WORLDWIDE EPIDEMIOLOGY OF HUMAN ADENOVIRUS INFECTIONS

Schmltz, H., R. Wlgand (Instltut für Hygiene, U. Kliniken, D-6650 Homburg/ Saar, FRG), and W. Helnrich. Worldwide epidemiology of human adenovlrus infections. Am J Epidemiol 1983; 117: 455–66. Approximately 25, 000 reports to WHO from 1967 to 1976 on isolations of adenovirus 1 to 31 showed an absolute frequency of Ad2, 1, 7, 3, 5, 6, 4, 8, and other species, in decreasing order. The relative frequency was analyzed by the X2 method; only significant deviations (p < 0.05; in many cases p < 0.001) from chance distribution were taken into account. To avoid small numbers, the three adenovirus species of subgenus A (Ad12, 18, 31) and several species of subgenera B and D were analyzed as one group. The incidence of Ad8, 7 and 19, less so of Ad3 and 4, showed a periodicity over the years. No definite seasonal incidence pattern was found for the countries of the Northern Hemisphere. The Southern Hemisphere showed a higher incidence of Ad4 and 7, and subgenus B (without Ad3 and 7), and a lower incidence of Ad6, whereas subgenus A, Ad8, and 19 were rarely reported. Highly significant age predilections were subgenus A for infants, subgenus C for infants and small children, Ad3 for school children, Ad7 for school children and adults, Ad4, 8, and other species of subgenera B and D for adults. A predilection for males was observed In all species of subgenera B and C, and in Ad4 and 19. The association between virus infection and clinical syndromes was analyzed for children up to age 14 years and for adults separately. Subgenus C viruses, mainly Ad2, occurred frequently in Infections of the lower respiratory and gastrointestinal tract In both children and adults. An association with disease of the central nervous system, fever, and cardiovascular disease was seen in adults only. Ocular infections in both children and adults were associated with Ad3; only children showed an association with upper respiratory tract disease and fever. Ad7 was frequent in ocular disease and fever in children, and in respiratory infections in adults. For Ad4, no organ specificity was found. Ocular infections in both children and adults were associated with Ad8; only children showed an association with upper respiratory tract disease. Subgenus A was associated with gastrointestinal disease in children. The hypothesis that all the adenovirus species from one subgenus may have similar epidemiologic and pathogenic properties appears to be largely true for subgenus C viruses. In subgenus B, many differences were found between Ad3 and 7, and other viruses of subgenus B.