Role of Interleukin-4 (IL-4) in Respiratory Infection and Allergy Caused by Early-Life Chlamydia Infection

( Shujun Li ),( Lijuan Wang ),( Yulong Zhang ),( Long Ma ),( Jing Zhang ),( Jianbing Zu ),( Xuecheng Wu ) 한국미생물 · 생명공학회 2021 Journal of microbiology and biotechnology Vol.31 No.8

Chlamydia pneumoniae is a type of pathogenic gram-negative bacteria that causes various respiratory tract infections including asthma. Chlamydia species infect humans and cause respiratory infection by rupturing the lining of the respiratory which includes the throat, lungs and windpipe. Meanwhile, the function of interleukin-4 (IL-4) in Ch. pneumoniae respiratory infection and its association with the development of airway hyperresponsiveness (AHR) in adulthood and causing allergic airway disease (AAD) are not understood properly. We therefore investigated the role of IL-4 in respiratory infection and allergy caused by early life Chlamydia infection. In this study, Ch. pneumonia strain was propagated and cultured in HEp-2 cells according to standard protocol and infant C57BL/6 mice around 3-4 weeks old were infected to study the role of IL-4 in respiratory infection and allergy caused by early life Chlamydia infection. We observed that IL-4 is linked with Chlamydia respiratory infection and its absence lowers respiratory infection. IL-4R α2 is also responsible for controlling the IL-4 signaling pathway and averts the progression of infection and inflammation. Furthermore, the IL-4 signaling pathway also influences infection-induced AHR and aids in increasing AAD severity. STAT6 also promotes respiratory infection caused by Ch. pneumoniae and further enhanced its downstream process. Our study concluded that IL-4 is a potential target for preventing infection-induced AHR and severe asthma.

호흡기 감염환자를 간호하는 간호사의 호흡기 감염병에 대한 위험인식, 감염관리 피로도, 긍정심리자본이 소진에 미치는 영향

이세영,김유정 간호행정학회 2022 간호행정학회지 Vol.28 No.2

Purpose: Nurses’ burnout is at risk due to increased of respiratory infections and their high demand and expectations. This study aimed to identify the factors that influence burnout among nurses caring for patients with respiratory infections. Methods: A total of 196 nurses caring for patients with respiratory infections from nine hospitals in Korea participated in this study. Data were collected through a structured, self-administered survey that included general characteristics, risk perception of respiratory infections, infection control fatigue, positive psychological capital, and burnout. Results: Burnout was significantly positively correlated with infection control fatigue and significantly negatively correlated with positive psychological capital; burnout was not significantly related to risk perception of respiratory infections. Infection control fatigue, positive psychological capital and the level of experience of nurses significantly influenced burnout. These variables accounted for 37.6% of the burnout among nurses caring for patients with respiratory infections. Conclusion: Evidence-based guidelines are needed to support the ability of nurses with little experience in responding to infectious diseases and reducing infection control fatigue and providing effective educational programs at institutions that can improve the positive psychological capital of individual nurses. 목적: 호흡기 감염으로 인한 간호 수요와 기대의 증가로 간호사의 소진이 위험하다. 본 연구의 목적은 호흡기 감염환자를 간호하는 간호사의 소진에 대한 영향요인을 확인하고자 한다. 방법: 참여자는 한국의 9개 병원에서 호흡기 감염환자를 돌보는 196명의 간호사였다. 자료는 일반적 특성, 호흡기 감염병에 대한 위험인식, 감염관리 피로도, 긍정심리자본과 소진 항목을 포함한 구조화된 설문지로 수집되었다. 결과: 소진은 감염관리 피로도와 유의한 양의 상관관계, 긍정심리자본과는 유의한 음의 상관관계가 있었고, 호흡기 감염병에 대한 위험인식과는 유의한 상관관계가 없었다. 긍정심리자본, 감염관리 피로도와 총 근무경력이 소진에 유의한 영향요인으로 나타났다. 이 변수들이 간호사의 소진에 대해 37.6% 설명하였다. 결론: 경력이 적은 간호사의 감염병 대응 역량 확보와 감염관리 피로도를 낮출 수 있는 근거중심 가이드라인이 필요하며, 간호사 개인뿐만 아니라 직종 전체의 긍정심리자본을 강화할 수 있는 기관과 국가 차원의 프로그램 및 지원이 필요하다.

