ENTERIC ADENOVIRUS AS A CAUSE OF OUTPATIENT DIARRHEA IN BALTIMORE CHILDREN

Abstract

Enteric adenoviruses (EA) are a recently described cause of diarrhea in hospitalized children, but the incidence in outpatients with less severe diarrhea is not well documented. In a 1 year prospective study of the etiology of diarrhea in outpatients <2 yrs of age, we used a monclonal antibody-based ELISA to identify EA in 10 (4%) of 245 patients (in association with rotavirus in 2, Aeromonas in 1, and Cryptosporidium in 1) and in none of 157 matched controls (p=.03). An enteric pathogen was recovered from the stools of an additional 81 patients (rotavirus (50), rotavirus plus Aeromonas (1), Salmonella (9), Shigella (4), Shigella plus Aeromonas (1), Campylobacter (2), Yersinia (2), Yersinia plus Aeromonas (1), Aeromonas (10), and Giardia (1) and 26 controls (rotavirus (15), Campylobacter (1), Yersinia (1), and Aeromonas (9). The mean age of patients with EA was 6.4 months (range 1-18 months). Eight of the 10 patients (pts) with EA presented between Sept. and March with a syndrome of watery diarrhea (8 pts), vomiting (7 pts), and fever (5 pts); none had blood in the stool. Respiratory symptoms, which have been reported to be associated with EA, were present in 8 pts and 89 controls (p=.26). No pts developed dehydration or required hospitalization. EA appears to be an important cause of infantile diarrhea in Baltimore outpatients, second only to rotavirus in frequency.