Adenovirus

 

Clinical Background

Adenoviruses usually cause mild, self-limiting respiratory illnesses primarily in children.

Epidemiology

  • Prevalence
    • 5-7% of respiratory infections in children
    • Year-round infection
    • Rarely fatal, but 50% of infants and young children have prolonged intermittent disease
  • Age – primary infection usually <10 years
  • Transmission
    • Respiratory droplet transfer
    • Neonatal transmission following vaginal delivery (rare)

Organism

  • Double-stranded DNA virus; belongs to Adenoviridae family
  • 52 serotypes described to date
    • Types 4 and 7 are common in military recruit outbreaks
    • Severe and sometimes fatal respiratory illnesses most commonly associated with adenovirus 14
    • Nosocomial transmission reported
  • Classified into 6 groups, A-F

Risk Factors

  • Military service (recruit)
  • Immunocompromised state
  • Malnutrition in children <2 years

Clinical Presentation

  • Most infections – mild, self-limited respiratory illness
  • Bronchiolitis, pneumonia (types 3, 7, 21)
  • Acute diarrhea (types 40, 41)
  • Hemorrhagic cystitis (types 7, 11, 21, 34, 35)
  • Epidemic keratoconjunctivitis (types 8, 19, 37)
  • Fatal adenovirus infections can occur in infants and immunocompromised adults (type 14)
  • Other organ involvement is frequent – hepatitis, colitis, cystitis, meningoencephalitis

Treatment

  • Treatment is supportive