Adenoviral Infections

Adenoviruses cause acute, self-limiting, febrile infections, with inflammation of the respiratory or ocular mucous membranes or both. Infections occur throughout the year, but are most common from fall to spring. Adenovirus accounts for 3% to 5% of acute respiratory infections in children and 2% in civilian adults.

Of the many known adenovirus types, only a few result in epidemics. Types 1,2,3, and 5 are frequent in children; types 4 and 7 (also types 3, 14, and 21) are associated with outbreaks in military corps. Nearly 100% of adults have serum antibody titers to several types.

Causes

• Inhaling airborne viruses
• Getting the virus in the eyes by swimming in contaminated water.
• Not washing the hands after using the bathroom, and then touching the mouth or eyes

Symptoms and Signs

The symptoms depend on the location of the infection, but often include a fever. The sore throat, for instance, may be confused with strep throat in the absence of a throat swab.

Diagnostic tests

Definitive diagnosis requires isolation of the virus from respiratory or ocular secretions or from fecal smears. During epidemics, typical symptoms alone allow the doctor to make a diagnosis. Because adenoviral illnesses resolve quickly, serum antibody titers aren't useful for diagnosis. Blood tests show lymphocytosis in children. A chest X-ray may show patchy infiltrates in pneumonia.

Treatment

No specific drugs are effective against adenoviruses, so treatment is mainly supportive. Pharyngocon­junctival fever lasts 1 to 2 weeks and resolves spontaneously. Ocular infections may require corticosteroids and direct supervision by an ophthalmologist. Infants with pneumonia should be hospitalized to monitor for and treat symptoms that can cause death; those with keratoconjunctivitis require hospitalization to treat symptoms that can cause blindness. Live vaccines have been successful against types 4 and 7 in military recruits.

Prevention

There's no way to completely prevent adenoviral infections in children. To reduce the risk of transmission, parents and other caregivers should encourage frequent hand washing, keep shared surfaces such as countertops and toys clean, and remove children with infections from group settings until symptoms subside.

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