If your child has been suffering from pink eye in addition to flu-like symptoms he may be infected with adenovirus. Let’s have a look at what adenovirus infection is and how it might affect your child.
Recently there has been an outbreak of eye infection what we call conjunctivitis along with other flu-like symptoms like cold cough fever. There are over 60 serotypes of adenoviruses.
What are adenoviruses?
Adenoviruses are a group of DNA viruses. They were first isolated in the 1950s and are a common cause of epidemics because of their highly contagious nature. They are commonly known to cause epidemics in groups living in close quarters like army camps, summer camps, residential schools etc.
Adenovirus infection – Causes and Symptoms:
How do you get an adenovirus infection?
- Adenoviruses are spread by aerosolised droplets, conjunctival inoculation and through the faecal route.
- Aerosol droplets are formed when any symptomatic child or adult coughs, allowing the virus to be suspended in the air for a few hours. Inhalation of this cough droplet can spread the infection.
- Conjunctival inoculation is when viral particles are transferred to a person’s eyes. This can usually be transferred from fingertips or sharing of hand towels.
- Faecoral route: It is seen that the virus is presently excreted in the intestinal cells into the faecal matter. Any food or water contaminated with such faecal matter becomes a source of infection. This might also be responsible for the spreading of infection through sharing of swimming pools.
What are the symptoms of adenovirus?
Adenovirus can affect multiple organ systems and cause a wide range of clinical symptoms.
Fever is a non-specific symptom which can occur as a result of our immune system trying to fight the infection.
- Respiratory symptoms like runny nose, cough, and sore throat are the most common symptoms, especially in children. These symptoms can last 5-7 days. Cough is probably the last symptom to disappear with a dry tacky cough from the sore throat lasting as long as two weeks.
- Tonsillitis: infection of the tonsils associated with painful swelling.
- Hoarseness of voice which can manifest as a change in voice while crying and noisy breathing
- Adenoviruses can also less commonly cause bronchitis and pneumonia which require prolonged hospitalisation and sometimes intensive care.
- Ear pain and ear infection: Like any other upper respiratory infection adenovirus infection can spread to the ears as well causing redness, and irritation, resulting in severe pain.
- Conjunctivitis (also called “pink eye”): This can be in the form of eye discharge, and stickiness of the lashes especially soon after a nap.
- Headache and generalised body aches
- Gastrointestinal symptoms like vomiting tummy aches and Diarrhoea
Age group prone to serious complications from adenovirus infection
Is there a particular age group that is more prone to serious complications than others?
Yes, children less than 2 years are particularly more prone to serious manifestations like pneumonia. The younger the child, the more severe the symptoms.
Prevention and Disinfection of Adenovirus Infection
How to prevent adenovirus infection?
Prevention of adenovirus infection can be done by practising good infection control measures like frequent hand washing, wearing masks and isolating infected or suspected individuals.
If your child is attending a daycare centre consider having a healthy discussion about symptoms screening, and disinfection methods.
How to disinfect to prevent adenovirus transmission?
Adenovirus is inactivated with ethyl alcohol between 70% and 90% which is usually what is seen in hand rubs and sanitisers. As adenoviruses are known to spread via public swimming pools make sure to keep chlorination levels at least 1ppm.
Surfaces can be effectively disinfected using a solution of bleach and water. Mix 1/3rd cup of bleach (or 5 tbsp) in 3 litres of water. Use this solution for disinfecting all surfaces.
Does adenovirus require isolation?
Self-imposed isolation is advised for patients who are symptomatic to avoid the further spread of the virus. The duration of isolation can be as long as the infected person is symptomatic which can be between 3 to 7 days.
How long is recovery for adenovirus?
Adenovirus infection varies in severity from simple flu-like symptoms to causing gastroenteritis, pneumonia etc. Flu-like illness associated with adenovirus can take 5-7 days to recover.
The fever tends to be high-grade and continuous for the initial 3-4 days after which it can persist as low-grade intermittent fever for couple more days.
