Novel recombinant human adenoviruses: A call for enhanced molecular surveillance, diagnosis, and management in pediatric acute respiratory infections

Human adenovirus (HAdV) is a major etiological agent responsible for acute respiratory infections (ARIs) in children.Historically, in the 1950s-1970s, large epidemics of pediatric pneumonia attributed primarily to HAdV-3 and HAdV-7 repeatedly occurred in northern China, with case fatality rates reaching as high as 33.3%.Since then, outbreaks of respiratory illness caused by various HAdV types have emerged intermittently. 1 Notably, in 2019, multiple regions in southern China experienced outbreaks of severe HAdV-7 pneumonia in infants, including fatal cases, underscoring that HAdV infection poses an ongoing and significant threat to child health. 2 This challenge, however, is not unique to China.Globally, HAdV is also recognized as a leading cause of ARIs among children, military personnel, and immunocompromised individuals, with outbreaks frequently documented across diverse settings.3 HAdV belongs to the genus Mastadenovirus within the family Adenoviridae, characterized by a non-enveloped, icosahedral viral particle.Its genome consists of linear double-stranded DNA, typically ranging from 26 to 45 kb in length.To date, HAdVs are classified into seven species (A-G), encompassing at least 117 distinct types.Notably,