Adenovirus

 

I usually include a ‘what’s going around section’ in my weekly newsletter/email. Parents have told me that it is very useful to know what to look out for. There is also some comfort in running with the pack. Misery loves company. For several months now, adenovirus has been on that list. Interestingly, although I have been working in pediatrics for more than 40 years (yikes), unlike RSV, hand-foot-mouth, and slap cheek, adenovirus was not an illness that I frequently discussed. Is it new? Nope! What’s new is the ability to easily do a respiratory panel to identify the actual virus. What I used to refer to as a ‘viral package’ or the ‘creeping crud’ now has a specific diagnosis. So, what is adenovirus? Adenovirus is a family of viruses that has more than 60 types. It is quite common. You've probably been exposed to it at some point in your life. In fact, by the age of 10-years, most children have had at least one adenovirus infection. It can happen year round but tends to be more common in the Winter and Spring. It is very contagious. Symptoms are variable and range from a mild cold to severe illness. Most people don’t bother to test a little sniffle, so it is hard to have accurate data on how common it actually is. The more annoying and serious presentations include: Runny nose and congestion Pinkeye fever Cough Headache Sore throat Muscle aches Pneumonia Ear aches Vomiting Diarrhea This is indeed the ‘viral package’ with a little bit of everything. The most recent wave, as reported by Dr. Ted, was a “pharyngoconjunctival fever,” aka sore throat, pink eye, and fever. Most cases last from 3 to 7 days, but the more severe cases can last for weeks. Like other nasty viruses, there can be secondary infections.  People with weakened immune systems, or existing respiratory or cardiac disease, are at higher risk of developing severe illness from an adenovirus infection. Exposure and spread The onset of respiratory symptoms is usually between two and fourteen days after exposure. When it is gut related (vomiting and diarrhea) it moves a little more quickly and you will see signs within 3-10 days. People are most contagious right before they get sick or within the first couple of days of the illness. Even people with very mild cases can spread it.  The most common ways that it spreads are Close contact (shaking hands) fecal/oral transmission  contaminated surfaces airborne transmission from one infected person to another.  Occasionally it can be spread through water and public pools Testing More often than not the diagnosis is the ‘best guess’ based on the symptoms. Those red eyes are often a big clue. If the patient is pretty sick or has a persistent illness, then your doctor may opt to do a respiratory panel to get a more definitive answer. A stool sample might also give a diagnosis. Blood work is not usually done, unless your provider wants to rule out something else, but it might show an elevated white blood cell count if done. Treatment Most of the time treatment is based on the symptoms and there are no special medications (or magic wands) This includes, fluids, rest, fever medications as needed and a humidifier at night. Soothing eye drops are helpful for the pinkeye and Manuka honey feels great for the throats (only for folks older than a year.) People who are immunocompromised and get a severe version may need to be hospitalized for supportive care. Those folks may have access to antiviral medications. Prevention Good hand washing and wiping down surfaces are important ways to protect yourself from this. Try hard not to touch your face with unwashed hands. Boost your immune system Try to get enough sleep. Vitamin D and ZInc are associated with a healthy immune system. I also like sambuccol/elderberry at the first sign of illness. Thanks as always to the amazing Dr Ted for his valuable input!!