Health: Virulent Virus

Non-Life-Threatening But Spreading

A new, apparently more virulent form of a virus that usually causes nothing worse than a nasty cold has caused outbreaks of severe pneumonia in at least three states this year. Dozens have been hospitalized, many requiring intensive care, and at least 10 have died.

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Health officials say so far the virus does not seem to be causing life-threatening illness on a wide scale, but it appears to be spreading and it is too soon to know how significant a threat it poses.

Washington Post science reporter Rob Stein was online Tuesday, Dec. 11, at a 11 a.m. ET to discuss the story.

A transcript follows.

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Rob Stein: Hello everyone. Thanks very much for joining us today to talk about adenovirus 14. I see there are already several interesting questions. So let's get started.

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Washington, D.C.: Should all unexpected deaths from pneumonia be regarded as suspect? I'm thinking in particular of the brother of a friend of mine, who was healthy one week, and dead of pneumonia the next. (On the other hand, he was 65 years old.) Also, are suspect deaths reported to the CDC after the fact, once people recognize the outbreak as an epidemic?

Rob Stein: Health officials say that doctors should consider whether adenovirus 14 may be involved in any unusual cases of pneumonia that do not have another explanation. But there are many other causes of pneumonia that will probably turn out to be to blame. And, yes, suspect cases are sometimes reported to the CDC after the fact, even in the absence of an outbreak. New York health officials, for example, determined that a 12-day-old girl who died in 2006 turned out to have been infected with adenovirus 14.

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Washington, D.C.: Our 3-year-old little girl Jane has pneumonia. All last week she had a terrible cough, fever (once it got up to 103.5) and vomiting. She was diagnosed with a mild, bacterial pneumonia on Friday and has been taking clarithromycin twice daily since then. Our doctor said she was not contagious after the first 48 hours. So she hasn't had a fever since Thursday, and we had her out for a short time on Sat. and Sun. She slept 15 last night and still has a deep cough. Should we be concerned?

Rob Stein: Since your doctor has diagnosed the cause of your daughter's pneumonia it sounds like it's unlikely to be adenovirus 14. I hope your daughter continues to improve.

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Washington, D.C.: How long does someone with this disease remain contagious? We have a relative coming to visit from San Antonio, Tex., (the location of Lackland Air Force Base) who is recovering from pneumonia and has said she is not contagious, she is not in the military. Should I be concerned about my 3-year-old?

Rob Stein: It's unlikely that you have any reason to be concerned, especially since your visitor is already recovering and is not in the military. Health officials say the best advice is always to take common sense preventive measures, such as frequent hand washing.

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Cape Coral, Fla.: I have asthma, respiratory allergies and low immunoglobin counts. Even the slightest cold or sinus infection spins out of control and attacks my lungs, requiring weeks of doctor visits, antibiotics and nebulizer treatments. This new adenovirus has me scared. Are my concerns valid? Do I need to be even more vigilant about seeing my physician if I develop troubling symptoms? I do the usual frequent hand washing and trying to avoid sick people. Thanks for you informative, if scary, article.

Rob Stein: Health officials say that while they are monitoring the situation with adenvirus 14, there's no reason for the public to be alarmed. They recommend that people simply continue to take practice the kind of commonsense personal hygiene measures, such as frequent hand-washing, that they would recommend to reduce the risk for colds and the flu.

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Washington, D,C.: Do you think flu shots could help prevent an individual from being seriously affected by this virus or would it not make a difference?

Rob Stein: The flu vaccine would not protect against this virus. There are vaccines available to protect against other strains of the adenvirus, and researchers are not trying to determine whether they might offer any protection against adenovirus 14.

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Anonymous: It would help all of us to talk about this virus if you'd include how to pronounce the name. Please.

Rob Stein: It's pronounced with a short "i" -- "adinovirus."

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Washington, D.C.: Is there always a high fever associated with the virus? My daughter has been sneezing and has a stuffed up head for a couple of weeks now, on and off, which I attributed to leaf mold allergies she has had in the fall before -- should I be concerned if she has not had a fever? As you can imagine, this morning's article probably freaked out a lot of people, everyone in D.C. has been sick the last couple of weeks!

washingtonpost.com: Virus Starts Like a Cold But Can Turn Into a Killer (Post, Dec. 11)

Rob Stein: A very high fever seems to be hallmark symptom of the very severe cases, usually along with a cough and shortness of breath. So if you daughter doesn't have any of those symptoms it's probably just a cold or allergies, as you suspected.

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Sewickley, Pa.: I received a pneumonia vaccine along with my flu shot this year. Am I protected? My husband is in the military and the last time I had influenza I caught it while visiting him at Fort Benning Ga. Military posts seem to be hotbeds of viral danger.

Rob Stein: Vaccines for other infections would not offer protection against this virus. There is a vaccine for other strains of adenovirus 14 that may offer some protection. It's unclear at the moment, but the military is studying that question.

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Arlington, Va.: Since I have occasional bouts with bronchitis and am 59 years old, my doctor gave me an pneumonococcal (sp?) vaccine earlier this year. I understand I need a booster in 7 years. What will this protect me from?

Rob Stein: Unfortunately that vaccine would not offer any protection. Scientists are trying to determine whether other vaccines that were designed to protect against other strains of adenvirus might offer some protection against this strain. But that's unclear at the moment.

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ADD-ih-no Virus.: It is easier to pronounce if you think of it as two words, like Adeno Virus, where Adeno is pronounced "ADD-ih-no"

Rob Stein: Yes. That's a better explanation than mine, I think.

