U.S.$2.8 to study a virus associated with respiratory infections

The Center for Emerging Infectious Diseases (CEID), based in the University of Iowa College of Public Health, has been awarded a five-year, $2.8 million grant by the National Institute of Allergy and Infectious Diseases to study a virus associated with respiratory infections.

The study, led by Gregory Gray, M.D., director of the CEID and UI professor of epidemiology, will establish a national laboratory surveillance system and risk factor analyses for emerging human adenovirus strains.

Numerous illnesses are caused by adenovirus infection, ranging from the common cold to pneumonia, kidney disease, diarrhea and brain disease. Recent studies, however, indicate that new, possibly more dangerous strains of the adenovirus have emerged in the United States during the past decade causing severe respiratory disease and deaths. Additionally, adenoviruses have become a major problem among patients receiving bone marrow or organ transplants.

"Since 1996, newly recognized genetic variants of adenoviruses have been associated with epidemics of severe respiratory infection in Memphis, Chicago, Des Moines and New York, as well as internationally," Gray said. "These data suggest that these emerging strains may be more virulent than previous endemic strains.

"We have recently shown that one of these new strains -- adenovirus 7d2, first reported in Israel in 1992 -- has supplanted other similar adenovirus 7 strains in Iowa and caused at least four deaths. Our hypothesis is that these new strains have become endemic throughout the U.S. and that they are associated with an increased risk of hospitalization and death."

CEID investigators will partner with 15 laboratories throughout the United States to collect a national sample of adenovirus isolates over a period of three winters. The isolates will be gathered from high-risk populations, including children under age seven, organ or allogeneic stem cell (such as bone marrow) transplant patients, and military trainees, as well as an "other patients with adenoviral disease" group.

Researchers will then use patient data and new gene sequencing techniques to type and subtype the isolates and identify human and viral risk factors for severe adenoviral disease. The results of the study will supply a much-needed update to the existing body of knowledge.

"The best adenoviral studies were conducted more than 30 years ago when less than 20 of the now recognized 51 serotypes were known," Gray explained. "Our study will help guide the development and use of rapid diagnostic tests and type-specific adenovirus vaccines for high-risk populations."

The adenovirus research team investigators include Leta Crawford-Miksza, Ph.D., Food and Drug Laboratory Branch of the California Department of Health Services in Richmond, Calif.; Jeffrey Dawson, Sc.D., Department of Biostatistics, UI College of Public Health; Gary Doern, Ph.D., professor of pathology in the UI Roy J. and Lucille A. Carver College of Medicine; Dean Erdman, Dr.P.H., Division of Viral and Rickettsial Diseases at the Centers for Disease Control and Prevention in Atlanta, Ga.; Adriana Kajon, Ph.D., Lovelace Respiratory Research Institute in Albuquerque, N.M.; Margaret Ryan, M.D., Department of Defense Center for Deployment Health Research, Naval Health Research Center, in San Diego, Calif.; David Schnurr, Ph.D., Viral and Rickettsial Disease Laboratory, California Department of Health Services in Berkeley, Calif.; and Sharon Setterquist, Emerging Pathogens Laboratory in the Epidemiology Department of the UI College of Public Health.

Investigators from 14 laboratories across the nation will soon be added to the research team. The Department of Defense Center for Deployment Health Research will serve as the 15th collaborating laboratory.

More information regarding the CEID may be found at the Center's Web site: http://www.public-health.uiowa.edu/ceid/.