Adenovirus Infections in Immunocompetent Children

Abstract

The focus of this review is on human adenovirus (HAdV) infections in immunocompetent children. HAdV infections are ubiquitous among children under 5 years of age. To date, over 100 different HAdV genotypes have been identified using genomic and bioinformatic analyses. While the vast majority of infections are mild or asymptomatic, severe, life-threatening manifestations including respiratory failure, meningoencephalitis, myocarditis, and disseminated disease can occur in otherwise healthy infants and children. Neonates are at highest risk of severe or disseminated infection, especially within the first 2 weeks of life. Microbiologic diagnosis of HAdV infection is helpful in cases of severe or disseminated disease or in outbreak settings. Molecular detection is the preferred diagnostic method. Evidence for antiviral therapy is limited, but may be warranted in immunocompetent children with severe disease. Hand hygiene, droplet/contact measures, and use of disinfectants are the mainstay for infection prevention in institutional settings. While a live, oral vaccine for types 4 and 7 is available, its use is restricted to military personnel. HAdV infections in immunocompetent children encompass a wide spectrum of clinical disease. Further research is required in understanding host and viral factors that predispose immunocompetent children to severe infection and to determine what treatments are most effective in those with severe disease.