Adenovirus infection is a contagious viral disease, caused by adenoviruses, commonly resulting in a respiratory tract infection.[1][10] Typical symptoms range from those of a common cold, such as nasal congestion, coryza and cough, to difficulty breathing as in pneumonia.[10] Other general symptoms include fever, fatigue, muscle aches, headache, abdominal pain and swollen neck glands.[2] Onset is usually two to fourteen days after exposure to the virus.[11] 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.[5] Very young children may just have an earache.[2] Adenovirus infection can present as a gastroenteritis with vomiting, diarrhoea and abdominal pain, with or without respiratory symptoms.[5] However, some people have no symptoms.[4]
Adenovirus infection in humans are generally caused by Adenoviruses types B, C, E and F.[12] Spread occurs mainly when an infected person is in close contact with another person.[7] This may occur by either fecal–oral route, airborne transmission or small droplets containing the virus.[7] Less commonly, the virus may spread via contaminated surfaces.[7] Other respiratory complications include acute bronchitis, bronchiolitis and acute respiratory distress syndrome.[5] It may cause myocarditis, meningoencephalitis or hepatitis in people with weak immune systems.[5]
Diagnosis is by signs and symptoms, and a laboratory test is not usually required.[4] In some circumstances, a PCR test on blood or respiratory secretions may detect adenovirus DNA.[4][8] Other conditions that appear similar include whooping cough, influenza, parainfluenza, and respiratory syncytial virus.[2] Adenovirus gastroenteritis appears similar to diarrhoeal diseases caused by other infections.[13] Infection by adenovirus may be prevented by washing hands, avoiding touching own eyes, mouth and nose with unwashed hands, and avoiding being near sick people.[9] A live vaccine to protect against types 4 and 7 adenoviruses has been used successfully in some military personnel.[9] Management is generally symptomatic and supportive.[9] Most adenovirus infections get better without any treatment.[9] Medicines to ease pain and reduce fever can be bought over the counter.[9]
Adenovirus infections affect all ages.[3] They 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.[11] Severe disease is rare in people who are otherwise healthy.[11] Adenovirus infection accounts for up to 10% of respiratory infections in children.[11] Most cases are mild and by the age of 10-years, most children have had at least one adenovirus infection.[5] 75% of conjunctivitis cases are due to adenovirus infection.[14] In 2016, the Global Burden of Disease Study estimated that globally, around 75 million episodes of diarrhea among children under the age of five-years, were attributable to adenovirus infection.[13] The first adenoviral strains were isolated in 1953 by Rowe et al.[15]
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