영아기 호흡기 질환의 이환요인에 관한 연구

신상원,김은영,노영일,양은석,문경래,박상기,박영봉 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

Purpose: Respiratory tract infections are common in the first year of life. Severity of respiratory tract infection in infants is associated with early-life environmental factors, In recent, genetic studies suggest a role of heredity in susceptibility to severe respiratory tract infection(RTI) in infants. We designed a case control study to further investigate relative importance of familial influence in risk of respiratory tract infection in infants compared to environmental factors. Methods: We selected 126 children(44 cases; 82 controls) that admitted or visited to Chosun University Hospital. Cases were infants under age 1 year admitted to hospital with severe respiratory tract infection. Familial history and other factors were recorded in cases and controls by questionnaire. Results: Out of 126 infants, Patients admitted with severe respiratory tract infection are 44 cases. Diagnosis of patients with RTI are acute bronchitis 15 cases(34.1%), pneumonia 12 cases (27.3%), acute nasopharyngitis 7 cases (15.9%), acute bronchiolitis 5 cases (11.4%), infantile asthma 3 cases (6.8%), and croup 2 cases (4.5%). The crude odd ratio of repiratory tract infection of parental smoking is 3.35 and cow mik feeding 3.13, Prematurity & low birth weight 2.39, maternal allergic disease 2.13, and child allergy 1.92. Conclusion: Maternal allergic disease, parental smoking, Prematurity and low birth weight, and Allergic diseases increased the risk of respiratory tract infection in infants. Breast milk feeding decreased that. These results support the possibility that genetic factors play an important role in susceptibility to recurrent and severe respiratory infections in early life.

단일 기관에서 경험한 호흡기 아데노바이러스 감염의 임상적 고찰

김태현 ( Tae Hyun Kim ),임정혁 ( Chung Hyuk Yim ),안성윤 ( Sung Yoon Ahn ),강국진 ( Kook Jin Kang ),최유미 ( Yu Mi Choi ),고정희 ( Jeong Hee Ko ),최경은 ( Kyong Eun Choi ),이정현 ( Jung Hyun Lee ),이원욱 ( Won Wook Lee ) 대한천식알레르기학회 2015 Allergy Asthma & Respiratory Disease Vol.3 No.6

Purpose: The purpose of this study is to identify the epidemiologic and clinical characteristics of respiratory adenovirus infections in children, and to investigate the difference in the clinical features between single adenovirus infection and coinfection with adenovirus and other respiratory viruses. Methods: A retrospective study was performed in 470 children hospitalized with respiratory adenovirus infections in Gwangmyeong Sungae Hospital between January 2013 and December 2013. Results: The mean age of the patients was 46.2 months and the peak incidence was in the 12- to 24-month age group. The mean duration of hospitalization and fever were 4.5±1.1 and 4.5±9.2 days, respectively. Seasonally it had occurred throughout the year, but showed the highest prevalence in August and high prevalence in July, September, and October. The frequency of viral coinfection with other respiratory viruses was 39.6%. The age was significantly younger in coinfection group than in the single adenovirus infection group (P<0.001). The prevalence rates of bronchiolitis (P<0.001) and pneumonia (P=0.042) were significantly higher in the respiratory syncytial virus coinfection group. The coinfection rate was significantly higher in children aged less than 2 years (P<0.001), and the prevalence rates of bronchiolitis (P<0.001) and pneumonia (P<0.001) were also higher in the group aged less than 2 years than other age groups. Conclusion: Adenovirus is an important viral agent in hospitalized children with acute respiratory tract infection. Lower respiratory tract infections, such as bronchiolitis and pneumonia, and coinfection with other respiratory viruses were more frequently occurred in patients under 2 years of age. Further studies are needed to clarify whether coinfection with other respiratory viruses would increase the rate of lower respiratory tract infections in patients with respiratory adenoviral infections. (Allergy Asthma Respir Dis 2015;3:402-409)

소아에서 human metapneumovirus 감염증의 임상적 고찰

백현,이양진,조형민,유은정,정권,김은영,김용욱,김경심,서진종,정윤석 대한소아감염학회 2008 Pediatric Infection and Vaccine Vol.15 No.2

