Infections in 18, 000 Infants and Children in a Controlled Study of Respiratory Tract Disease. I. Adenovirus Pathogenicity in Relation to Serologic Type and Illness Syndrome1

Brandt, Carl D.; Kim, Hyun Wha; Vargosko, Andrew J.; Jeffries, Barbara; Arrobio, Julita O.; Rindge, Beatrice; Parrott, Robert H.; Chanock, Robert M.

doi:10.1093/oxfordjournals.aje.a121094

Cited by 258 publications

(122 citation statements)

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“…This is similar to earlier studies that have documented ADV as a cause of ϳ7% to 8% of pediatric respiratory infections. 4,11 The mean age of patients in our study was 23 months, and 90% of patients were Յ60 months old. This is consistent with previous studies that reported very few cases of school-aged children requiring hospital evaluation for ADV.…”

Section: Discussionmentioning

confidence: 68%

Adenoviral Infections in Children: The Impact of Rapid Diagnosis

et al. 2004

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ABSTRACT. Background. Adenovirus (ADV) infections were difficult to diagnose in the past, and many infections were unrecognized. Direct fluorescent assay (DFA) for the rapid diagnosis of ADV infection, as part of a viral respiratory panel, became available at Primary Children's Medical Center (Salt Lake City, UT) in December 2000.Objective. To describe children with ADV infection diagnosed by DFA and viral culture and document the impact of rapid ADV testing on patient care.Methods. DFA testing for respiratory viruses including ADV was performed on nasal wash specimens with parallel viral culture. Chart review was performed for all ADV-positive patients identified from microbiology records between December 2000 and May 2002.Results. Of 1901 patients positive for respiratory viruses, 143 (7.5%) were ADV-positive by DFA or culture. The mean age of ADV-positive children was 23 months; 90% were <60 months old. Eighty percent were previously healthy, and 56% required admission with a mean length of stay of 3.4 days. The most common diagnoses included fever (31%), bronchiolitis (24%), and pneumonia (14%). Other conditions included suspected Kawasaki disease (KD) and hepatitis. Forty-six percent of ADV-positive children were given antibiotics at presentation, but only 2 (1.4%) had documented bacterial infection (one had Escherichia coli urinary tract infection and one had Moraxella catarrhalis bacteremia). Thirty-six percent of children had a change in management based on positive ADV DFA. In children with suspected KD (n ‫؍‬ 5), 100% had positive ADV DFA, and immune globulin was withheld in 4. One immunocompetent patient with fulminant liver failure received cidofovir treatment after a positive ADV DFA and recovered before liver transplant.Conclusions. ADV is a common infection in young children and often results in admission and unnecessary antibiotic therapy. Identifying ADV as the cause of illness can favorably impact care and in some instances may be life-saving. DFA testing for ADV should be considered for infants and children requiring admission for fever, respiratory illness, suspected KD, and hepatitis. Pediatrics 2004;113:e51-e56. URL: http://www.pediatrics. org/cgi/content/full/113/1/e51; adenovirus, rapid diagnosis, Kawasaki disease.ABBREVIATIONS. ADV, adenovirus; PCMC, Primary Children's Medical Center; DFA, direct fluorescent assay; ED, emergency department; RSV, respiratory syncytial virus; KD, Kawasaki disease; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; IVIG, intravenous immune globulin.A denovirus (ADV) is a well-known cause of respiratory illness in children. [1][2][3][4] It may produce upper or lower respiratory infection including bronchiolitis and pneumonia. 5 In addition, ADV infection is frequently associated with entities such as pharyngoconjunctival fever and epidemic conjunctivitis that are often diagnosed based on clinical examination alone. 6 Although most infections are self-limited, ADV can be associated with severe or lethal infection in both immunocompromised and healt...

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Section: Discussionmentioning

confidence: 68%

Adenoviral Infections in Children: The Impact of Rapid Diagnosis

et al. 2004

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“…Secondly, in this survey, as in the two large surveys of the Medical Research Council (M.R.C. Report, 1965;Poole & Tobin, 1973), the chance of isolating an agent was greatest during the first few days of an illness; only in the case of adenoviruses (Brandt et al 1969) and M. pneumoniae (Foy et al 1966) has it been shown that isolations can be made for long periods after the initial infection. Thirdly, some viruses tend to be associated with distinctive clinical illnesses.…”

Section: Discussionmentioning

confidence: 81%

Respiratory viral infection in childhood. A survey in general practice, Roehampton 1967–1972

Horn

Brain

Gregg

et al. 1975

J. Hyg.

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SUMMARYThe role of viruses and M. pneumoniae in episodes of acute respiratory illness in childhood has been studied in a London general practice. The total isolation rate was 31P7 %, but the rate varied from 32-6 % in upper respiratory infections to 640% in pneumonia. The clinical features associated with infection were influenced not only by the type of agent but also by age and other host factors in the infected children. Rhinoviruses were more commonly isolated than any other agent and were frequently associated with wheezy bronchitis.

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“…Many studies have been done to establish the frequencies of isolation and their role in causing disease. It has also been shown that as many as one half of adenovirus infections are asymptomatic (Bell, Rowe & Rosen, 1962;Fox et al 1969;Brandt et al 1969). Information is still limited on the spread ofnonpathogenic serotypes, since the data gathered hitherto came more from in patients than from the normal population, as a whole.…”

Section: Introductionmentioning

confidence: 99%

Neutralizing antibodies against 33 human adenoviruses in normal children in Rome

D'Ambrosio¹,

Grosso²,

A³

et al. 1982

J. Hyg.

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SUMMARYThere are few data about the distribution ofneutralizing antibodies (NA) against adenovirus types in the Italian population, especially the high-numbered ones. We tested the sera from 453 children and 51 young adults to evaluate NA against adenovirus prototypes 1-33. Using the microneutralization test, 338 (74-6 %) of the children's sera were positive for at least one adenovirus type. Antibody to type 2 was the most frequently detected followed, in descending order, by antibody to types 5, 1 and 3. All these types are known to be associated with disease but antibody to type 7, a type also associated with disease, was less frequent than that to other serotypes such as 18 and 31, the pathogenicity of which in man is not clearly established. The antibody positivity rate rose with age for the more frequent types while it did not vary for the less frequent ones. The number of sera with NA against more than one adenovirus type increased with age. With regard to types 1-8, we found that their frequencies in Italy were similar to those found in the U.S.A.

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Infections in 18, 000 Infants and Children in a Controlled Study of Respiratory Tract Disease. I. Adenovirus Pathogenicity in Relation to Serologic Type and Illness Syndrome1

Cited by 258 publications

References 0 publications

Adenoviral Infections in Children: The Impact of Rapid Diagnosis

Adenoviral Infections in Children: The Impact of Rapid Diagnosis

Respiratory viral infection in childhood. A survey in general practice, Roehampton 1967–1972

Neutralizing antibodies against 33 human adenoviruses in normal children in Rome

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