UNIVERSITY OF THE PHILIPPINES | COLLEGE OF HUMAN ECONOMICS

CLOTHING, TEXTILES, AND INTERIOR DESIGN DEPARTMENT

By: Ernesto Canos Jr.

ADENOVIRUSES
 Human Adenoviruses
.Adenoviruses were first isolated in 1935
from human adenoid tissues.
—Since then, at least 49 distinct antigenic
types have been isolated from humans and
many other types from animals.
—All human serotypes are included in a
single genus within the family
Adenoviridae.

UNIVERSITY OF THE PHILIPPINES | COLLEGE OF HUMAN ECONOMICS

CLOTHING, TEXTILES, AND INTERIOR DESIGN DEPARTMENT
WHAT ARE ADENOVIRUSES
ADENOVIRUSES ARE A GROUP OF
MEDIUM SIZED, NONENVELOPEDD,
DOUBLE STRANDED DNA VIRUSES
THAT SHARE A COMMON
COMPLEMENT FIXING ANTIGEN
• THEY INFECT HUMANS AND
ANIMALS
 ADENOVIRUSES ARE MEDIUM-SIZED
(90–100 NM), NONENVELOPEDD
(NAKED) ICOSAHEDRAL VIRUSES
COMPOSED OF A NUCLEOCAPSID AND
A DOUBLE-STRANDED LINEAR DNA
GENOME. THERE ARE OVER 52
DIFFERENT SEROTYPES IN HUMANS,
WHICH ARE RESPONSIBLE FOR 5–10%
OF UPPER RESPIRATORY INFECTIONS IN
CHILDREN, AND MANY INFECTIONS IN
ADULTS AS WELL.
 CLASSIFICATION
ADENOVIRUSES ARE DIVIDED INTO SIX GROUPS (A
TO F) BASED ON:
• PHYSICAL, • CHEMICAL • BIOLOGICAL
PROPERTIES

ANTIGENIC STRUCTURE DIVIDES ADENOVIRUSES

INTO: - 49 SEROTYPES:

- ABOUT 1/3 OF THE 49 KNOWN HUMAN

SEROTYPES ARE RESPONSIBLE FOR MOST CASES OF
ADENOVIRUS DISEASE.
STRUCTURE AND COMPOSITION
ADENOVIRUSES ARE 70–90 NM IN DIAMETER AND DISPLAY
ICOSAHEDRAL SYMMETRY, WITH CAPSIDS COMPOSED OF 252
CAPSOMERES. THERE IS NO ENVELOPE.
ADENOVIRUSES ARE UNIQUE AMONG ICOSAHEDRAL VIRUSES IN
THAT THEY HAVE ASTRUCTURE CALLED A “FIBER” PROJECTING
FROM EACH OF THE 12VERTICES, OR PENTON BASES.
THEREST OF THE CAPSID IS COMPOSED OF 240 HEXON
CAPSOMERES.
THE HEXONS, PENTONS, AND FIBERS CONSTITUTE THE MAJOR
ADENOVIRUS ANTIGENS IMPORTANT IN VIRAL CLASSIFICATION.
APPEAR AS SPACE
VEHICLE
 THE DNA GENOME (26–45 KBP) IS LINEAR AND DOUBLE
STRANDED. THE GC CONTENT OF THE DNA IS LOWEST
(48–
49%) IN GROUP A (TYPES 12, 18, AND 31) ADENOVIRUSES,
THE MOST STRONGLY ONCOGENIC TYPES, AND RANGES
AS HIGH
AS 61% IN OTHER TYPES. THIS IS ONE CRITERION USED IN
GROUPING HUMAN ISOLATES. A VIRUS-ENCODED PROTEIN
IS
COVALENTLY LINKED TO EACH 5′ END OF THE LINEAR
GENOME.
ADENOVIRUSES ARE PREVALENT ALL
OVER THE WORLD
OVER 50 SEROTYPES ARE
ISOLATED
• MOST OF THE RECENT
ISOLATES ARE FROM AIDS
PATIENTS
• INFECTIONS ARE COMMON IN
CHILDREN AND WORLD WIDE
PREVALENCE.
 ADENOVIRUS
INFECTIONS IN HUMANS


