Clinical Manifestations, Diagnosis, and Treatment & Control

Clinical Manifestations

Most adenovirus infections are sub-clinical. The most common clinical manifestation of Adenovirus infection is a respiratory infection. These include:

  • Pharyngitis: Seen particularly in young children. Symptoms include cough, nasal congestion, fever, inflamed throat, tonsillitis. Occasionally a pertussis-like illness (whooping cough) is seen.
  • Acute respiratory disease (ARD): fever, pharyngitis, cervical adenitis, cough, malasie (body pains). Often occurs in epidemic form for military recruits due to close quarters.
  • Pneumonia: can be severe and occasionally fatal. A serious problem in colder climates, such as Canada and northern China, as well as for immuno-suppressed patients.

    Ocular infections are also quite common. These include


  • Pharyngoconjunctival fever: commonly known as "pink-eye". This is common for young children, highly contagious, occurs in epidemics, and may be referred to as "swimming pool conjunctivitis."
  • Epidemic keratoconjunctivitis: often referred to as "shipyard eye", gaining this name from reports of industrial workers exposed to dust. This is a more serious eye infection, and can progress to involve the cornea (keratitis). Nosocomial (hospital) infections are also common when an infected person is present.

    Genitourinary infections


  • Cervicitis, urethrititis, may be causes of venereal infection in women.
  • cystitis may be seen in young boys.

    Enteric Infections


  • gastroenteritis in infants.

    Laboratory Diagnosis


  • can use a wide variety of samples, including stool, pharyngeal swab, nasopharyngeal aspirate, transtracheal aspirate, or bronchial lavage, conjunctival swab (eye), corneal scraping, tears, genital secretions, urine, or biopsy tissues.
  • can be detected by Enzyme immunoassay (EIA), which uses a monoclonal antibody (MAb) for a common surface protein, or serum polyclonal antibody to identify the family. Specific types require Mab which is type-specific. This is a very reliable method (90-95% specificity), and the antibodies are commercially available.
  • can also detect using Immunofluorescense, using a Mab and a secondary Ab covalently linked to a fluorescent protein (caveat=time consuming and relatively unreliable), or
  • Virus isolation (also time-consuming, and expensive).

    Treatment and Control


    There are no treatments for adenovirus infection. A vaccine (live, virulent in a gelatin capsule) was developed for military recruits against ARD in the 1960s, however it is not used in the general public because it induces mucousal immunity in the respiratory and intestinal tracts. The oncogenic potential of the virus is also a hindrance for vaccine development.

    Epidemic adenovirus outbreaks can be cotrolled in a number of ways. Personal hygiene is an excellent method of reducing fecal-oral transmission. Proper sanitation facilities, water preparation methods, and chlorination of puplic swimming pools may also greatly reduce the risk of infection. To reduce nosocomail infections, sterilization of equipment, frequent hand-washing, and conscious avoidance of transmission by direct contact, are all effective measures.