Background
Acute diarrheal disease in young children is a major cause of morbidity worldwide and is a leading cause of nortality in developing countries. Research has shown that enteric adenoviruses, primarily Ad40 and Ad41, are a leading cause of diarrhea in many of these children, second only to the rotaviruses. Howevey, many different symptoms can manifest, depending on the type of infecting adenovirus. There are 49 distinct serotypes that can cause infections in humans.
The diarrhea resulting from enteric adenovirus infection is longer in duration than that of rotavirus infections, usually lasting 7-8 days. Adenovirus infections often show up as conjunctivitis, tonsillitis (which may look exactly like strep throat and cannot be distinguished from strep except by throat culture), ear infection, or croup. Adenoiruses can also cause gastroenteritis (stomach flu).
A combination of conjunctivitis and tonsillitis is particularly common with adenovirus infections. Small children as especially prone to develop adenovirus bronchiolitis or pneumonia, both of which can be severe. In babies, adenoviruses can also cause coughing fits that is very similar to whooping cough. Adenovirus can also lead to viral meningitis or encephalitis. Although rare, adenovirus can causes inflammation of the urinary bladder, also known as cystitis, producing blood in the urine. In children, adenovirus may cause acute upper respiratory infections with fever and runny nose. Adenovirus types 1,2, 3, 5, and 6 are responsible for most of these infections.
Specific diagnosis of the adenovirus infection is made by identification of the virus in the patient's stool. Enzyme linked immunosorbent assay (ELISA) is the test most widely used to screen clinical specimens. Electron microscopy and polyacrylamide gel electrophoresis are used in some laboratories in addition or as an alternative to ELISA.