PATHOGENESIS
ADENOVIRUSES INFECT AND REPLICATE IN EPITHELIAL CELLS OF
THE RESPIRATORY TRACT, EYE, GASTROINTESTINAL TRACT, AND
URINARY TRACT. THEY USUALLY DO NOT SPREAD BEYOND THE
REGIONAL LYMPH NODES. GROUP C VIRUSES PERSIST AS LATENT
INFECTIONS FOR YEARS IN ADENOIDS AND TONSILS AND ARE
SHED IN THE FECES FOR MANY MONTHS AFTER THE INITIAL
INFECTION. IN FACT, THE NAME “ADENOVIRUS” REFLECTS THE
RECOVERY OF THE INITIAL ISOLATE FROM EXPLANTS OF HUMAN
ADENOIDS. MOST HUMAN ADENOVIRUSES REPLICATE IN
INTESTINAL EPITHELIUM AFTER INGESTION BUT USUALLY PRODUCE
SUBCLINICAL INFECTIONS RATHER THAN OVERT SYMPTOMS.

 CLASSIFICATION
CONTAIN TWO GENERA
• MAST ADENOVIRUS-INFECTS THE MAMMALS

• AVIAADENOVIRUS-INFECTS BIRDS

• THEY INFECT ONLY THE HOMOLOGUES SPECIES WITH THE

EXCEPTION OF ONCOGENIC HUMAN ADENOVIRUS

• TYPE 12, 18,AND 31 CAUSE SARCOMA WHEN INJECTED INTO

NEW BORN HAMSTERS.
 CLINICAL FEATURES
• CLINICAL FEATURES: ADENOVIRUSES MOST COMMONLY
CAUSE RESPIRATORY ILLNESS; HOWEVER, DEPENDING ON
THE INFECTING SEROTYPE, THEY MAY ALSO CAUSE VARIOUS
OTHER ILLNESSES, SUCH AS GASTROENTERITIS,
CONJUNCTIVITIS, CYSTITIS, AND RASH ILLNESS. SYMPTOMS
OF RESPIRATORY ILLNESS CAUSED BY ADENOVIRUS
INFECTION RANGE FROM THE COMMON COLD SYNDROME
TO PNEUMONIA, CROUP, AND BRONCHITIS.
 A. RESPIRATORY
DISEASES
TYPICAL SYMPTOMS INCLUDE COUGH, NASAL CONGESTION, FEVER,
AND SORE THROAT. THIS SYNDROME IS MOST COMMONLY
MANIFESTED
IN INFANTS AND CHILDREN AND USUALLY INVOLVES GROUP C
VIRUSES,
ESPECIALLY TYPES 1, 2, AND 5. INFECTIONS WITH TYPES 3, 4, AND 7
OCCUR MORE OFTEN IN ADOLESCENTS AND ADULTS.

ADENOVIRUSES—PARTICULARLY TYPES 3, 7, AND 21—ARE

THOUGHT TO BE RESPONSIBLE FOR ABOUT 10–20% OF PNEUMONIAS
IN
CHILDHOOD. ADENOVIRAL PNEUMONIA HAS BEEN REPORTED TO
HAVE
A MORTALITY RATE UP TO 10% IN THE VERY YOUNG.
 DIFFERENT SYNDROMES OF RESPIRATORY INFECTION
HAVE BEEN LINKED TO ADENOVIRUSES.
• ACUTE FEBRILE PHARYNGITIS:
- MOST COMMONLY SEEN IN INFANTS AND YOUNG CHILDREN,
-SYMPTOMS INCLUDE COUGH, STUFFY NOSE, FEVER AND SORE
THROAT.

• PHARYNGO CONJUNCTIVAL FEVER:

-SYMPTOMS ARE SIMILAR TO THOSE OF ACUTE FEBRILE
PHARYNGITIS BUT CONJUNCTIVITIS IS ALSO PRESENT.
-IT TENDS TO OCCUR IN OUTBREAKS SUCH AS AT CHILDREN'S
SUMMER CAMPS (SWIMMING POOL CONJUNCTIVITIS).
 B. EYE INFECTIONS
MILD OCULAR INVOLVEMENT MAY BE PART OF THE RESPIRATORY

