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Views: 357 Author: BioTeke Corporation Publish Time: 2025-09-04 Origin: Bioteke
Respiratory adenoviruses (Adenovirus, AdV) are a group of adenovirus serotypes that primarily infect human respiratory epithelial cells, causing a range of respiratory illnesses. They are a key pathogen causing acute respiratory infections (ARIs), particularly in children and immunocompromised individuals, and are prone to outbreaks.
Virus Classification
Adenoviruses belong to the Adenoviridae family, genus Mastadenovirus. They are non-enveloped, double-stranded DNA viruses with icosahedral symmetry. Their genetic material is relatively stable and highly resilient to environmental influences. They are insensitive to lipid solvents (such as ethanol), acids, and bile salts, which allows them to survive on surfaces for extended periods and resist rapid inactivation by conventional alcohol-based disinfectants. Temperatures above 56°C, formaldehyde, and chlorine-containing disinfectants can effectively inactivate the virus.
2. Serotype and Tissue Tropotropy
Over 100 human adenovirus (HAdV) genotypes have been identified. Serotypes closely associated with respiratory infections include:
Group B (e.g., HAdV-3, 7, 14, 55): These are the primary types responsible for severe respiratory infections (e.g., pneumonia). HAdV-7 and HAdV-3, in particular, are common pathogens of severe pneumonia in children.
Group C (e.g., HAdV-1, 2, 5, 6): These often cause mild upper respiratory tract infections in infants and young children and can establish latent infection in lymphoid tissues (e.g., tonsils and adenoids).
Group E (HAdV-4): These are the primary causes of community-acquired infections and acute respiratory illness in children.
The tissue tropism of the virus is mainly determined by the ability of its fiber protein to bind to specific receptors on the host cell surface (such as Coxsackie-adenovirus receptor CAR, CD46, sialic acid, etc.).
Sources of infection: Patients, asymptomatic carriers, and those in the latent infection period.
Routes of transmission
Droplet transmission: Transmission occurs through respiratory droplets produced by coughing or sneezing from an infected person.
Contact transmission: Contact with contaminated objects or surfaces (droplet transmission), followed by hand contact with the mucous membranes of the mouth, nose, and eyes, leads to infection. This is the most important route of transmission.
Fecal-oral transmission: The virus can be excreted through the intestines and spread through contaminated water or food.
Susceptible populations: The entire population is susceptible, but children under five are most susceptible. Immunodeficient individuals (such as organ transplant recipients and those infected with HIV) experience more severe illness and a longer course of illness. Closed, crowded environments (such as childcare facilities, schools, and military barracks) are prone to clusters of infections.
Pathogenesis
After invading respiratory epithelial cells, the virus replicates within the cell nucleus, causing cell degeneration, necrosis, apoptosis, and inflammation, resulting in local tissue damage. The virus can disseminate to regional lymph nodes or enter the bloodstream, resulting in viremia and subsequently infecting other organs (such as the liver, heart, and central nervous system).
Clinical Syndrome
Acute upper respiratory tract infection
Presents with common cold symptoms such as fever, sore throat, cough, and runny nose.
Pharyngoconjunctival fever
Characterized by the triad of high fever, acute pharyngitis, and non-purulent acute conjunctivitis, it is often caused by HAdV types 3, 4, and 7 and is associated with swimming pool transmission.
Acute respiratory illness
Commonly seen in new recruits in military camps, it presents with high fever, fatigue, headache, sore throat, and cough.
Pneumonia
It can present as interstitial pneumonia of varying severity. Severe pneumonia is more common in infants and immunocompromised individuals and is characterized by persistent high fever, severe cough, shortness of breath, cyanosis, and multilobar infiltrates on chest imaging. Pneumonia caused by HAdV types 7 and 3 can have sequelae such as obliterative bronchiolitis and bronchopulmonary dysplasia.
Other manifestations
Adenoviruses can also cause gastroenteritis (diarrhea, vomiting), hemorrhagic cystitis, meningitis, and hepatitis.
1. Pathogen Testing
Nucleic acid testing
Real-time fluorescence quantitative PCR is currently the most commonly used and most sensitive test method, enabling rapid detection and typing of specimens such as nasopharyngeal swabs and bronchoalveolar lavage fluid.
Antigen testing
Immunofluorescence or colloidal gold immunochromatography are used to rapidly detect adenovirus antigens in respiratory specimens. While rapid, they are less sensitive than PCR.
Viral isolation and culture
This is the "gold standard" for diagnosis, but is time-consuming (days to weeks) and requires a high laboratory biosafety level. It is primarily used for scientific research and epidemic tracing.
2. Serological testing
This tests for specific IgM and IgG antibodies in serum. A positive IgM antibody indicates recent infection. Because antibodies develop later, these tests are primarily used for retrospective diagnosis or epidemiological investigations.
Treatment
1. Supportive care
This is the mainstay for most mild cases and includes rest, rehydration, fever reduction (acetaminophen or ibuprofen), and maintenance of fluid and electrolyte balance.
2. Antiviral Therapy
Currently, there are no globally approved, effective antiviral drugs for the treatment of common adenovirus infections. For patients with severe infection or immunodeficiency, cidofovir may be considered; however, it carries significant nephrotoxicity and requires close monitoring and the use of probenecid and hydration therapy for prophylaxis.
3. Management of Complications
For patients with severe pneumonia who develop respiratory failure, oxygen therapy or mechanical ventilation is recommended.
Prevention
1. General prevention
Strictly perform hand hygiene (washing with soap and water is superior to alcohol-based hand rubs); thoroughly disinfect contaminated surfaces with chlorine-based disinfectants; and isolate patients from respiratory and contact tract infections.
2. Vaccines
Currently, only live oral vaccines (for HAdV-4 and HAdV-7) are used in specific settings in some countries and have not yet been widely adopted by the general public.
Bioteke 5-in-1 Multiple Respiratory Multipathogen Antigen Test Kit uses immunochromatography and a double-antibody sandwich method to simultaneously in vitro diagnose five common respiratory pathogens: SARS-CoV-2, Influenza A & B, RSV, and Adenovirus.
Only 3 drops of sample are required, and accurate results are available in 15 minutes.
EU IVDR certified for self-testing.
Ideal for self-screening and diagnosis during respiratory infection season.
Respiratory adenovirus is a highly contagious DNA virus with numerous serotypes and diverse clinical manifestations, ranging from mild upper respiratory tract infection to life-threatening severe pneumonia and systemic disease. It is of great epidemiological significance in children and confined populations. Rapid and accurate diagnosis is key to identifying outbreaks and guiding clinical management.