Purpose : Human metapneumovirus (hMPV) was recently discovered in children with respiratory tract infection. The aim of this study was to determine the frequency and the clinical manifestation of hMPV infection in Korean children. Methods : From January to December, 2005, we collected throat swabs from 1,098 children who were hospitalized for acute respiratory illness at the Department of Pediatrics, Kwang- Ju Christian Hospital. hMPV was detected by performing reverse transcriptase-polymerase chain reaction (RT-PCR). The medical records of the patients with positive results were retrospectively reviewed. Results : We detected hMPV in 25 (2.2%) of the 1,098 hospitalized children. The mean age of the hMPV infected children was 2.3 years, and 84% of the illnesses occurred between April and June. The most common diagnoses were pneumonia (60%) and bronchiolitis (20 %). The clinical manifestations included cough, fever, coryza, rale, wheezing and injected throats. Peribronchial infiltration and consolidation were the common chest X-ray findings. Four (16%) of 25 patients with hMPV infection had exacerbation of asthma. Coinfection with other respiratory viruses was found in six children (24%). Conclusion : hMPV is the cause of an important proportion of acute respiratory tract infection in Korean children. Additional studies are required to define the epidemiology and the extent of disease caused by hMPV and to determine future development of this illness in Korean children. (Korean J Pediatr Infect Dis 2008;15:129-137) Purpose : Human metapneumovirus (hMPV) was recently discovered in children with respiratory tract infection. The aim of this study was to determine the frequency and the clinical manifestation of hMPV infection in Korean children. Methods : From January to December, 2005, we collected throat swabs from 1,098 children who were hospitalized for acute respiratory illness at the Department of Pediatrics, Kwang- Ju Christian Hospital. hMPV was detected by performing reverse transcriptase-polymerase chain reaction (RT-PCR). The medical records of the patients with positive results were retrospectively reviewed. Results : We detected hMPV in 25 (2.2%) of the 1,098 hospitalized children. The mean age of the hMPV infected children was 2.3 years, and 84% of the illnesses occurred between April and June. The most common diagnoses were pneumonia (60%) and bronchiolitis (20 %). The clinical manifestations included cough, fever, coryza, rale, wheezing and injected throats. Peribronchial infiltration and consolidation were the common chest X-ray findings. Four (16%) of 25 patients with hMPV infection had exacerbation of asthma. Coinfection with other respiratory viruses was found in six children (24%). Conclusion : hMPV is the cause of an important proportion of acute respiratory tract infection in Korean children. Additional studies are required to define the epidemiology and the extent of disease caused by hMPV and to determine future development of this illness in Korean children. (Korean J Pediatr Infect Dis 2008;15:129-137)

소아에서 발병한 human metapneumovirus와 respiratory syncytial virus에 의한 호흡기 감염의 임상 양상

김유경,유은경,김진우,위영선,한만용 대한 소아알레르기 호흡기학회 2009 Allergy Asthma & Respiratory Disease Vol.19 No.1

Purpose : To identify the clinical features of human metapneumovirus (hMPV) and the respiratory syncytial virus (RSV) infection in children. Methods : The participants of our study were 1,104 children who were admitted to Bungdang CHA hospital for lower respiratory infection from August 2006 through July 2007. Nasopharyngeal swabs were taken from the patients, and viruses were identified by RT-PCR. The clinical features of 51 patients with hMPV infection and 138 patients with RSV infection were compared by retrospective review of their medical records. Results : The peak incidence of hMPV infection was noted in April, and that of RSV was noted in November. Both viruses had the highest incidence in patients age <1 year and hMPV infections occurred in 40% and 25% of patients age <6 months, respectively. In the hMPV group, 33.4% of the patients were age ≥2 years, while in the RSV group, 19% were age ≥2 years. In both groups, pneumonia was the most common clinical diagnosis, followed by acute bronchiolitis, acute bronchitis, and asthma. The white blood cell counts were higher in the RSV group, and fever was more frequent on admission in the hMPV group. Conclusion : hMPV was the fourth most common virus causing lower respiratory tract infections in children. The clinical features of hMPV infection were similar to those of RSV infection. This study may be helpful for the effective treatment of lower respiratory tract infection in children. 목 적 : 국내에서 호발하는 hMPV와 RSV감염의 임상 양상의 차이가 아직 명확하지 않아 이를 확인하고자 한다. 방 법 : 2006년 8월부터 2007년 7월까지 분당 차병원에 하부 호흡기 감염으로 입원한 환아 1,104명을 대상으로 비인강 흡입법과 RT-PCR을 이용하여 바이러스를 검출하였다. 이중 hMPV와 RSV 감염 양성인 환자 각각 51명과 138명을 대상으로 후향적인 의무기록분석을 통해 검출 시기, 연령, 성별, 임상 진단명, 임상 양상 및 검사 소견을 비교 분석하였다. 결 과 : hMPV감염은 4월에, RSV감염은 11월에 가장 많이 발생하였다. 두 군 모두 1세 미만의 영아가 가장 많았으나 6개월 이하의 군에서 hMPV는 25% RSV는 40%를 차지하였다. 2세 이상의 군에서는 hMPV가 33.4%, RSV는 19%였다. 진단명은 두 군 모두 폐렴, 급성 세기관지염, 급성 기관지염 순으로 차이를 보이지 않았다. 말초 혈액 백혈구수는 RSV 감염시 더 높았고, 입원 당시 열이 있는 환아의 비율은 hMPV군에서 더 높았다. 결 론 : 본 연구에서 hMPV는 영유아에서 바이러스성 하부 호흡기 감염의 네 번째로 흔한 원인으로, hMPV 감염의 임상양상은 RSV 감염과 유사하였다. 향후 이러한 연구가 호흡기 바이러스 감염의 효율적인 관리에 도움이 될 것이라 여겨진다.

