Which patient groups have the highest prevalence of adenovirus infections?

Updated: Apr 15, 2021
  • Author: Sandra G Gompf, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Adenoviruses are isolated most commonly in infants and children and cause 5 to 10 percent of all febrile illnesses in this population. Adenovirus infections are prevalent in daycare centers and in households with young children.  An increased incidence of infection was found in military recruits until the introduction of an effective vaccine against serotype 4 (Ad4) and serotype 7 (Ad7) in 1971. The economy-driven cessation of vaccine production by its sole producer in 1996 resulted in re-emergence of outbreaks, with Ad4 predominating in 98% of cases. The reservoirs exist within the crowded training environment itself, and Ad4 has been detected on lockers, rifles, and bedding. Ad4 seropositivity of new recruits has been demonstrated to rise from 30% to almost 100%. Prolonged pharyngeal shedding and communal quarters contribute to outbreaks, with illness most commonly arising in weeks 3 to 5.

Lost productivity and interrupted military training prompted reinvestigation of vaccine production. Live oral adenovirus types 4 and 7 vaccine was approved by the FDA in 2011, significantly decreasing and the incidence of febrile respiratory illness. Notably, co-infection with non-vaccine strains (B1 and E) have developed following vaccination, [4]  and surveillance for emerging non-vaccine strains is still needed.

In 2007, media attention following adenovirus outbreaks in the United States focused on serotype 14. The CDC's Morbidity and Mortality Weekly Review published an article entitled " Acute Respiratory Disease Associated with Adenovirus Serotype 14—Four States, 2006-2007."


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