{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T23:41:39Z","timestamp":1789688499058,"version":"4.0.1"},"reference-count":50,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"SingHealth and Duke-NUS Medical School","award":["SingHealth\/Duke-NUS\/RCG\/2015\/0007"],"award-info":[{"award-number":["SingHealth\/Duke-NUS\/RCG\/2015\/0007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A number of serious human adenovirus (HAdV) outbreaks have been recently reported: HAdV-B7 (Israel, Singapore, and USA), HAdV-B7d (USA and China), HAdV-D8, -D54, and -C2 (Japan), HAdV-B14p1 (USA, Europe, and China), and HAdV-B55 (China, Singapore, and France).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To understand the epidemiology of HAdV infections in Singapore, we studied 533 HAdV-positive clinical samples collected from 396 pediatric and 137 adult patients in Singapore from 2012 to 2018. Genome sequencing and phylogenetic analyses were performed to identify HAdV genotypes, clonal clusters, and recombinant or novel HAdVs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The most prevalent genotypes identified were HAdV-B3 (35.6%), HAdV-B7 (15.4%), and HAdV-E4 (15.2%). We detected 4 new HAdV-C strains and detected incursions with HAdV-B7 (odds ratio [OR], 14.6; 95% confidence interval [CI], 4.1\u201352.0) and HAdV-E4 (OR, 13.6; 95% CI, 3.9\u201346.7) among pediatric patients over time. In addition, immunocompromised patients (adjusted OR [aOR], 11.4; 95% CI, 3.8\u201334.8) and patients infected with HAdV-C2 (aOR, 8.5; 95% CI, 1.5\u201348.0), HAdV-B7 (aOR, 3.7; 95% CI, 1.2\u201310.9), or HAdV-E4 (aOR, 3.2; 95% CI, 1.1\u20138.9) were at increased risk for severe disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Singapore would benefit from more frequent studies of clinical HAdV genotypes to identify patients at risk for severe disease and help guide the use of new antiviral therapies, such as brincidofovir, and potential administration of HAdV 4 and 7 vaccine.<\/jats:p><\/jats:sec>","DOI":"10.1093\/infdis\/jiz489","type":"journal-article","created":{"date-parts":[[2019,9,26]],"date-time":"2019-09-26T11:24:46Z","timestamp":1569497086000},"source":"Crossref","is-referenced-by-count":13,"title":["Adenoviral Infections in Singapore: Should New Antiviral Therapies and Vaccines Be Adopted?"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0024-3400","authenticated-orcid":false,"given":"Kristen K","family":"Coleman","sequence":"first","affiliation":[{"name":"Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chui Ching","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayanthi","family":"Jayakumar","sequence":"additional","affiliation":[{"name":"Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tham T","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail W L","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su","family":"Yadana","sequence":"additional","affiliation":[{"name":"Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koh C","family":"Thoon","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Infectious Disease Service, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwai Peng","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Singapore General Hospital, Singapore"},{"name":"Academic Clinical Programme for Pathology, Duke-NUS Medical School, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny G","family":"Low","sequence":"additional","affiliation":[{"name":"Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore"},{"name":"Department of Infectious Diseases, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirin","family":"Kalimuddin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoaleh","family":"Dehghan","sequence":"additional","affiliation":[{"name":"Bioinformatics and Computational Biology Program, School of Systems Biology, George Mason University, Manassas, Virginia, USA"},{"name":"Chemistry Department, American University, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"June","family":"Kang","sequence":"additional","affiliation":[{"name":"Bioinformatics and Computational Biology Program, School of Systems Biology, George Mason University, Manassas, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amirhossein","family":"Shamsaddini","sequence":"additional","affiliation":[{"name":"Bioinformatics and Computational Biology Program, School of Systems Biology, George Mason University, Manassas, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Seto","sequence":"additional","affiliation":[{"name":"Bioinformatics and Computational Biology Program, School of Systems Biology, George Mason University, Manassas, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne C F","family":"Su","sequence":"additional","affiliation":[{"name":"Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4628-5908","authenticated-orcid":false,"given":"Gregory 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