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Toovey OTR, Kulkarni P, David J, Patel A, Lai FY, Burns J, Thompson C, Ellis J, Tang JW. An outbreak of adenovirus D8 keratoconjunctivitis in Leicester, United Kingdom, from March to August 2019. J Med Virol 2021; 93:3969-3973. [PMID: 33135807 PMCID: PMC8246710 DOI: 10.1002/jmv.26647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 10/21/2020] [Accepted: 10/27/2020] [Indexed: 12/28/2022]
Abstract
We report a large epidemic (n = 126) of keratoconjunctivitis predominantly with two lineages of adenovirus (AdV) type D8 in patients seen in eye casualty between march and August 2019. Other AdV species identified by viral sequencing included B, C, and E. Despite various features of more severe eye disease being present, these were not significantly different between the different AdV species, with similar rates of pseudomembrane formation and keratitis observed in patients with AdV species B as for those with AdV species D.
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Affiliation(s)
- Oliver T. R. Toovey
- Department of Microbiology and VirologyUniversity Hospitals of Leicester NHS TrustLeicesterUK
| | - Priti Kulkarni
- Department of OphthalmologyUniversity Hospitals of Leicester NHS TrustLeicesterUK
| | - Joicy David
- Department of Microbiology and VirologyUniversity Hospitals of Leicester NHS TrustLeicesterUK
| | - Ayushi Patel
- Department of Microbiology and VirologyUniversity Hospitals of Leicester NHS TrustLeicesterUK
| | - Florence Y. Lai
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
| | - Joyce Burns
- Department of OphthalmologyUniversity Hospitals of Leicester NHS TrustLeicesterUK
| | | | - Joanna Ellis
- Respiratory Virus UnitPublic Health EnglandLondonUK
| | - Julian W. Tang
- Department of Microbiology and VirologyUniversity Hospitals of Leicester NHS TrustLeicesterUK
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
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Nguyen TTH, Le TA, Nguyen VH, Nguyen TU, Nguyen PT, Tran TTA, Nguyen QH, Hoang AT, Hoang MH, Le TS, Nguyen VS. Molecular typing of conjunctivitis-causing adenoviruses in Hanoi, Vietnam from 2017 to 2019 and complete genome analysis of the most prevalent type (HAdV-8). J Med Virol 2020; 92:3100-3110. [PMID: 32266999 DOI: 10.1002/jmv.25844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/12/2020] [Accepted: 04/06/2020] [Indexed: 11/11/2022]
Abstract
Adenoviral conjunctivitis is a common epidemic worldwide. In Vietnam, up to 80,000 patients are infected with adenoviral conjunctivitis annually. However, there are few investigations on the pathogenic adenoviruses that cause conjunctivitis. In total, 120 eye-swab samples were collected from patients with viral conjunctivitis symptoms in Hanoi, Vietnam from 2017 to 2019. Human adenoviruse (HAdV) was detected in 67 samples (55.83%) using polymerase chain reaction amplification of at least one of three HAdV-specific marker genes (hexon, penton, and fiber). Of the 67 HAdV samples, 46 samples could be analyzed by all three marker genes. DNA sequence analysis and phylogenetic tree building based on the three marker genes from the 46 HAdV samples revealed five different HAdV types associated with conjunctivitis in Hanoi, including HAdV-3 (4.3%), HAdV-4 (2.2%), HAdV-8 (89.1%), HAdV-37 (2.2%), and a potential recombinant type between types HAdV-8 and HAdV-3 (2.2%). This showed that HAdV-8 was the most common type identified in Hanoi. Complete genome analysis of HAdV-8 isolated from a Vietnamese patient (VN2017) using Sanger sequencing revealed 34 unique nucleotide changes, indicating that the adenovirus continuously accumulates new mutations. Hence, continuous surveillance of HAdV-8 changes in Vietnam is necessary in the future.