Intensive Care Management in the Immunocompromised Patients with Severe Pulmonary Infection

( Kyeongman Jeon ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.0

The proportion of critically ill patients with immune deficiency has risen in recent years to about a third of patients admitted to medical intensive care unit (ICU). Severe pulmonary infection is the leading cause for ICU admission in immunocompromised patients, are often life threatening and associated with hypoxemic acute respiratory failure (ARF), resulting in mortality. Therefore, rapid and accurate diagnosis with extensive investigations and proper respiratory support for hypoxemia caused by pulmonary infection is a major cornerstone for the intensive care of immunocompromised patients with severe pulmonary infection. In this symposium, diagnostic strategy and respiratory management in immunocompromised patients with severe pulmonary infection will be discussed. Existing guidelines for managing pulmonary infections in critically ill immunocompromised patients emphasize the importance of obtaining valid samples for the diagnosis of infection. However, antimicrobial therapy is often started immediately, before adequate samples are collected. As a result, causative microorganisms are identified in only about half the patients even with bacterial pneumonia. Therefore, a detailed analysis of the clinical, laboratory, and radiologic findings would be needed, which can provide valuable diagnostic orientation in these cases. Nevertheless, the frequency of pulmonary infection is probably underestimated as signs and symptoms of infection may be subtle as a result of blunted immune response. On the other hand, non-infectious pulmonary abnormalities may be mistakenly diagnosed as clinically presumed infections. Therefore, the etiological diagnosis can be extremely challenging especially in critically ill immunocompromised patients, as the effects of pulmonary infection can be combined with those of the underlying disease and treatments, creating extraordinarily complicated clinical features. In addition, some patients have more than one concurrent infection, and others have non-infectious causes of ARF that mimic infection. Chest radiography is the preferred initial diagnostic imaging examination in the ICU for evaluation of suspected pulmonary infection in immunocompromised patients. Due to the blunted host immune response, however, radiographic findings may be subtle or occult until more widespread infection has developed. Computed tomography (CT) using thin-section provides superior resolution and can better characterize and localize radiographic abnormalities. In addition, CT scan is helpful in differentiating infectious from non-infectious cause. Furthermore, bronchoalveolar lavage and transbronchial lung biopsy are commonly used for diagnosis even in the ICU, but may cause further respiratory deterioration in patients with mechanical ventilation (MV) support. However, first-line bronchoalveolar lavage should be considered in which patients have a possible diagnosis of atypical pulmonary infections, such as CMV or Pneumocystis pneumonia. Non-invasive diagnostic tests offer an alternative to bronchoalveolar lavage, however, these tests are more sensitive than specific, and the clinical relevance of a positive PCR is sometimes uncertain. Over the past two decades, studies have consistently shown higher mortality in immunocompromised patients who required invasive MV. Therefore, priority has been given to avoidance of invasive MV by use of non-invasive devices. However, a recent multicenter RCT showed that failure of non-invasive ventilation (NIV) or high-flow nasal cannula (HFNC) was associated with higher mortality, and previous studies even suggested that early invasive MV was associated with improved survival. These data raise concerns about the use of NIV or HFNC in immunocompromised patients with hypoxemic acute respiratory failure. Therefore, response of patients to HFNC or NIV should be carefully assessed in immunocompromised patients with respiratory failure caused by severe pulmonary infection.