Complications associated with adenovirus whether gastroenteritis or pneumonia may take longer between 5-10 days to recover.
Diagnosis and Treatment of Adenovirus Infection
How is adenovirus infection diagnosed?
Adenoviruses are usually isolated from clinical samples like a nasopharyngeal swab, throat swab, conjunctival swab, rectal swab, blood or CSF.
But you do need to remember that definitive diagnosis is resorted to mostly when a child is critically sick and unresponsive to treatment. Most children who suffer from flu-like symptoms may not require testing as it is more convenient and economical to treat than to test.
Here are some of the tests that you may be recommended for a definitive diagnosis
- Viral Culture
- Viral antigen assay
- Viral PCR (polymerase chain reaction)
- Adenovirus antibody testing
How do you treat adenovirus?
Adenovirus treatment depends on the severity of the infection. Mild to moderate infection is usually treated with supportive conservative management. This may include hydration and symptom-based treatment.
Antiviral drugs like cidofovir and immunotherapy with intravenous immunoglobulin are used only in severely critically ill patients at the discretion of medical professionals.
When should you consult a doctor if you think your child has adenovirus?
Adenovirus almost always starts with flu-like symptoms. However, you may need to talk to your paediatrician in case your child fulfils any of the following criteria:
- If the child is less than 2 years of age
- If there is a persistent cold and cough beyond two days
- If there is a high-grade fever (102 F)
- If your child is breathing unusually fast even without a fever
Is there a vaccine for adenovirus?
Currently, there is no vaccine available in India to immunise against adenovirus. Vaccines approved in the United States are primarily used in military recruits. However, it has been found that children who have been immunised with the pneumococcal vaccine are known to have less severe infection compared to those who have not.
How long does an adenovirus infection last?
The infection duration largely depends on the extent of the infection. If the child has symptoms limited to flu-like illness then the duration can be 5-7 days. On the other hand, serious manifestations like pneumonia require a slightly longer time to recover which can vary from 1-3 weeks.
When is adenovirus most common?
Adenovirus infections can occur anytime throughout the year. In India, infections tend to be more common during early summer.
Can you be hospitalised for adenovirus?
Adenovirus infections can vary from a mild flu-like illness to occasionally causing serious manifestations like lung infections, especially in children less than 2 years. While mild flu-like illnesses can be managed at home, serious infections like pneumonia may need hospitalisation for observation, monitoring and respiratory support like oxygen.
When should I be worried about adenovirus?
Any illness in a child requires careful monitoring whether at home or in a hospital. Of course at home, the onus of responsibility lies with you as a parent to ensure your child is well enough not to need hospitalisation. Here are some pointers that should alert you to seek medical help
- A child who has poor oral intake. Any sick child may not have a normal appetite and is naturally consuming less than usual. But a child who is consuming less than 60% of their previous normal intake might require assessment from a healthcare professional.
- A lethargic child can be a sign of dehydration and low electrolyte levels and may require replenishment with intravenous fluids.
- A child who is refusing to take any fluids at all. The discomfort that comes with any illness might make children more averse to any fluid or food. But decreased oral intake also means that the child is getting low on body reserves which, to begin with, are low in children. These children might need close observation in a medical setup along with intravenous hydration.
- A child who is vomiting or has loose watery stools. Such a child will go into severe dehydration as there is an active loss of fluids and electrolytes from the body.
Is adenovirus highly contagious?
Adenovirus is a highly contagious virus which spread via different routes like respiratory droplets, faecal-oral routes or direct inoculation of viral particles.
Can kids go to school with adenovirus?
Given that the adenovirus is highly contagious and also that the child himself is sick to handle day-to-day activities of schooling or play it is advisable to avoid school during this illness.
Are adenoviruses seasonal?
Adenoviral infections are not seasonal and can occur at any time of the year. However, outbreaks tend to be more in summer in comparison to the rest of the year. Infection can occur in clusters like in summer camps.