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Lawmakers Questioning CDC Guidelines for Adenovirus Alerts After Student’s Death

Maryland lawmakers are asking the Centers for Disease Control and Prevention to re-evaluate federal guidelines for adenovirus outbreaks following the death of a University of Maryland freshman last year.

Sens. Benjamin L. Cardin (D) and Chris Van Hollen (D), along with Rep. Steny H. Hoyer (D), sent a letter to the director of the CDC, Dr. Robert R. Redfield, on Tuesday. The lawmakers have also asked for a briefing on CDC guidelines regarding adenovirus outbreaks within the next 10 days.

In November, College Park freshman Olivia Paregol died from adenovirus 7, a particularly virulent strain of the virus, which has symptoms similar to the flu and can be dangerous for immunocompromised people, like Paregol, who was taking medication for Crohn’s Disease. More than 40 students were sickened and 15 were hospitalized.

The university’s first public warnings about adenovirus came 18 days after officials first learned of a diagnosis on campus, and after Paregol died. University officials defended the response in a Washington Post investigation, noting that they followed current CDC guidelines – which don’t require public alerts for adenovirus outbreaks – and had provided more generalized warnings about virus prevention.

“Despite causing severe illness and even death in some individuals, adenovirus 7 is not a nationally notifiable disease in the United States, and as such, clinicians are not required to test for or report cases to health departments or the CDC. Recommending prompt adenovirus testing, especially for those with compromised immune systems, may help to prevent another tragedy,” the lawmakers wrote to Redfield.

The lawmakers included a list of five questions they’d like answered before a briefing:

  1. What are the current CDC guidelines for medical facilities and university-based health centers during adenovirus outbreaks?
  2. How soon does outreach and education begin once an adenovirus outbreak is suspected?
  3. CDC acknowledges that adenovirus 7 has been associated with more severe outcomes, particularly in people with weakened immune systems. Does the CDC have specific recommendations for immunocompromised individuals and their healthcare practitioners when there is a suspected or confirmed outbreak of adenovirus?
  4. If not, why does the CDC not have specific recommendations related to immunocompromised individuals during an adenovirus outbreak?
  5. Given the unique situation faced by immunocompromised individuals living on college campuses, does the CDC have any specific guidelines to inform university-based health center medical staff how to best educate and work with this special population, in order to mitigate possible infection risks?

“The large social gatherings present at universities may increase the spread of communicable diseases, which necessitates further guidance to healthcare providers in order to best protect immunocompromised individuals on campus,” the lawmakers also wrote in their letter.

“We are concerned that the guidelines did not protect Ms. Paregol, and that they leave immunocompromised people like her at risk of serious illness or death.”

Last month, Paregol’s family filed a notice required by the Maryland Tort Claims Act that indicates a possible future lawsuit against the state.

The University System of Maryland’s Board of Regents announced Friday they would begin an investigation into the handling of the outbreak and Paregol’s death. Gov. Lawrence J. Hogan Jr. (R) has called on the process to be thorough and publicly transparent.

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