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MESH Headings
- Humans
- Vietnam/epidemiology
- Adenoviruses, Human/genetics
- Adenoviruses, Human/classification
- Adenoviruses, Human/isolation & purification
- Phylogeny
- Adenovirus Infections, Human/virology
- Adenovirus Infections, Human/epidemiology
- Genome, Viral/genetics
- Molecular Typing
- Male
- Conjunctivitis, Viral/virology
- Conjunctivitis, Viral/epidemiology
- Female
- Adult
- Whole Genome Sequencing
- Middle Aged
- Prevalence
- Sequence Analysis, DNA
- DNA, Viral/genetics
- Young Adult
- Genotype
- Adolescent
- Child
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Affiliation(s)
- Thi Thu Huyen Nguyen
- Faculty of Biology, VNU University of Science, Vietnam National University, Hanoi, Vietnam
| | - Tuan Anh Le
- Faculty of Biology, VNU University of Science, Vietnam National University, Hanoi, Vietnam
| | - Viet Ha Nguyen
- Faculty of Biology, VNU University of Science, Vietnam National University, Hanoi, Vietnam
| | - Thi Uyen Nguyen
- Faculty of Biology, VNU University of Science, Vietnam National University, Hanoi, Vietnam
| | - Phuong Thao Nguyen
- Faculty of Biology, VNU University of Science, Vietnam National University, Hanoi, Vietnam
| | - Thi Thuy Anh Tran
- Faculty of Biology, VNU University of Science, Vietnam National University, Hanoi, Vietnam
| | - Quang Hung Nguyen
- Faculty of General Diagnostic, National Hospital of Ophthalmology, Hanoi, Vietnam
| | - Anh Tuan Hoang
- Faculty of General Diagnostic, National Hospital of Ophthalmology, Hanoi, Vietnam
| | - My Hanh Hoang
- Faculty of Biology, VNU University of Science, Vietnam National University, Hanoi, Vietnam
| | - Tho Son Le
- Department of Molecular Genetics and Gene Technology, College of Forestry Biotechnology, Vietnam National Forestry University, Hanoi, Vietnam
| | - Van Sang Nguyen
- Faculty of Biology, VNU University of Science, Vietnam National University, Hanoi, Vietnam
- Molecular and Cellular Biology Laboratory, Center for Life Science, Faculty of Biology, VNU University of Science, Vietnam National University, Hanoi, Vietnam
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Aoki K, Gonzalez G, Hinokuma R, Yawata N, Tsutsumi M, Ohno S, Kitaichi N. Assessment of clinical signs associated with adenoviral epidemic keratoconjunctivitis cases in southern Japan between 2011 and 2014. Diagn Microbiol Infect Dis 2019; 95:114885. [PMID: 31607514 DOI: 10.1016/j.diagmicrobio.2019.114885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/26/2019] [Accepted: 08/05/2019] [Indexed: 01/03/2023]
Abstract
Adenoviral epidemic keratoconjunctivitis (EKC) is a major cause of ocular morbidity worldwide and specific antiviral therapies are not available. EKC is primarily caused by Human adenovirus D (HAdV-D) types 8, 37, 53, 54, 56 and 64. Considering the genomic variation in HAdV-D, we hypothesized that clinical signs could be differentiated by virus type. The hypothesis was retrospectively tested with clinical signs recorded from 250 patients with ocular infections visiting an ophthalmological clinic in southern Japan between 2011 and 2014. The results showed that conjunctival opacity, corneal epithelial disorders and pre-auricular lymphadenopathy, were more frequently associated with EKC than other ocular infections. Furthermore, HAdV types 8, 37 and 54, caused corneal complications and longer infections significantly more frequently than infections by types 53 and 56 (P < 0.05). Our descriptive results supported that symptoms severity vary with the infecting type, however, further research is needed to improve diagnosis of EKC.
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Affiliation(s)
- Koki Aoki
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; Department of Ophthalmology, Health Sciences University of Hokkaido, Sapporo, Japan
| | - Gabriel Gonzalez
- Division of Bioinformatics, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | | | - Nobuyo Yawata
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Singapore Eye Research Institute, Singapore; Duke-NUS Medical School, Singapore
| | - Masayuki Tsutsumi
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; Department of Ophthalmology, Health Sciences University of Hokkaido, Sapporo, Japan
| | - Shigeaki Ohno
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; Department of Ophthalmology, Health Sciences University of Hokkaido, Sapporo, Japan
| | - Nobuyoshi Kitaichi
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; Department of Ophthalmology, Health Sciences University of Hokkaido, Sapporo, Japan.
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Gonzalez G, Yawata N, Aoki K, Kitaichi N. Challenges in management of epidemic keratoconjunctivitis with emerging recombinant human adenoviruses. J Clin Virol 2019; 112:1-9. [PMID: 30654207 DOI: 10.1016/j.jcv.2019.01.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/21/2018] [Accepted: 01/08/2019] [Indexed: 01/14/2023]
Abstract
Adenoviral epidemic keratoconjunctivitis (EKC) presents as severe conjunctival inflammations involving the cornea that can lead to the development of corneal opacities and blurred vision, which can persist for months. EKC is highly contagious and responsible for outbreaks worldwide, therefore accurate diagnosis and rapid containment are imperative. EKC is caused by a number of types within Human adenovirus species D (HAdV-D): 8, 37 and 64 (formerly known as 19a) and these types were considered the major causes of EKC for over fifty years. Nonetheless, recent improved molecular typing methodologies have identified recombinant HAdV-D types 53, 54 and 56, as newly emerging etiologic agents of EKC infections worldwide. EKC cases due to these recombinant types have potentially been underdiagnosed and underestimated as a source of new EKC outbreaks. Recombination events among circulating HAdV-D types represent a source of new infectious disease threats. Also, the growing number of adenoviral types enabled genomic and phenotypic comparisons to determine pathological properties related to EKC. This review covers the clinical features of EKC, current challenges in clinical practice and recent progress in EKC-related HAdV research, which focuses on the development of novel diagnostic and therapeutic approaches.
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Affiliation(s)
- Gabriel Gonzalez
- Division of Bioinformatics, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Nobuyo Yawata
- Department of Medicine, Ophthalmology, Fukuoka Dental College, Fukuoka, Japan; Singapore Eye Research Institute, Singapore; Department of Ophthalmology, Kyushu University, Japan; Duke-NUS Medical School, Singapore
| | - Koki Aoki
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; Department of Ophthalmology, Health Sciences University of Hokkaido, Sapporo, Japan
| | - Nobuyoshi Kitaichi
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; Department of Ophthalmology, Health Sciences University of Hokkaido, Sapporo, Japan.
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