Respiratory Syncytial Virus A , B 아형의 유행 양상 및 임상상

윤보영,박진영,이환종,윤종구 대한감염학회 1996 감염 Vol.28 No.6

목적 : 우리나라에서 Respiratory Syncytial Virus (RSV)의 중요성 및 A, B아형 각 감염증의 임상상을 분석하여, 치료 제제, 백신 개발 등 향후 국내 RSV 연구의 기초 자료로 이용하고자 한다. 방법 : 1990년 11월부터 1994년 4월까지 서울대학교 어린이병원에 입원하거나 외래 또는 응급실을 방문한 소아 중 croup, 기관지염, 모세기관지염, 폐렴 등의 하기도 감염증으로 진단받은 환아 712명에서 804회에 걸쳐 비흡인물(nasal aspirate)을 채취하여 단클론 항체를 이용한 면역 형광 검사법 및 바이러스 배양으로 219례(27.2%)에서 RSV감염증을 진단하였으며, 이들을 A,B아형으로 분류하고 각 아형의 유행 양상 및 임상상을 분석하였다. 결과 : 219례의 RSV 감염증 중 134례에서 아형분류가 가능하였으며, A 아형이 99례(73.9%), B 아형이 34례(25.3%), A 아형도 아닌 것이 1례이었다. RSV는 연구 기간 중 매년 겨울에 유행하여 4회의 유행이 관찰되었다. 4회의 RSV 유행 기간 중 1회는 A 아형만이 검출되었고(1991-92년), 1회는 A 아형이 우세하였고(1992-93년), 1회는 B 아형에 이어 A 아형이 B 아형과 동등한 비율로 유행하였으며(1990-91년), 나머지 1회는 B 아형만이 검출되었다(1993-94년). 각 아형간에 감염 연령, 성별, 임상 양상, 선행 질환 유무, 입원 여부등은 차이가 없었으나, 병원 감염의 빈도는 A 아형의 경우에 더 많았다(p=004). 인공 호흡기 사용 여부를 중증도의 척도로 하였을 때, 아형에 따른 차이는 관찰할 수 없었다(p=959). 결론 : 본 연구에서 RSV는 우리나라 소아 하기도 감염증의 흔한 원인임이 확인되었고, 국내 RSV A,B 아형의 유행 양상을 처음으로 밝혔으며, A,B 아형간에 중증도의 차이는 발견할 수 없었다. Background : Respiratory syncytial virus(RSV) is the most important cause of respiratory tract infections in infants and young children. RSV can be classified into two major subgroups based on their reactivity with monoclonal antibodies, and relative frequency of each subgroup may differ by geographic location and epidemic year. It has been suggested that severity of infection may differ depending on the subgroup of RSV Methods : RSV infection was diagnosed by indirect immunofluorescent staining and viral culture employing KEp-2 cell line in patients with lower respiratory tract infections who were admitted to the Seoul National University Children's Hospital. RSV strains isolated over four successive outbreaks from November 1990 to April 1994 were typed by indirect immunofluorescence with subgroup-specific monoclonal antibodies. Clinical characteristics of RSV infection were reviewed retrospectively, with special emphasis on comparison between two subgroups of RSV. Results : RSV was detected in 219(27%) of 804 episodes of lower respiratory tract infections. One hundred and thirty four strains(61.2%) of 219 RSV strains were sero grouped. Ninety-nine(73.9%) strains were identified as subgroup A, 34(25.3%) strains as subgroup B, and 1 strain was neither subgroup A nor subgroup B. Three patterns of yearly outbreaks existed: (1) only subgroup A strains(1991-92) or strong predominance of subgroup A strains(1992-93 with 93% A strains), (2) relatively equal proportions of subgroup A and B strains(1990-91), (3) only subgroup B strains in 1993-94. Eleven(11%) of 99 subgroup A infection and 3(9%) of 34 RSV subgroup infection required assisted ventilation, the difference of which was not significant statistically. Ten of 219 patients expired, all of whom had underlying diseases. Four of them were infected by subgroup A, while 6 infections were not sero-grouped. Conclusion : These data shows that RSV is an smportant cause of lower respiratory tract infection in Korean children. Comparison of this study with similar studies from other geographic locations about RSV subgroups indicates that the pattern of RSV subgroup prevalence is a localized phenomenon, and whether or not there is a difference in clinical severity of disease caused by the two RSV subgroups is uncertain. Possible significance of the geographic difference in the prevalence of each subgroup should be considered in the future vaccine development.

