What is Adenovirus? Inside the “Killer Cold”

This fall, adenovirus  (add-eh-noh-VY-rus) has slain eleven children in New Jersey and one young woman in Maryland. Several others have been sickened. What causes adenovirus, who is at risk, and how can we prevent it from harming our families?

Health departments do not break out statistics for adenovirus and in most cases, adenovirus infections are lumped in with rhinovirus, human coronavirus, and other cold and flu like illnesses. Most adenovirus infections do not require visits to the doctor, let alone viral antigen detection tests.

Adenoviruses are a very common group of viruses that result in illnesses ranging from pinkeye to pneumonia. There are more than fifty known strains. Most children have successfully weathered at least one adenovirus infection by the age of ten. Today, we are going to be looking at a few of the more common variants, as well as two serotypes that have resulted in fatalities in the United States.

Common Adenovirus Variants

Adenoviruses were first discovered in the adenoids of a Washington, D.C. seven-year-old in 1953. Adenovirus 2 can cause respiratory infections and is not to be confused with Canine Adenovirus 2, a common illness in dogs. In studies, adenovirus 2 was found to live from three to eight weeks on surfaces. Chlorine is also not as effective on this strain, which thrives in swimming pools and ground water.

Adenovirus 3 is associated with Acute Respiratory Distress Syndrome. It can survive for ten days on a sheet of paper. Small children are targeted by this virus, although a recent outbreak in a New Jersey rehabilitation center has sickened thirteen. Adenovirus 3 can also result in conjunctivitis.

A relationship between adenovirus 36 and obesity has now been illustrated by multiple studies on both humans and animals. Adenovirus 36 is associated with higher body mass index and waist circumference. Adenovirus 36 may be considered a risk factor for obesity, although many studies have included non-obese individuals infected with adenovirus 36.

Adenovirus serotypes 40 and 41 are responsible for causing gastroenteritis. After rotaviruses, they are the second most common cause of diarrhea in young children. They are commonly transmitted in daycare centers, and it is estimated that 50% of children cared for in these settings have antibodies to these viruses by the age of four.

Adenovirus 7

Adenovirus 7 is responsible for the current outbreaks in Maryland and New Jersey. Waves of adenovirus 7 struck down new military recruits during the 1950s. It has been estimated that up to 40% of these healthy young people needed to be hospitalized, although once they recovered, they had immunity to adenovirus 7. A combined Adenovirus 4/Adenovirus 7 vaccine was eventually developed for military use only. There is no vaccine commercially available for any adenovirus strain.

Along with adenovirus serotypes 3, 4 and 14, adenovirus 7 is a common cause for Acute Respiratory Distress Syndrome. This illness smothers its victims in their own pulmonary fluid and is very serious for those with heart, lung, airway, or immune system deficiencies. It is commonly associated with communal living conditions, like dorms or rehabilitation facilities.

Adenovirus outbreaks can be prevented. According to the New Jersey Department of Health, the adenovirus 7 outbreak that has sickened 36 and killed 11 at the Wanaque Center for Rehabilitation and Nursing may have been worsened by improper hand washing protocol. The adenovirus strains can survive long periods on surfaces and skin and are passed by contact.

Earlier this year, the United States Department of Agriculture carried out a study in which it found that 97% of US adults failed to wash their hands correctly. Adenovirus can live on the skin and be rubbed into eyes or transferred to items entering the mouth.

Adenovirus 14

Adenovirus 14 usually kills the very young, the very old, and those with compromised immune systems. However, those slain by adenovirus 14 have included very healthy people, including an Air Force recruit in Texas in 2007.

Adenovirus 14 claimed its first confirmed victim in the United States in 2006, when a 12-day-old infant girl was found dead in her crib. An autopsy showed that the baby, born after a healthy pregnancy and normal delivery, suffered a deep lung infection from adenovirus 14.

Adenovirus 14 can worsen very quickly and patients should be monitored by their doctor daily.

Risk Factors for Adenovirus

Everyone will contract some strains of adenovirus during their lifetime. All strains of adenovirus cause illnesses such as pinkeye, colds, gastrointestinal distress, respiratory infections, and pneumonia. Most people will be able to fight off the infection, gaining immunity to future exposures.

People who live in close proximity to one another are at risk for infection. This is why outbreaks often occur in military barracks, dormitories, and rehabilitation centers. Age is also a risk factor for adenovirus infection. The very young lack immunity, and the elderly suffer a loss of immune system function.

Medications that weaken immune systems are another risk factor. Olivia Paregol, the 18-year-old college student who died in Maryland on Nov. 18, was taking immune suppressing drugs for her Crohn’s disease. During a 2007 adenovirus 14 outbreak at a rehabilitation center, a patient who had AIDS was among those who died.

Preventing Adenovirus Infection

Proper hand washing is the number one way to ensure that viruses are not spread. While only alcohol-based hand sanitizers can kill viruses, washing your hands in hot, soapy water for at least 20 seconds will remove most viruses and bacteria. When you dry your hands, use a clean towel.

Wipe clean surfaces that are frequently touched such as door handles, remotes, phones, desks, and counters. Use a clean cloth and a sanitizing spray. While many adenoviruses are resistant to common household disinfectants, you can wipe away the virus.

Wash children’s toys frequently, especially after they have been handled by other children or adults. Hot water and a mild detergent will rid the surface of most viruses.

Adenovirus is also found in swimming pools and ponds. Proper chlorination can mitigate the risk of contracting most adenoviruses.

After Adenovirus Infection

Most adenovirus infections can be treated with over-the-counter medications. If the illness becomes severe or does not respond to treatment, medical care should be sought. It is very important to monitor illnesses and colds. Some adenovirus strains, such as adenovirus 14, can turn deadly very quickly.

Adenoviruses multiply quickly and caregivers should wipe surfaces frequently. After recovery begins, it is very important to clean all toys and fabrics that have come into contact with the sick person and their caregiver.

Because adenovirus serotypes are usually mild in those who have immunity to other strains, they often have their seriousness discounted. It is very important to avoid those with lowered immune system function while you are unwell, even if you do not know the cause.

Adenoviruses are illnesses that usually resolve without much medical intervention. Because of their serious nature, it is important that preventive measures be taken so that vulnerable populations are not sickened.