Aerosol-induced adenoviral illness resembling the naturally occurring illness in military recruits.

A major disease problem in military personnel is acute, febrile undifferentiated respiratory disease, the well known ARD of military recruits. This disease, as well as nonstreptococcal exudative pharyngitis and atypical pneumonia without cold agglutinins, has been associated most prominently with types 4 and 7 adenovirus infection (1-4). Previous attempts to induce these diseases in volunteers have resulted in asymptomatic virus infection, mild afebrile upper respiratory illness, conjunctivitis, or pharyngoconjunctival fever (5-7). The latter syndrome includes frank conjunctivitis, a rare finding in naturally occurring acute respiratory disease (1). In reviewing the problem of adenoviral disease, it was observed that volunteers were previously inoculated in the eye or nasopharynx, and that inoculation of the lower respiratory tract had never been evaluated. Consequently, studies were performed in which one of these adenoviral types (type 4) was administered to volunteers by inhalation in an aerosol with a high probability of deposition in the lower respiratory tract and, in one, with a low probability of deposition at this site. These inhalations reproduced the naturally occurring disease syndromes of recruits, and suggest that the important factor in producing this response was deposition of virus in the lower respiratory tract.