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Washington, D.C.: Off the subject but similar ... A Montgomery County teacher who contracted a staph infection died Sunday night. They say it was the MRSA virus. Do you know the details about this and the symptoms?

Rob Stein: My colleagues wrote a story about that case that appeared in today's paper. Here's the link:

Montgomery Teacher With Staph Infection Dies (Post, Dec. 11)

As you'll see, some of the symptoms can be similar. But MRSA infections begin with a skin infection, such as a boil.

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Silver Spring, Md.: What's interesting to me, when I think about flu and other viruses, is that cold viruses are usually so benign (although unpleasant). Any idea why adenoviruses are -- or at least have been, until now -- so much less dangerous than some other types of virus?

Rob Stein: That's right. Adenoviruses can cause a wide variety of illness, ranging from colds to pinkeye and stomach flus. They are usually relatively mild though, in part because most people have been exposed to them previously at some point and have built up some resistance. One of the theories about about adenvirus 14 may be sometimes causing more severe illness is that it's new to this country and most people have not been exposed to it before.

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Gaithersburg, Md.: At Thanksgiving, my 20-year-old, healthy-as-a-horse son came home from college in North Carolina with what he thought was the flu. He was very sick but seemed to be recovering. One evening we were eating dinner and he suddenly complained about pain in his back. We took him to the doctor the next morning. Luckily, his doctor ordered an X-ray and caught the pneumonia. He was put on a very strong antibiotic and cough medicine. He stayed home to recover and missed a week of school. After reading today's newspaper account, how can we find out if he had adenovirus 14?

Rob Stein: If the doctor took and saved any samples from your son they could be sent to a lab for analysis. One of the problems with adenovirus is that a lot of hospitals don't test for it or don't the capacity to test for it. But there are labs available that can do the testing.

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Gaithersburg, Md.: How come CDC didn't connect the dots? And how come they didn't get the word out to local hospitals and medical professionals? A college friend of my son's went to the local emergency room and was told he "just had the flu" and to go back to his dorm and drink plenty of liquids and rest. He, like my son, was extremely sick. I think I'm counting my blesssings that my son came home for Thanksgiving and we were able to get him the medical help he needed.

Rob Stein: The CDC published a report about outbreaks in Oregon, Washington and Texas (and one case in New York City) on Nov. 16 to try to alert doctors to be on the look-out for adenovirus 14 infections.

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Maryland: Maybe I am missing something, but why are we shocked when someone dies from pneumonia?

People need to note that when they are sick they are SICK and need to stay home, rest, recover, and more importantly not expose others to what could be a serious disease. Companies need to address this by allocating sick time for people (and requiring a doctor's note if they are worried about abuse).

Rob Stein: What's different about these cases is that otherwise healthy people are suddenly developing very severe pneumonia.

But you make a very good point -- one of the best ways to reduce the risk for infections such as adenovirus 14 is for people who are sick to stay home until they are better and no longer contagious.

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The Plains, Va.: I was shocked to see this story this morning. On Sept. 20, upon returning from about 5 weeks in San Diego (my husband had surgery at the UCSD medical center) I came down with the most debilitating symptoms two days later. I started to shake and shiver, throw up, run a high fever. Went to doctor and was given antibiotics. The next day I was worse, never been so sick in my life, and was taken to Fauquier hospital in Warrenton by ambulance. I have almost no memory of that trip or the next 3 days. I was immediately pumped with every strong antibiotic they could give me (I learned this later). I could not adequately breathe, my vision started to blur and had no balance. After four days they took me off the IVs and said it was a virus. They told me they checked with CDC. I had a spinal tap, brain scan, MRIs, chest X-Ray,EKG, etc. Elevated blood pressure and liver enzymes. After all medication was removed I did start to get better. I was discharged after 8 days to recuperate at home -- in bed for a week and restricted activity after that.

The diagnosis was an "unknown viral infection."

I was told at the one month check up that if I wasn't it such good physical condition, I would be dead. I am a 70-year-old, small-framed fox hunter, who hikes and rides. Thank God!

I still have memory loss, especially in the afternoon when I "fall off the edge of a cliff" tired. Mornings from 6:00 a.m. are good.

Rob Stein: So very sorry to hear about your ordeal, but very glad to hear that you are recovering. Those symptoms sound very similar to the symptoms that can occur from adenovirus 14 infection. I'm curious if the CDC was able to confirm whether or not that is actually what caused your illness.

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Gaithersburg, Md.: Thanks, Rob. November 16 was the week before Thanksgiving. I'm going to e-mail the Post article and the link to this discussion to the director of the student health clinic at my son's college. She needs to know about this. Again, many thanks for the article. It was very helpful.

Rob Stein: Glad the story was helpful. You might consider including a couple of links to the CDC's Web site:

Acute Respiratory Disease Associated with Adenovirus Serotype 14 -- Four States, 2006--2007 (CDC, Nov. 16)

Adenoviruses (CDC, Jan. 21, 2005)

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Philadelphia, Pa.: How does the increasing frequency of outbreaks like this impact the recent push for "consumer-driven" health care -- the one where we're supposed to pay more out of pocket so that we consume less, order fewer tests, etc?

There would be a compounding effect of more people getting less treatment, spreading diseases more readily, wouldn't there?

It would seem that the "free market" approach to health care may kill us all, no?

Rob Stein: Interesting question. I haven't' seen any research that makes that connection. Researchers tend to blame other factors, such as increased air travel, for the spread of infectious diseases, or overuse of antibiotics for the emergence of resistant infections.

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Rob Stein: Thanks everyone for all the great questions. It's clear that there's a lot more to learn about adenovirus 14.

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