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Fecal adenoviruses from a longitudinal study of families in metropolitan Washington, D.C.: laboratory, clinical, and
Insights
Enteric adenoviruses (EAds), specifically type 41, were detected in young children with gastroenteritis. These infections were generally mild, with limited spread among family contacts, unlike rotavirus.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Gastroenterology
Background:
- Enteric adenoviruses (EAds) are a known cause of gastroenteritis in children.
- Understanding the incidence and transmission of EAds is crucial for public health management.
Purpose of the Study:
- To investigate the incidence and clinical presentation of enteric adenoviruses in a pediatric population.
- To compare the transmission patterns of EAds with other common enteric viruses like rotavirus.
Main Methods:
- Prospective study over 29 months involving 70 families.
- Detection of fecal adenoviruses using tissue culture and electron microscopy.
- Clinical data collection on symptoms and hospitalization.
Main Results:
- Enteric adenoviruses (subgenus G, type 41) were identified in 18 patients, with an incidence of 3 per 100 individuals/year for confirmed EAds.
- EAd-associated enteritis was more common in infants aged 6-11 months.
- Patients with EAds experienced mild symptoms (diarrhea, vomiting, fever); none required hospitalization.
- Non-EAd adenoviruses were associated with combined gastrointestinal and respiratory symptoms more frequently than in controls.
- Adenovirus was detected in ~6% of gastroenteritis episodes; confirmed EAds in ~2% of episodes in children <2 years.
- Limited person-to-person transmission of EAds and non-EAds was observed within families, contrasting with efficient rotavirus spread.
Conclusions:
- Enteric adenoviruses, particularly type 41, are detected in pediatric gastroenteritis cases but typically cause mild illness.
- Transmission within families appears less efficient for adenoviruses compared to rotavirus.
- Further research is needed to understand the full spectrum and public health impact of EAd infections.
Abstract:
During a 29-month period, we studied enteric infection in 70 families from a pediatric practice in suburban Washington, D.C. Fecal adenoviruses were detected in stools of 18 patients by tissue culture and electron microscopic procedures. From 6 through 11 months of age, the incidence of fecal adenoviruses associated with enteritis was seven per 100, and of confirmed enteric adenoviruses (EAds), three per 100 individuals per year. All EAds belonged to subgenus G (type 41). All three patients with EAds had diarrhea; two had vomiting and one had fever, but none required hospitalization. Ten of the 15 patients with non-EAds were younger than 2 years, and 60% had diarrhea, 40% had vomiting, and 20% had fever. Combined gastrointestinal and respiratory symptoms occurred more often in those who shed non-EAds (three of 11) than in matched controls (two of 48, P = 0.04). An adenovirus was detected in approximately 6% of gastroenteritis episodes, and confirmed EAds were present in approximately 2% of episodes of gastroenteritis in children younger than 2 years of age. None of the contacts of patients with non-EAds shed such virus in their stools. None of nine family contacts of those with EAd appeared to shed adenovirus in stool. In contrast, rotavirus spread readily to exposed adults (25% of 65) and children (56% of 62) when a child in similar families had rotavirus infection.