Adenovirus Infections in Immunocompetent Children
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PEDIATRIC INFECTIOUS DISEASES (I BROOK, SECTION EDITOR)
Adenovirus Infections in Immunocompetent Children Kescha Kazmi 1 & Waison Wong 1 & Ari Bitnun 1,2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review The focus of this review is on human adenovirus (HAdV) infections in immunocompetent children. Recent Findings 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. Summary 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. Keywords Adenovirus . Respiratory viral infections . Viral gastroenteritis . Children . Neonate . Immunocompetent
Introduction Human adenoviruses (HAdVs) are non-enveloped, doublestranded DNA viruses that measure 70–100 nm in diameter and have a characteristic icosahedral capsid [1••, 2•, 3]. Their name was derived from the word “adenoid,” subsequent to their initial detection in surgical human adenoid samples in
This article is part of the Topical Collection on Pediatric Infectious Diseases * Ari Bitnun [email protected] Kescha Kazmi [email protected] Waison Wong [email protected] 1
Division of Infectious Diseases, Hospital for Sick Children (SickKids), 555 University Avenue, Toronto, ON M5G1X8, Canada
2
Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
1953 [4]. HAdVs can cause a broad range of clinical syndromes in childhood, typically involving the respiratory tract, conjunctiva, or gastrointestinal (GI) tract [1••, 2•, 3]. Severe, life-threatening manifestations such as respiratory failure [5•, 6, 7, 8•], myocarditis [9–11], or encephalitis [12••, 13••], though rare, can occur in otherwise healthy infants and children, with neonates being the most vulnerable [14••]. The purpose of this review is to describe the virology, epidemiology, clinical manifestations
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