Adenovirus may be cause of summer illnesses

Summer vacation wasn't starting out quite like the family intended. Four kids, no school, blue skies — but one by one the siblings were coming down with fevers, and soon the whole gang was homebound.

One of the children came into the office to be examined. He appeared to be fighting off a virus and steadily improved on his own. When his 7-year-old sister stopped in a few days later with runny eyes, cough, sore throat and fever, mom really wanted her checked for strep throat to see if the other three might have something “treatable.” It was a reasonable request, so the brave little girl took one for the team and had her throat swabbed. Mom was soon relieved to hear that her daughter did not have strep.

Good news, bad news. The kids didn't have strep so they did not need to take antibiotics to treat their sore throats. However, the family most likely had been hit with adenovirus, a common and very contagious virus that generally can't be “fixed” with medication. Adenoviral illnesses tend to run their course and fade away after up to one week of mild to moderate misery.

Adenovirus is usually a presumptive diagnosis since it's not typically tested for unless a patient is sick enough to require hospitalization. As with many other viral illnesses, outpatient treatment of adenovirus involves supportive care, with plenty of fluids, and pain and fever management to keep the patient hydrated and comfortable. Medical evaluation is indicated if new symptoms such as severe cough, prolonged fever or dehydration develop.

The Centers for Disease Control and Prevention report that there are more than 50 strains of adenovirus, a hearty virus that can live up to two weeks outside of the body. Adenovirus is best known for causing a variety of respiratory illnesses ranging in severity from mild cold symptoms and croup to bronchitis and pneumonia. Infants and immunocompromised individuals are at particular risk of severe disease complications.

Depending on the particular strain of virus, adenoviral infection can also result in throat infections, conjunctivitis, stomach flu, bladder infections and skin rashes. Infection can occur year-round, but most adenoviral illness is recorded during the late winter, spring and early summer months. The incubation period varies, with adenoviral gastroenteritis occurring three to 10 days after exposure, and respiratory illnesses cropping up from as soon as two days to as long as two weeks after contact.

In an article in “Pediatrics in Review,” Canadian researcher Dr. Joanne Langley notes that adenovirus can cause respiratory illness in all age groups but is most often seen in younger and school-age children. Adenovirus is also commonly spread among groups who live in close quarters, such as those in day care centers, residential institutions and military settings.

Langley finds that for kids younger than 2 years of age, up to 8 percent of acute respiratory illnesses are caused by adenovirus. The virus is also responsible for about 25 percent of all pediatric cases of exudative pharyngitis (pus on the tonsils).

Adenovirus is shared through contact with an infected individual's respiratory droplets, eye secretions or feces. Contact can occur person-to-person or by touching contaminated toys and household objects. Transmission of the virus has also been found to be waterborne, with the adenovirus targeting kids who swim in inadequately chlorinated pools or small contaminated lakes.

To reduce the spread of adenovirus, the CDC recommends contact and droplet precautions: Remember to disinfect toys and counters; sneeze into your elbow; wash hands frequently; and properly chlorinate your pool.

Ÿ Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.