PHARYNGEAL SYNDROMES CAUSED BY ADENOVIRUSES. PHARYNGO-

CONJUNCTIVAL FEVER TENDS TO OCCUR IN OUTBREAKS, SUCH AS AT

CHILDREN’S SUMMER CAMPS (“SWIMMING POOL CONJUNCTIVITIS”), AND

IS
ASSOCIATED WITH TYPES 3 AND 7. THE DURATION OF CONJUNCTIVITIS IS
1–
2 WEEKS, AND COMPLETE RECOVERY WITH NO LASTING SEQUELAE IS THE
COMMON OUTCOME.
 OTHER MANIFESTATIONS
• ACUTE FOLLICULAR CONJUNCTIVITIS, TYPES 3,4
AND 11 ARE RESPONSIBLE
• ADENOVIRAL AND CHLAMYDIAL CONJUNCTIVITIS
ARE CLINICALLY SIMILAR
• DIARRHEA – NOT CONCLUSIVELY ESTABLISHED
• ACUTE HAEMORRHAGIC CYSTITIS IN CHILDREN
AND TYPES 11 AND 21 ARE RESPONSIBLE
• MESENTERIC ADENITIS AND INTUSSUSCEPTIONS
IN CHILDREN
 ADENOVIRUS IN IMMUNOCOMPROMISED

• PATIENTS WITH COMPROMISED IMMUNE

SYSTEMS ARE ESPECIALLY SUSCEPTIBLE TO
SEVERE COMPLICATIONS OF ADENOVIRUS
INFECTION. ACUTE RESPIRATORY DISEASE
(ARD), FIRST RECOGNIZED AMONG MILITARY
RECRUITS DURING WORLD WAR II, CAN BE
CAUSED BY ADENOVIRUS INFECTIONS DURING
CONDITIONS OF CROWDING AND STRESS.
 IMMUNITY IN CHILDREN
• MOST CHILDREN HAVE BEEN INFECTED
BY AT LEAST ONE ADENOVIRUS BY THE
TIME THEY REACH SCHOOL AGE. MOST
ADULTS HAVE ACQUIRED IMMUNITY TO
MULTIPLE ADENOVIRUS TYPES DUE TO
INFECTIONS THEY HAD AS CHILDREN.
 DIAGNOSIS: ANTIGEN DETECTION, POLYMERASE CHAIN REACTION
ASSAY, VIRUS ISOLATION, AND SEROLOGY CAN BE USED TO IDENTIFY
ADENOVIRUS INFECTIONS. ADENOVIRUS TYPING IS USUALLY
ACCOMPLISHED BY HEMAGGLUTINATION-INHIBITION AND/OR
NEUTRALIZATION WITH TYPE-SPECIFIC ANTISERUM. SINCE
ADENOVIRUS CAN BE EXCRETED FOR PROLONGED PERIODS,
 LABORATORY DIAGNOSIS DIRECT DETECTION:
• VIRUS PARTICLE BYEM CAN BE DETECTED BY DIRECT EXAMINATION OF
FECAL EXTRACTS
• DETECTION OF ADENOVIRAL ANTIGENS BYELISA. ENTERIC ADENOVIRUSES
• DETECTION OF ADENOVIRAL NA BY POLYMERASE CHAIN REACTION: CAN
BE USED FOR DIAGNOSIS OF ADENOVIRUS INFECTIONS IN TISSUE SAMPLES
OR BODY FLUIDS.

LABORATORY DIAGNOSIS ISOLATION

• ISOLATION DEPENDING ON THE CLINICAL DISEASE, THE VIRUS MAY BE
RECOVERED FROM THROAT, OR CONJUNCTIVAL SWABS OR AND URINE.
• ISOLATION IS MUCH MORE DIFFICULT FROM THE STOOL OR RECTAL
SWABS
 SEROLOGY
INFECTION OF HUMANS WITH ANY ADENOVIRUS TYPE STIMULATES
ARISE IN COMPLEMENT-FIXING ANTIBODIES TO ADENOVIRUS GROUP
ANTIGENS SHARED BY ALL TYPES. THE COMPLEMENT-FIXATION TEST IS
AN EASILY APPLIED METHOD FOR DETECTING INFECTION BY ANY
MEMBER OF THE ADENOVIRUS GROUP, ALTHOUGH THE TEST HAS LOW
SENSITIVITY.
A FOURFOLD OR GREATER RISE IN COMPLEMENT-FIXING ANTIBODY TITER
BETWEEN ACUTE-PHASE AND CONVALESCENT PHASE SERA INDICATES
RECENT INFECTION WITH AN ADENOVIRUS, BUT IT GIVES NO CLUE ABOUT
THE SPECIFIC TYPE
INVOLVED.
 EPIDEMIOLOGY
THE MOST COMMON SEROTYPES IN CLINICAL SAMPLES ARE THE
LOW-NUMBERED RESPIRATORY TYPES (1, 2, 3, 5, AND 7) AND THE
GASTROENTERITIS TYPES (40 AND 41). ADENOVIRUSES ARE SPREAD BY
DIRECT CONTACT, BY THE FECAL–ORAL ROUTE, BY RESPIRATORY DROPLETS,
OR BY CONTAMINATED FOMITES. MOST ADENOVIRUS-RELATED
DISEASES ARE NOT CLINICALLY PATHOGNOMONIC, AND MANY
INFECTIONS ARE SUBCLINICAL.

