National Burden of Human Adenovirus Infections in China: A Community-Based Multiplier Modeling Study.
2026-08-01, Journal of Medical Virology (10.1002/jmv.71088) (online)Ling-Zi Yao, Shigui Yang, Liyang Ma, Qianqian Feng, Anqi Dai, Xiaofei Zhou, Huihui Zhang, Rongrong Qu, Mengsha Chen, Jiaxin Chen, Jiani Miao, Jiaxing Qi, Wenkai Zhou, Mengting Cen, Zhennan Chen, Can Chen, and Jingtong Zhou (?)
Human adenovirus (HAdV) is an important cause of respiratory infections, yet community-level burden estimates remain limited. We aimed to estimate post-pandemic HAdV burden in China. Using nationwide respiratory pathogen surveillance data and a multiplier model, we estimated the incidence of HAdV infections, symptomatic illnesses (SI), and medically attended illnesses (MAI) in China from 2023 to 2024. Age-, species-, and province-specific analyses were conducted. Uncertainty was assessed using Monte Carlo simulations. We estimated 44.21 million HAdV infections (95% UI, 26.68-77.08 million) over the 19-month study period, corresponding to an average monthly incidence of 1.58 per 1000 persons (95% UI, 1.01-2.61), equivalent to an annualized incidence of 18.96 per 1000 persons (95% UI, 12.12-31.32). The estimated average monthly incidences of SI and MAI were 0.41 (95% UI, 0.30-0.57) and 0.30 (95% UI, 0.21-0.40) per 1000 persons, corresponding to annualized incidences of 4.92 (95% UI, 3.60-6.84) and 3.60 (95% UI, 2.52-4.80) per 1000 persons, respectively. Children aged 0-4 years had the highest average monthly incidence (16.66 [95% UI, 10.26-28.54] per 1000 persons). HAdV species B showed higher incidence than species C among children aged 5-14 years. The highest incidence rates occurred in several south-central and southwestern provinces, including Hunan, Guangxi, Hubei, Guangdong, and Yunnan. HAdV imposed a substantial and under-recognized respiratory disease burden in China during the post-pandemic period. Children experienced the highest burden, and marked species-specific and geographic heterogeneity were observed. These findings provide community-based evidence to inform adenovirus surveillance and respiratory disease control strategies in China.
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