J Korean Med Sci.  2024 Jan;39(4):e38. 10.3346/jkms.2024.39.e38.

Prevalence and Burden of Human Adenovirus-Associated Acute Respiratory Illness in the Republic of Korea Military, 2013 to 2022

• Kim D
• Lee E
• Eom J
• Kim Y
• Kwon SH
• Oh HS
• Huh K
• Park H
• Jung J
• Park B

• KMID: 2551968
• DOI: http://doi.org/10.3346/jkms.2024.39.e38

Abstract

Background
Human adenovirus (HAdV) is a common cause of acute respiratory disease (ARD) and has raised significant concerns within the Korean military. Here, we conducted a comprehensive epidemiological analysis of HAdV-associated ARD by evaluating its prevalence, clinical outcomes, and prognosis.
Methods
We reviewed data from multiple sources, including the New Defense Medical Information System, Defense Medical Statistical Information System, Ministry of National Defense, Army Headquarters, Navy Headquarters, Air Force Headquarters, and Armed Forces Medical Command. We analyzed data of patients who underwent polymerase chain reaction (PCR) testing for respiratory viruses between January 2013 and July 2022 in all 14 Korean military hospitals. The analysis included the PCR test results, demographic characteristics, health care utilization, and prognosis including types of treatments received, incidence of pneumonia, and mortality.
Results
Among the 23,830 individuals who underwent PCR testing at Korean military hospitals, 44.78% (10,670 cases) tested positive for respiratory viruses. Across all military types and ranks, HAdV was the most prevalent virus, with a total of 8,580 patients diagnosed, among HAdV, influenza virus, human metapneumovirus, human parainfluenza virus, and human respiratory syncytial virus. HAdV-infected patients exhibited higher rates of healthcare use compared to non-HAdV-infected patients, including a greater number of emergency visits (1.04 vs. 1.02) and outpatient visits (1.31 vs. 1.27), longer hospitalizations (8.14 days vs. 6.84 days), and extended stays in the intensive care unit (5.21 days vs. 3.38 days). Furthermore, HAdV-infected patients had a higher proportion of pneumonia cases (65.79%vs. 48.33%) and greater likelihood of receiving advanced treatments such as high flow nasal cannula or continuous renal replacement therapy.
Conclusion
Our findings indicate that HAdV posed a significant public health concern within the Korean military prior to the coronavirus disease 2019 (COVID-19) pandemic. Given the potential for a resurgence of outbreaks in the post-COVID-19 era, proactive measures, such as education, environmental improvements, and the development of HAdV vaccines, are crucial for effectively preventing future outbreaks.

Keyword

Human Adenovirus; Korean Military; Acute Respiratory Diseases; Prevalence; Disease Burden

Figure

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  Fig. 1 Proportion of HAdV infections among acute respiratory virus infections in the Korean military from January 2013 to July 2022. The height of each bar corresponds to the number of infections observed in each month. The blue bars indicate the number of HAdV infections, and the grey bars represent the number of non-HAdV infections, which include influenza virus, human metapneumovirus, human parainfluenza virus, and human respiratory syncytial virus. (A) Monthly trend in the number of HAdV and non-HAdV infections. (B) Yearly trend in the number of HAdV and non-HAdV infections with percentages.HAdV = human adenovirus.

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