INFECTIONS WITH TYPES 1, 2, 5, AND 6 OCCUR CHIEFLY

DURING THE FIRST YEARS OF LIFE; TYPES 3 AND 7 ARE
CONTRACTED DURING SCHOOL YEARS; AND OTHER TYPES (SUCH
AS 4, 8, AND 19) ARE NOT ENCOUNTERED UNTIL ADULTHOOD.
 TREATMENT
THERE IS NO SPECIFIC TREATMENT FOR
ADENOVIRUS INFECTIONS.
 PREVENTION: VACCINES WERE DEVELOPED FOR
ADENOVIRUS SEROTYPES 4 AND 7, BUT WERE AVAILABLE
ONLY FOR PREVENTING ARD AMONG MILITARY RECRUITS.
STRICT ATTENTION TO GOOD INFECTION-CONTROL
PRACTICES IS EFFECTIVE FOR STOPPING NOSOCOMIAL
OUTBREAKS OF ADENOVIRUS-ASSOCIATED DISEASE,
SUCH AS EPIDEMIC KERATOCONJUNCTIVITIS.
MAINTAINING ADEQUATE LEVELS OF CHLORINATION IS
NECESSARY FOR PREVENTING SWIMMING POOL-
ASSOCIATED OUTBREAKS OF ADENOVIRUS
CONJUNCTIVITIS
 PREVENTION AND CONTROL

• CAREFUL HAND WASHING IS THE EASIEST WAY TO

PREVENT INFECTION.
• DISINFECTION OF ENVIRONMENTAL SURFACES WITH
HYPOCHLORITE'S.
• THE RISK OF WATER BORNE OUTBREAKS OF
CONJUNCTIVITIS CAN BE MINIMIZED BY CHLORINATION OF
SWIMMING POOLS.
• EPIDEMIC KERATOCONJUNCTIVITIS CAN BE CONTROLLED
BY STRICT ASEPSIS DURING EYE EXAMINATION.
 VIRUS: ADENOVIRUS
FAMILY: ADENOVIRIDAE
CHARACTERISTICS: MEDIUM-SIZED (90-100 NM), NON-ENVELOPED ICOSOHEDRAL
VIRUSES WITH DOUBLE-STRANDED DNA
TRANSMISSION: ADENOVIRUSES ARE UNUSUALLY STABLE TO CHEMICAL OR PHYSICAL AGENTS
AND ADVERSE PH CONDITIONS, ALLOWING FOR PROLONGED SURVIVAL OUTSIDE OF THE BODY
AND WATER. ADENOVIRUSES ARE SPREAD PRIMARILY VIA RESPIRATORY DROPLETS, HOWEVER
THEY CAN ALSO BE SPREAD BY FECAL ROUTES.

DISEASES: COMMON COLD OR FLU-LIKE SYMPTOMS.

FEVER. SORE THROAT ACUTE BRONCHITIS (INFLAMMATION OF THE AIRWAYS OF THE LUNGS,
SOMETIMES CALLED A “CHEST COLD”)
PNEUMONIA
DETECTION: ANTIGEN DETECTION, POLYMERASE CHAIN REACTION (PCR), VIRUS ISOLATION, AND
SEROLOGY. ADENOVIRUS TYPING IS USUALLY DONE BY MOLECULAR METHODS.
EPIDEMIOLOGY: ANTIGEN DETECTION, POLYMERASE CHAIN REACTION (PCR), VIRUS ISOLATI
ON, AND SEROLOGY. ADENOVIRUS TYPING IS USUALLY DONE BY MOLECULAR METHODS.
TREATMENT: NONE
PREVENTION: WASH YOUR HANDS OFTEN WITH SOAP AND WATER FOR AT LEAST 20 SECONDS .
AVOID TOUCHING YOUR EYES, NOSE, OR MOUTH WITH UNWASHED HANDS. AVOID CLOSE
CONTACT WITH PEOPLE WHO ARE SICK.
 REFERENCES:

JAWETZ, MELNICK, & ADELBERG’S

MEDICAL MICROBIOLOGY
TWENTY-SIXTH EDITION

ADENOVIRUS BY DR.T.V.RAO MD