Adenovirus infection in humans are generally caused by Adenoviruses types B, C, E and F.
Family of approximately 50 viruses that cause respiratory infections such as colds and pneumonia.
Some people have no symptoms.
Onset is usually two to fourteen days after exposure to the virus.
Other general symptoms include fever, fatigue, muscle aches, headache, abdominal pain and swollen neck glands.
Adenovirus infections affect all ages.
Adenovirus infections occur sporadically throughout the year, and outbreaks can occur particularly in winter and spring, when they may spread more quickly in closed populations such as in hospitals, nurseries, long-term care facilities, schools, and swimming pools.
A mild eye infection may occur on its own, combined with a sore throat and fever, or as a more severe adenoviral keratoconjunctivitis with a painful red eye, intolerance to light and discharge.
Very young children may just have an earache.
Onset is usually two to fourteen days after exposure to the virus.
Adenovirus infection may be associated with no symptoms.
Generally associated with fever, tiredness, chills, muscle aches, headache, stomachache, tonsillitis, lymphadenopathy.
Pharyngoconjunctival fever associated with pink-red eyes, fever, sore throat.
Keratoconjunctivitis: red painful eye, poor vision, intolerance to light, watery eyes, discharge, swelling of the conjunctiva.
Gastroenteritis: diarrhea, vomiting, abdominal pain.
Urinary tract infection: dysuria and increase frequency of passing urine.
Complications of adenovirus infection:
Respiratory: pneumonia, acute respiratory distress syndrome, bronchiolitis, acute bronchitis
Brain: meningoencephalitis
Heart: myocarditis, cardiomyopathy, pericarditis
Liver: hepatitis, liver disease
Kidney: nephritis
Differential diagnosis: Whooping cough, influenza, parainfluenza, respiratory syncytial virus.
Prevention:
Washing hands, social distancing, avoid touching eyes, nose and mouth.
Strict attention to good infection-control practices is effective for stopping transmission in hospitals of adenovirus-associated disease, such as epidemic keratoconjunctivitis.
Treatment is symptomatic and supportive.
Prognosis: patients usually recover without treatment.
A common infection affecting all ages.
Typically occurs children under 5-years.
Adenovirus infection can present as a gastroenteritis: vomiting, diarrhea and abdominal pain, with or without respiratory symptoms.
Sometimes a skin rash appears.
Generally, a day or two after developing a sore throat with large tonsils, lymphadenopathy can be felt in the neck.
Adenovirus infections are generally caused by Adenoviruses types B, C, E and F.
Spread occurs mainly when an infected person is in close contact with another person: fecal–oral route, airborne transmission or small droplets containing the virus.
Less commonly, adenovirus may spread via contaminated surfaces.
Respiratory complications include acute bronchitis, bronchiolitis and acute respiratory distress syndrome.
Adenovirus infection may cause myocarditis, meningoencephalitis or hepatitis in people with immunosuppression.
DIAGNOSIS:
By signs and symptoms, and a laboratory confirmation is not usually required.
A PCR test on blood or respiratory secretions may detect adenovirus DNA.
Similar conditions include: whooping cough, influenza, parainfluenza, and respiratory syncytial virus.
Adenovirus gastroenteritis appears similar to diarrheal diseases caused by other infections.
Prevention of adenovirus infections: washing hands, avoiding touching own eyes, mouth and nose, and avoiding being near overtly ill people.
Maintaining adequate levels of chlorination is necessary for preventing swimming pool-associated outbreaks of adenovirus conjunctivitis.
MANAGEMENT: symptomatic and supportive care.
Severe disease is rare in people who are otherwise healthy.
Adenovirus infection accounts for up to 10% of respiratory infections in children, which are mostly mild.
By the age of 10-years, most children have had at least one adenovirus infection.
75% of conjunctivitis cases are due to adenovirus infection.
In 2016, the Global Burden of Disease Study
An estimated global 75 million episodes of diarrhea among children under the age of five-years, were attributable to adenovirus infection in 2016.
Symptoms and clinical findings
depend on the type of adenovirus, where it enters into the body, and on the age and well-being of the person.
Patterns of clinical features with adenovirus infections include: respiratory, eye, gastrointestinal, genitourinary and central nervous systems.
In immunocompromised individuals the pattern of disease is widespread.
Infants may also have symptoms of an ear infection.
Preschool children with adenovirus colds tend to present with a nasal congestion, runny nose and abdominal pain, fever, sore throat, and a cough.
Up to one in five infants with bronchiolitis will have adenovirus infection.
Bronchiolitis obliterans is uncommon, but can occur if adenovirus causes pneumonia with prolonged fever, and can result in dyspnea.
Severe pneumonia is most common in very young children age three-to-18 months.
Six to nine-days following exposure to adenovirus, one or both eyes, typically in children may present as pink/red eye, and may be associated with fever, pharyngitis and lymphadenopathy.