Respiratory Syncytial Virus에 의한 소아 하기도감염의 방사선학적 소견

김우선 대한영상의학회 1992 대한영상의학회지 Vol.28 No.4

Respiratory syncytial virus is the most common cause of lower respiratory infection (bronchiolitis and pneumonia) of infancy and early childhood. We analyzed clinical and radiological features of 76 patients with lower respiratory infections by respiratory syncytial virus, which were diagnosed by indirect immunofluorescent test or culture of nasal aspirate in Hep-2 cell monolayer, during the period of January-December, 1991. There were peaks of incidences in March-May and November-December, accounting for 87% of eases. Sixty-two cases (82%) were under 1 year of age. Fifty cases (66%) had underlying diseases. Major radiographical findings were overaeration (83%), parahilar peribronchial infiltrates (67%), segmental or subsegmental atelectasis (32%), and segmental or lobar consolidation (16%). In 15 cases (20%), overaeration was the only radiological findings. There was no evidence of pleural effusion or hilar lymph node enlargement in all cases. By considering clinical features (symptoms, age, underlying diseases, epidemic seasons) in addition to the radiological findings, radiologists would be familiar with lower respiratory infection by respiratory syncytial virus. Air space consolidation, which is generally thought to represent bacterial pneumonia, is also observed not inferquently in respiratory syncytial virus infections.

Epidemiological Investigation of the Outbreak of Acute Respiratory Infection caused by Adenovirus Type B55 in a Physical Education School in 2017

송정석,이혜림,조은희 대한감염학회 2019 Infection and Chemotherapy Vol.51 No.2

Background: On May 19, 2017, the cluster of 6 acute respiratory infections due to adenovirus in the swimming department of a physical education school (School J) was reported to Korea Centers for Disease Control and Prevention. An epidemiological investigation was conducted to identify the transmission route of the infection and to control the outbreak. Materials and Methods: A retrospective cohort study (Study 1) was conducted on students and teachers of the athletic departments using the swimming pool, and a prospective surveillance (Study 2) was conducted on all students and teachers of the School J. A case was defined as any student and school personnel who developed more than two of the following symptoms from April 10 to July 2, 2017: fever, sore throat, cough, rhinorrhea, or headache. Relative risks (RRs) were calculated to compare the attack rates according to potential risk factors. Multivariable logistic regression was performed to identify the risk factors for infection in the outbreak. Results: 47 cases were identified: 33 (55.9%) cases occurred among 59 students and teachers in Study 1 and 14 (3.9%) among 362 students and school personnel in Study 2. There were 18 laboratory confirmed adenovirus infection cases. The common symptoms were headache (71.7%), fever (69.6%), rhinorrhea (63.0%), sputum (56.5%), and sore throat (54.3%). 23.9% of the cases were accompanied with diarrhea and 19.6% with eye congestion. None of the cases developed pneumonia. 32.6% of the cases were hospitalized. In Study 1, attack rate in the swimming department was higher than that in others (RR: 1.90; 95% confidence interval [CI]: 1.01-3.60). In Study 2, being a member of the shooting department (RR: 20.70; 95% CI: 4.90 - 87.47) and being a first year high school student (RR: 10.95; 95% CI: 2.90 - 41.33) were identified as risk factors for the infections. Genetic analyses of the adenoviruses showed 100% identical sequence in homology and confirmed the human adenovirus B55 (HAdV-B55). No adenovirus was detected at examining the water and environment of the swimming pool and dormitory. Conclusion: The outbreak is inferred to be occurred via propagated transmission among the students in the same athletic department, while the students with symptoms of respiratory infection continued performing school activities without any restrictions. Infection control measures such as early detection of symptoms of respiratory infection and restriction of group activity are necessary to prevent respiratory infection outbreak in the communal living setting.