Monday, November 19, 2007

Killer Cold Virus UPDATED

A few day's ago I posted an article about a new cold virus that is proving to be deadly. Since then I have noticed that many people have found this blog because they were searching for information about this virus. So I am posting an update to help people find all the available information right here.

The following is from the Medpage:

Here is the link and parts of the article are below:

Killer Cold Virus Caused 10 Deaths

ATLANTA, Nov. 16
-- Clinicians should keep their eyes peeled for a mutated form of adenovirus 14 that has caused at least 10 deaths, most of them among adults, the CDC warned.

The new strain of adenovirus 14 differs in that most of its victims have been otherwise healthy adults, CDC officials said.

"What really got people's attention is these are healthy young adults landing in the hospital and, in some cases, the ICU," said John Su, M.D., Ph.D., of the CDC.

But the first case that came to the CDC's attention was a 12-day-old infant who died in a New York hospital in May 2006. The baby girl was full-term and the delivery was uncomplicated, the agency reported.

Postmortem examination found adenovirus 14, as well as chronic inflammatory cells with intranuclear inclusions, in the lungs, consistent with adenoviral bronchiolitis and acute respiratory distress syndrome.

The strain would prove to be genetically identical to isolates found in three clusters of adenovirus 14 disease over the following 18 months, the CDC said, but different in some respects from the reference strain, first isolated in 1955.

The finding suggests "the emergence and spread of a new [adenovirus 14] variant" in the U.S., the agency said in the Nov. 15 issue of Morbidity and Mortality Weekly Report.

The later clusters were reported in 2007 in Oregon, Washington state, and Texas, the CDC said.
The largest outbreak took place from Feb. 3 to June 23 at Lackland Air Force Base in Texas, where 27 patients were sent to the hospital with pneumonia, including five who were admitted to the intensive care unit.

One of the five required extracorporeal membrane oxygenation for about three weeks and ultimately died. Medical personnel collected throat swabs from 16 of the 27 -- including the intensive care patients -- and all tested positive for the virus.

Also, during that period, medical personnel collected and tested 423 specimens associated with an outbreak of febrile respiratory infection, of which, 268 tested positive for adenovirus. A little less than half of the specimens (44%) were also serotyped and 90% were adenovirus 14.

The deadliest outbreak, identified retrospectively, occurred in Oregon, after a local clinician reported multiple patients admitted to a single hospital for pneumonia over a five-week period in March and April.

Of the 17 specimens obtained, 15 were positive for adenovirus 14, the CDC said, leading Oregon public health authorities to review records from virology labs and find 68 people who tested positive between Nov. 1, 2006, and April 30, 2007.

Of those, 50 isolates could be serotyped and 31 were adenovirus 14, the CDC reported, while 15 were another serotype and four were not actually adenovirus.

Review of medical records for 30 of the 31 with adenovirus 14 showed that 22 patients required hospital care, 16 required intensive care, and seven died, all from severe pneumonia. Most of the dead were adults, but one infant also died.

In contrast, only two of the 13 non-type 14 patients whose charts were available needed hospital care, none needed intensive care, and none died. (See: IDSA: Outbreak of Severe Pneumonia Traced to Adenovirus 14)

In Washington, officials reported four patients -- one with AIDS and three with chronic obstructive pulmonary disease -- with cough, fever, or shortness of breath between April 22 and May 8, 2007.

Three required intensive care and mechanical ventilation for severe pneumonia, and after eight days of hospital care, the AIDS patient died, while the other patients recovered.

All four tested positive for adenovirus and the three with isolates available for serotyping were shown to have adenovirus 14.

The CDC urged clinicians to follow its 2003 guidelines for pneumonia care. Among other things, the guidelines suggested changes in ventilation practices:
Orotracheal rather than nasotracheal tubes should be used in patients who need mechanically assisted ventilation.

Noninvasive ventilation should be used to reduce the need for and duration of endotracheal intubation.

The breathing circuits of ventilators should be changed when they malfunction or are visibly contaminated.

When feasible, an endotracheal tube with a dorsal lumen should be used to allow drainage of respiratory secretions.

Here is a great article from WebMd:
Killer Cold Virus Appears in U.S.
10 Deaths From Outbreaks in 4 States as Ad14 Cold Virus Becomes More Common

Here are a few excerpts from the article:
Nov. 15, 2007 -- A virulent new form of an old cold virus is spreading in the U.S., causing severe pneumonia and death even in healthy adults.

The virus is adenovirus type 14 or Ad14. Since May 2006, when it killed a 12-day-old girl in New York City, there have been 10 deaths among 141 confirmed cases. Except for the infant girl, the cases came in outbreaks in Oregon, Washington, and Texas.

Different adenovirus strains have caused outbreaks in the past. But this seems to be a particularly "challenging" virus, says CDC epidemic intelligence officer John Su, MD, PhD.

The CDC, in the Nov. 16 issue of Morbidity and Mortality Weekly Report, chronicles the four known Ad14 outbreaks.

As I was reading the article the above statement caught my attention:

My question was can I read the Morbidity and Mortality Report: So I did some research and I found it:

This Week in MMWR
November 16, 2007 / Vol. 56 / No. 45
Acute Respiratory Disease Associated with Adenovirus Serotype 14

Ad14 is a rarely reported but emerging adenovirus serotype that can cause severe and sometimes fatal respiratory illness. In May 2006, an infant in New York died from respiratory illness caused by Ad14. During March--June 2007, a total of 140 additional cases were identified in patients in Oregon, Washington, and Texas; nine of these patients died. Ad14 isolates from the four states were identical to one another but distinct from the Ad14 reference strain from 1955, suggesting emergence of a new Ad14 variant in the United States.

Here is the link to download the entire report in PDF format:


I will continue to follow this story and provide the best information I can find

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> posted by Trevor Hammack @ 9:21 AM   0 comments links to this post


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