The onset of symptoms are usually sudden, and is often accompanied by rhinitis.
Adenovirus infections can cause adenoviral keratoconjunctivitis. where one eye is affected after an incubation period of up to a week.
Keratoconjunctivitis symptoms may last around 10-days to three-weeks.
Keratoconjunctivitis may be is associated with blurred vision, photophobia and swelling of the conjunctiva, and tends to occur in epidemics, affecting predominantly adults.
In very young children, keratoconjunctivitis it may be associated with high fever, sore throat, otitis media, diarrhoea, and vomiting.
Adenovirus infection can cause a gastroenteritis with diarrhea, vomiting and abdominal pain, with or without respiratory or general symptoms.
Children under the age of one-year appear particularly vulnerable to gastroenteritis, that usually resolves within three-days.
Rarely, the bladder may be affected, with dysuria followed hematuria.
Meningismus may occur in adenovirus associated meningoencephalitis, which may occur in people with immunosuppression.
Adenovirus infection may result in symptoms of myocarditis, dilated cardiomyopathy, pericarditis, hepatitis, and urethritis.
Adenoviruses are transmitted by direct contact, fecal-oral transmission, and occasionally waterborne transmission.
Some types of adenoviruses are capable of establishing persistent asymptomatic infections in tonsils, adenoids, and intestines of infected hosts, and shedding can occur for months or years.
Adenovirus serotypes 1, 2, 5, and 6 are endemic in parts of the world where they have been studied, and infection is usually acquired during childhood.
Different types cause sporadic infection and occasional outbreaks.
Epidemic keratoconjunctivitis is associated with adenovirus serotypes 8, 19, and 37.
Epidemics of conjunctivitis are associated with waterborne transmission of some adenovirus types, with inadequately chlorinated swimming pools and small lakes.
Adenovirus respiratory disease is most often associated with adenovirus types 4 and 7 in the United States.
Enteric adenoviruses 40 and 41 cause gastroenteritis, usually in children.
Infection with adenovirus 7 acquired by inhalation is associated with severe lower respiratory tract disease, whereas oral transmission of the virus typically causes no or mild disease.
Adenovirus-associated respiratory disease is more common in the late winter, spring, and early summer.
Adenovirus infections however, can occur throughout the year.
Diagnosis; usually made by signs and symptoms, and a laboratory confirmation is not usually necessary.
When a diagnosis needs to be confirmed, a PCR test on blood or respiratory secretions may detect adenovirus DNA.
Adenovirus can be isolated by growing in cell cultures in a laboratory.
Similar illnesses include: whooping cough, influenza, parainfluenza, and respiratory syncytial virus.
Adenovirus can be excreted for prolonged periods, so its presence virus does not necessarily mean it is associated with disease.
A live adenovirus vaccine to protect against types 4 and 7 adenoviruses has been used in some military facilities..
TREATMENT:
Generally symptomatic and supportive, as most adenovirus infections get better without any treatment.
After recovery from adenovirus infection, the virus can be carried for weeks or months.
Adenovirus can cause severe necrotizing pneumonia in which all or part of a lung has increased translucency radiographically, which is called Swyer-James Syndrome.
Severe adenovirus pneumonia also may result in bronchiolitis obliterans, a subacute inflammatory process in which the small airways are replaced by scar tissue, resulting in a reduction in lung volume and lung compliance.
Adenovirus infections occur sporadically throughout the year.
Adenovirus infection outbreaks can occur particularly in winter and spring.
Epidemics may spread more quickly in closed populations such as in hospitals, nurseries, long-term care facilities, boarding schools, orphanages and swimming pools.
Severe disease is rare in people who are healthy.
Around 10% of respiratory infections in children are caused by adenoviruses.
Most are mild and by the age of 10-years, most children have had at least one adenovirus infection.
Adenoviruses are the most common viruses causing an inflamed throat.
75% of conjunctivitis cases are due to adenovirus infection.
Under two-year olds are particularly susceptible to adenovirus gastroenteritis by types 40 and 41, with type 41 being more common than type 40.
Type 40/41 adenovirus as one of the second most common causes of diarrhea in children in low and middle income countries; the most common being rotavirus.
Around 75 million episodes of diarrhea among children under the age of five-years, were attributable to adenovirus infection, with a mortality of near 12%, in 2016.
Adenovirus infection associated with upper respiratory: nasal congestion, coryza, cough, wheeze, and fast breathing sometimes.
Typical symptoms are of a mild cold or resembling the flu; fever, nasal congestion, coryza, cough, and pink/red eyes.
Adenovirus infection is a contagious viral disease, caused by Adenoviruses, commonly resulting in a respiratory tract infection.
Typical symptoms range from those of a common cold, such as nasal congestion, coryza and cough, to difficulty breathing as in pneumonia.
Symptoms are variable, and can range from mild symptoms to severe illness.
Can cause intestinal or urinary tract inflammation.
May be responsible for conjunctivitis.