Incidence of enteric adenoviruses among children in Thailand and the significance of these viruses in gastroenteritis

Abstract

In countries with temperate climates, enteric adenoviruses have been shown to be a substantial cause of pediatric gastroenteritis. To determine the incidence of àdenovirus infection in a tropical climate, stools were collected from children under age 7 during a 1-year period at an outpatient clinic in Bangkok, Thailand. Stools from 1,114 children with gastroenteritis and from 947 children without gastroenteritis were tested. Each stool was tested for adenovirus group antigen and for specific enteric adenovirus types (Ad4O and Ad41) by monoclonal antibody enzyme immunoassays. We found that 4.4% (49 of 1,114) of children with gastroenteritis and 1.8% (17 of 947) of children without gastroenteritis were positive for adenovirus group antigen. In tests for specific enteric adenovirus types, 2.0% (22 of 1,114) of the tests were positive in children with gastroenteritis and 0.6% (6 of 947) were positive in children without gastroenteritis. There was a significant correlation (P < 0.02) of gastroenteritis with nonenteric adenovirus types (27 of 1,114) as well as with specific enteric adenovirus types (P < 0.01). By comparison, 19.7% of children with gastroenteritis and 0.7% of those without gastroenteritis were positive for rotavirus infection. In the adenovirus-infected children with gastroenteritis, there were coinfections with rotavirus only in those with nonenteric adenovirus infection (7 of 27 children). There were no significant differences in the association of bacterial or parasitic infections with either enteric or nonenteric adenovirus infections in either group of children studied. These data demonstrate that Ad4O and Ad41 are causes of gastroenteritis in this population, but among the spectrum of diarrheal etiologies, they may be proportionately less important than they are in countries with temperate climates.

Molecular Epidemiology of Adenovirus Infection among Pediatric Population with Diarrhea in Asia

“…This finding suggested that about 4.4% of acute gastroenteritis in infants and children in Japan, Korea and Vietnam was due to adenovirus and 95.6% caused by other etiologic agents. This result was consistent with previously published reports worldwide and confirmed adenovirus as one of the important etiological agents for acute gastroenteritis among infants and children (13,14). Among all children with acute gastroenteritis, 88.9% were aged less than 36 months.…”

“…Among six subgenera, subgenus F adenoviruses were the most important etiologic agents of severe acute gastroenteritis, accounting for 1 to 20% of cases. They had a global distribution and were of comparable prevalence both in outpatients and hospitalized children in developed and developing countries (14,18,21,25).…”

Adenovirus genome types isolated from stools of children with gastroenteritis in São Paulo, Brazil

“…Enteric adenoviruses types 40141 were detected by Adenoclone EIA in 4.5% of the patients with diarrhea and in one child in the control group (1.3%). Similar detection rates have been reported by others [Kidd et al, 1986;Herrmann et al, 1988;Shinozaki et al, 1988;Jarecki-Khan et al, 1993;de Jong et al, 1993;Leite et al, 1985;Niel et al, 1986;Mistchenko et al, 19921. The etiological relationship of adenovirus and diarrhea was supported by the exclusion of other causative microorganisms and toxins [Stewien et al, 19931 except in one case with dual infection with astrovirus and especially for the enteric adenoviruses (Ad 40141) by significant difference in detection rates in diarrhea and in the controls.…”

Astroviruses, Enteric Adenoviruses, and Other Gastroenteritis Viruses

“…In the few studies that have examined the role of EAs in an adult population, they appear to be less important causes of gastroenteritis than in children. No seasonality of EA infections was apparent in studies in temperate 31,[71][72][73] or tropical countries, 68,74 but few studies have reviewed multiple seasons.…”