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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

Transmission occurs by direct inoculation into the eye by fecal-oral contamination (adenoviruses may persist in the GI tract for years after infection) or by inhalation of an infected droplet. The incubation period usually is less than 1 week. Although the acute illness lasts less than 5 days, it may be followed by prolonged asymptomatic re-infection.

Signs and symptoms

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

In addition to a complete medical history and physical examination, diagnostic tests for adenoviruses may include:

  • blood work
  • culture of respiratory secretions by nasal swab
  • stool culture
  • chest x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

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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