At a glance
- There are more than 100 serologically different adenovirus types, 49 of which can infect humans.
- Adenoviruses typically cause respiratory illnesses or conjunctivitis, but other clinical presentations also occur.
- There is no specific time of year when adenovirus infections and outbreaks are more common. Outbreaks can occur throughout the year.
Overview
Adenovirus infections are not nationally notifiable in the United States. Clinicians are not required to test for or report cases to health departments or CDC. Therefore, many outbreaks of adenovirus likely go either undetected or unreported. Many different adenovirus types, which can cause sporadic cases and outbreaks, have been detected.
Acute respiratory illness
- Adenovirus types 1, 2, 3, 4, 7, and 14 are most commonly associated with acute respiratory illness.
- Adenovirus types 4, 7, and 14 have been associated with outbreaks of acute respiratory illness in congregate settings.
Severe outcomes
- Adenovirus types 4 and 7 have been associated with more severe outcomes compared to other adenovirus types, particularly in people with weakened immune systems.
- In the last 10 years, instances of severe illness and death from adenovirus types 4 and 7 have been reported in the United States.
Epidemic keratoconjunctivitis
- Adenovirus types 8, 19, 37, 53, and 54 can cause epidemic keratoconjunctivitis, a highly contagious viral infection that causes inflammation of both the cornea and conjunctiva.
Gastroenteritis
- Enteric adenovirus types 40 and 41 can cause gastroenteritis (inflammation of the stomach and intestines) and hepatitis (infection of the liver), usually in children.
Spread in bodies of water
Some adenoviruses, including types 4 and 7, may spread in bodies of water, such as swimming pools without adequate chlorine or lakes. These can cause outbreaks of febrile disease with conjunctivitis
Clinician guidelines
- Get clinical guidance for adenovirus Nucleic Acid Amplification Tests (NAATs), including PCR, and additional testing. for adenovirus Nucleic Acid Amplification Tests (NAATs), including PCR, and additional testing.
- Instructions for testing, typing, and submission.
Recommendations
If potential outbreaks in healthcare settings are identified, take appropriate infection control measures specific to adenovirus to help prevent or control outbreaks. This may include:
- active surveillance (i.e. maintaining awareness and actively monitoring patients for illnesses or infections)
- isolating ill patients when possible and using personal protective equipment
- restricting visitors and new admissions
- monitoring staff for illness and sending them home when sick
- environmental cleaning
- frequent handwashing or sanitizing
- environmental cleaning using disinfectants included in EPA's List G.
- Disinfectants effective against norovirus are also effective against adenovirus
Keep Reading
Clinical Overview of Adenovirus
Content Source:
National Center for Immunization and Respiratory Diseases; Coronavirus and Other Respiratory Viruses Division
- Abdirizak F; Winn AK; Parikh R; Scobie HM; Lu X; Vega E; Almendares O; Kirking HL; Rose EB; Silk BJ. Surveillance of Human Adenovirus Types and the Impact of the COVID-19 Pandemic on Reporting — United States, 2017–2023. MMWR. 2024. 73(50);1136–1141.
- Almendares, O., Baker, J. M., Sugerman, D. E., Parashar, U. D., Reagan-Steiner, S., Kirking, H. L., ... & Tate, J. E. (2024). Deaths Associated with Pediatric Hepatitis of Unknown Etiology, United States, October 2021–June 2023. Emerging Infectious Diseases, 30(4), 644.
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- Notes from the Field: Fatalities Associated with Human Adenovirus Type 7 at a Substance Abuse Rehabilitation Facility — New Jersey, 2017. MMWR. 2018;67:371–372.
- Killerby ME, Rozwadowski F, Lu X, et al. Respiratory Illness Associated With Emergent Human Adenovirus Genome Type 7d, New Jersey, 2016–2017, Open Forum Infectious Diseases, Volume 6, Issue 2, 1 February 2019, ofz017.
- Adenovirus-associated epidemic keratoconjunctivitis outbreaks — four states, 2008–2010. MMWR. 2013;62(32);637-41.
- James L, Vernon M, Jones R, et al. Outbreak of Human Adenovirus Type 3 Infection in a Pediatric Long-Term Care Facility—Illinois, 2005. Clinical Infectious Diseases. Volume 45, Issue 4, 15 August 2007, Pages 416–420.