by: Dr. William R. Otto, MD, FAAP
Adenoviruses are a group of viruses that can cause many different types of infections. Currently, more than 50 different adenoviruses have been identified. Adenoviruses infections occur year-round.
How and where do adenoviruses spread?
Adenoviruses are mainly spread through person-to-person contact, respiratory droplets, and through contact with contaminated surfaces. They can cause infections in people of all ages, but these infections are more common in children under 5 years old.
Young children, especially if they are in daycare, are more likely to come into contact with children who are infected. Children in this age also more likely to put items into their mouths and are less likely to practice good
hand washing. Virus outbreaks have also happened at schools,
summer camps, or at contaminated pools.
Once a child is exposed to adenovirus, there is an incubation period of 2 days to 2 weeks before symptoms start.
What are the symptoms of adenovirus infections?
Most often, an adenovirus infection develops in the respiratory tract. When this happens, symptoms of infection are usually similar to the
Children will commonly have a high fever, which may last for several days. Children may have a runny nose or congestion, and some children may develop an ear infection. Some children will have respiratory infections such as bronchiolitis or
pneumonia. A sore throat is another common symptom. Children can also develop symptoms of pinkeye, which is also called conjunctivitis.
Some strains of adenovirus will cause infections in the stomach and gastrointestinal tract. This can lead to
diarrhea, abdominal cramps, and other symptoms of gastroenteritis. Others may have infection of the bladder, which will cause painful urination and
blood in the urine. In children who have received an organ transplant or who have problems with their immune system, adenoviruses can cause
severe and overwhelming infection.
When should you call your doctor?
You should call your doctor if you ever have concerns about your child's illness. Important things to look for with adenovirus infections include:
Fever, particularly fever >104°F or fever for longer than 5 days.
dehydration (less than 3 wet diapers in a 24-hour period)
Decreased activity and alertness
Poor sleep or fussiness, chest pain, ear tugging, or ear drainage
How do doctors diagnose adenovirus infection?
Your doctor may perform a swab of your child's nose to send special tests for viruses. Tests can also be done on blood, stool, or urine samples. There is no specific medicine to treat adenoviruses and most children recover, so these tests may not be necessary.
What do we know about hepatitis & adenovirus?
Since fall 2021 severe hepatitis (inflamed liver) has been reported
in children in several states. Most of the children with hepatitis were 5 years old and younger. Their symptoms included gastrointestinal illness, liver injury and liver failure. Nearly half of the children with hepatitis also had adenovirus. The Centers for Disease Control and Prevention is looking closely at the reports to find out if the severe hepatitis is related to adenovirus. So, if your child has hepatitis, their pediatrician may test them to rule out possible adenovirus infection associated with hepatitis
Are there any treatments for adenovirus infections?
There is no specific medical treatment for adenovirus infections, and antibiotics will not work on adenoviruses. There is no good evidence that antiviral drugs work with adenovirus infections in children with normal immune systems.
What can you do to make your child feel better?
Treatment is not always needed! If your child's symptoms are not bothering them, then they may not need medicine or home remedies. Remember, fevers help your body's immune system fight infection, so only treat a fever if it is causing your child to be uncomfortable. If your child is having trouble sleeping or has bothersome symptoms (fevers >102°F, severe sore throat, or a hacking cough), then treating their symptoms is warranted.
You can do what you would do for any bad cold, including suctioning with nasal saline to allow for better breathing and feeding. A humidifier might help break up mucus and allow your child to breathe easier.
Make sure that your child is able to rest and drinks plenty of fluids. Sometimes your child will not want to eat when they feel sick, but it is important that they drink enough liquids to stay hydrated. If your child is still feeling poorly, acetaminophen or ibuprofen (if your child is older than six months) may help with fever. Do not give aspirin to your child. Talk to your child's doctor before giving over-the-counter cough and cold medicines.
Most infections are mild, and children get better with care to help relieve symptoms. However, some children will have a severe infection and will need to be admitted to the hospital.
How can you protect your children from adenovirus infections?
Wash your hands! Good
hand washing is the most important thing when trying to prevent adenovirus infections. It is also important to clean and
disinfect toys and other objects, because adenoviruses can survive for a long time on surfaces. There is no vaccine available to prevent adenovirus infections in children.
About Dr. Otto
Dr. William R. Otto, MD, FAAP, is a board-certified pediatrician and is a fellow in Infectious Diseases at the Children's Hospital of Philadelphia. He is a member of the Pennsylvania Chapter of the American Academy of Pediatrics and is a training fellow liaison for the Section on Infectious Diseases Executive Committee.