This disease is characterized by conjunctivitis, fever, pharyngitis and adenoidal enlargements. This is frequently associated with swimming pools.
Acute Respiratory Disease (ARD) in Military Recruits
The crowding of people, allowing repeated exposure to highly infectious doses, and the strenuous physical exercise may account for the unusually high degree of severe infections. Characteristic symptoms include fever, malaise, sore throat, hoarseness and cough. Pneumonia develops in around 10% of cases.
Acute follicular conjunctivitis , which is part of the syndrome of pharyngoconjunctival fever, can also occur as a separate entity.
Epidemic keratoconjunctivitis is a distinctly different syndrome. This syndrome is characterized by an aggressive conjunctivitis, pain, photophobia and lymphadenopathy followed by the development of superficial punctate keratitis.
Adenoviruses are associated with 4-15% of all children hospitalized with viral gastroenteritis. The enteric adenoviruses Ad40 and Ad41 are associated with 2/3rds of cases of adenovirus-associated diarrhea.
Adenovirus infection in immunocompromised patients
Severe combined immunodeficiency (SCID) and immunocompromised hosts. - Children with SCID are prone to develop pneumonia and hepatitis with high mortality.
AIDS - latent infections of the kidneys are occasionally seen in patients with AIDS. Members of subgenus D are often seen in the stools of AIDS patients.
Bone marrow transplant recipients - These patients are vulnerable to activation of all latent DNA viruses. Adenovirus infections have been demonstrated in 8% of bone marrow transplant recipients.
Adenovirus may be isolated from most body fluids and secretions; eye swabs, NPA, throat swabs, urine, faeces, and CSF.
Human embryonic kidney cells Hep-2 cells
Primary monkey kidney cells 293 cells
CPE includes rounding, clustering of cells with refractile intranuclear inclusion bodies
Detection of antigen by Immunoflurescence (IF)
Infection of humans with any adenovirus type stimulates a rise in complement-fixing antibodies to adenovirus group antigens shared by all types. A four-fold or greater rise in these antibodies between acute phase and convalescent phase sera indicates recent infection.
The fastidious (no growth on cell cultures) enteric adenoviruses can be detected by direct examination of fecal samples by ELISA or latex agglutination tests.
There is no specific antiviral chemotherapy against adenoviruses at present.
Swimming pool-associated conjunctivitis can be prevented with adequate levels of chlorine in the water.
Effective vaccines are available for use in the military against adult respiratory distress syndrome. These vaccines are not currently licensed for administration to civilians. Live attenuated Adenovirus types 4, 7, and occasionally 21 are packaged into enteric capsules only replicate once they reach the intestine, resulting in an asymptomatic infection of the intestine. The vaccine had been shown to be both safe and effective.
RSV is the most common cause of severe lower respiratory disease in young infants . It is responsible for 50 - 90% of cases of bronchiolitis , 5 - 40% of pneumonias and bronchitis and less than 10% of croups in young children.
Older children & adults
common cold like – disease
Lower respiratory tract involvement
Tachypnoea and dyspnoea
In bronchiolitis, the respiratory rate may be elevated, with wheezing and hyperinflation. Cyanosis may be present in severe cases.
All infants with RSV lower respiratory tract disease are hypoxemic and oxygen should be given to hospitalized infants
Aerosolized ribavirin in severely ill infants
RespiGam contains a high concentration of protective antibodies against RSV . It is given for the prevention in children under 24 months with bronchopulmonary dysplasia or a history of premature birth.