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Adenovirus Infection – Symptoms, Causes and Treatment

Adenovirus infection is an infectious disease caused by adenoviruses that can affect the respiratory tract, eyes, and gastrointestinal tract. It is especially common in children.

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Adenovirus infection is an infectious disease caused by adenoviruses that can affect the respiratory tract, eyes, and gastrointestinal tract. It is especially common in children.

What is an Adenovirus Infection?

An adenovirus infection, also known as adenovirosis, is an infectious disease caused by adenoviruses -- a group of DNA viruses with more than 50 known types capable of causing illness in humans. The infection primarily affects the respiratory tract, eyes, and gastrointestinal tract, and less commonly the urinary tract. Adenovirus infections occur worldwide and can affect people of all ages, but are particularly common in infants and young children.

Causes and Transmission

Adenovirus infections are caused by adenoviruses, which spread from person to person through several routes:

Droplet transmission: Virus-containing droplets are released into the air when an infected person coughs, sneezes, or talks.
Fecal-oral transmission: Spread through contaminated hands or surfaces, particularly in gastrointestinal infections.
Direct contact: Touching infected secretions, for example in cases of eye infections.
Contaminated water: In rare cases, transmission can occur through insufficiently chlorinated swimming pool water.

Adenoviruses are highly resilient and can survive on surfaces for several hours to days. The incubation period is typically 2 to 14 days.

Symptoms

The symptoms of an adenovirus infection depend on which organ system is affected:

Respiratory Tract

Cold-like symptoms including runny nose, sore throat, and cough
Fever, often above 38.5 °C (101.3 °F)
Bronchitis or, in severe cases, pneumonia

Eyes

Conjunctivitis: Red, watery, and sticky eyes
Keratoconjunctivitis: Inflammation of both the conjunctiva and cornea, which can temporarily affect visual acuity

Gastrointestinal Tract

Diarrhea, nausea, and vomiting
Abdominal pain and loss of appetite

Other Possible Manifestations

Urinary tract infection with blood in the urine (hemorrhagic cystitis), particularly in children
Meningitis or encephalitis (very rare, mainly in immunocompromised individuals)

Diagnosis

Adenovirus infection is usually diagnosed clinically based on symptoms and physical examination. When needed, the following diagnostic methods may be used:

Rapid antigen tests: Available for nasal or throat swabs as well as stool samples.
PCR test: Molecular detection of adenovirus genetic material is the most accurate method and can be performed on various body fluids.
Virus culture: Growing the virus in a laboratory setting; rarely used in routine diagnostics due to the time required.
Serology: Detection of adenovirus antibodies in the blood, mainly for epidemiological purposes.

Treatment

There is currently no specific antiviral therapy approved for adenovirus infections in the general population. Treatment is therefore supportive and aimed at relieving symptoms:

Adequate fluid intake, especially in cases of diarrhea and fever
Fever-reducing medications such as paracetamol or ibuprofen
Pain relief for sore throat or headache
Eye drops to relieve conjunctivitis symptoms

In immunocompromised patients (e.g., organ transplant recipients or individuals with HIV), adenovirus infections can be severe. In such cases, the antiviral drug cidofovir is sometimes used off-label, although it is not officially approved for this indication.

Prognosis and Recovery

In otherwise healthy individuals, adenovirus infections typically resolve on their own within one to two weeks without complications. The immune system develops a type-specific immune response after infection. However, since there are more than 50 different adenovirus types, reinfection with a different type is possible. In immunocompromised individuals, the infection can take a severe and potentially life-threatening course.

Prevention

The most important measures to prevent adenovirus infection include:

Regular and thorough handwashing
Avoiding close contact with infected individuals
Not sharing towels or drinking vessels with others
Disinfecting surfaces and shared objects in communal facilities

In some countries, particularly within military settings, live oral vaccines against adenovirus types 4 and 7 are available. No broadly approved vaccine exists for the general public at this time.

References

Centers for Disease Control and Prevention (CDC): Adenoviruses. Atlanta, USA (2023). Available at: https://www.cdc.gov/adenovirus
Wold, W.S.M. & Toth, K.: Adenovirus vectors for gene therapy, vaccination and cancer gene therapy. Current Gene Therapy, 13(6), 421-433 (2013). PubMed PMID: 24188240.
World Health Organization (WHO): Adenovirus infections -- fact sheet. Geneva (2022). Available at: https://www.who.int

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