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Abstract
Human adenovirus type 14 (HAdV-B14p) was originally identified as an acute respiratory disease (ARD) pathogen in The Netherlands in 1955. For approximately fifty years, few sporadic infections were observed. In 2005, HAdV-B14p1, a genomic variant, re-emerged and was associated with several large ARD outbreaks across the U.S. and, subsequently, in Canada, the U.K., Ireland, and China. This strain was associated with an unusually higher fatality rate than previously reported for both this prototype and other HAdV types in general. In China, HAdV-B14 was first observed in 2010, when two unrelated HAdV-B14-associated ARD cases were reported in Southern China (GZ01) and Northern China (BJ430), followed by three subsequent outbreaks. While comparative genomic analysis, including indel analysis, shows that the three China isolates, with whole genome data available, are similar to the de Wit prototype, all are divergent from the U.S. strain (303600; 2007). Although the genomes of strains GZ01 and BJ430 are nearly identical, as per their genome type characterization and percent identities, they are subtly divergent in their genome mutation patterns. These genomes indicate possibly two lineages of HAdV-B14 and independent introductions into China from abroad, or subsequent divergence from one; CHN2012 likely represents a separate sub-lineage. Observations of these simultaneously reported emergent strains in China add to the understanding of the circulation, epidemiology, and evolution of these HAdV pathogens, as well as provide a foundation for developing effective vaccines and public health strategies, including nationwide surveillance in anticipation of larger outbreaks with potentially higher fatality rates associated with HAdV-B14p1.
Emerging Microbes & Infections (2017) 6, e92; doi:10.1038/emi.2017.78; published online 1 November 2017
Acknowledgments
This work was funded by the National Natural Science Foundation of China (31370199 and 31570155) and the Excellent Young Teacher Training Plan of Guangdong Province (Yq2013039), as well as by the Young Top-notch Talents of Guangdong Province Special Support Program (2014), and the Guangzhou Healthcare Collaborative Innovation Major Project (201400000002). Portions of this manuscript were completed at the Department of Ophthalmology, Howe Laboratory, Massachusetts Eye and Ear Infirmary, Harvard Medical School (Boston, Massachusetts, USA) as Q.Z. was funded by the China Scholarship Council (CSC No. 201508440056) as a Visiting Scholar (2015–2016); he thanks James Chodosh and Jaya Rajaiya for providing a stimulating intellectual environment. This project was additionally supported by a summer research grant (2016) to D.S. from the Office of the Vice President for Research at George Mason University. The Funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
