14.9%, 51/343), Hadv (10.8%, 37/343), human metapneumovirus (9.6%, 33/343) and human bocavirus (2.0%, 7/343). One subject was co-infected with Hadv and H.

The prevalence of viral pathogenic ARTI caused by Hadv in Wuxi City is higher than in other regions of China.2,3,5 More children were involved in this study than in other studies.

Of 37 Hadv specimens, 30 sequences were submitted into GenBank with accession number KF954030–KF954059. Phylogenetic analysis showed that 20 (67%) belonged to Species Hsdv-C. Ten sequences were Species Hsdv-B. Previous studies showed that Hadv-B was predominant, accounting for 77.9% of cases.5 In this study, Hsdv-C was predominant. Moreover, as shown in Figure, Supplemental Digital Content 1,, the sequences isolated from the same year did not cluster together, implying that these cases were sporadic.

In conclusion, our study highlight that the species of Hadv circulating in China differ among various regions.

Guangyuan Ma, MS

Network Laboratory of Chinese National Influenza Surveillance Wuxi Center for Disease Control and Prevention Wuxi, China

Yongzhang Zhu, PhD

Department of Medical Microbiology and Parasitology Shanghai Jiao Tong University School of Medicine Shanghai, China

Yong Xiao, MS

Yayong Ji, BS

JiaLin Wu, MS

Jing Bao, MS

Dan Sha, MS

Network Laboratory of Chinese National Influenza Surveillance Wuxi Center for Disease Control and Prevention Wuxi, China

HongXiong Guo, PhD

Department of STD and AIDS Control and Prevention Jiangsu Provincial Center for Disease Control and Prevention Nanjing, Jiangsu, China


1. Jin Y, Zhang RF, Xie ZP, et al. Prevalence of adenovirus in children with acute respiratory tract infection in Lanzhou, China. Virol J. 2013;10:271
2. Xie L, Yu XF, Sun Z, et al. Two adenovirus serotype 3 outbreaks associated with febrile respiratory disease and pharyngoconjunctival fever in children under 15 years of age in Hangzhou, China, during 2011. J Clin Microbiol. 2012;50:1879–1888
3. Tang L, Wang L, Tan X, et al. Adenovirus serotype 7 associated with a severe lower respiratory tract disease outbreak in infants in Shaanxi Province, China. Virol J. 2011;8:23
4. Xiao-Qiu Q. Professional training series textbooks of Chinese centers for disease prevention and control. 2009
5. Guo L, Gonzalez R, Zhou H, et al. Detection of three human adenovirus species in adults with acute respiratory infection in China. Eur J Clin Microbiol Infect Dis. 2012;31:1051–1058

Supplemental Digital Content

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.