Adenovirus Kills 12 in 2 States, But What Is It?
Dec. 5, 2018 — Adenoviruses were discovered in 1953, but the common contagion wasn’t very well-known until earlier this century when an outbreak sickened U.S. military recruits.
But now, ongoing outbreaks in two states have put the virus in the public light again. The University of Maryland confirmed 22 cases of the virus last week. One of the infected students, a freshman, died from the virus. The campus outbreak follows a rash of infections at the Wanaque Center for Nursing and Rehabilitation’s Pediatric Center in New Jersey. Eleven children at the facility have died, and 25 other children and one staff member have become sick. But what is adenovirus, and who is at risk?
Adenovirus refers to a cluster of viruses — more than 50 known strains — that most commonly infect the respiratory system. Each strain may bring about a different set of symptoms, such as the common cold, sore throat, fever, bronchitis, and pneumonia. Other strains might lead to pinkeye, diarrhea, and, in rare cases, brain and spinal cord infections.
Some strains, such as type 7, can cause more serious illness than others. The New Jersey children and at least four University of Maryland students have this strain. A handful of strains are more commonly associated with outbreaks. Most cases of the virus are mild. Severe infections like those in New Jersey and Maryland are less common.
“These adenoviruses seem to cause quite serious infections in people whose immune systems are compromised, whether from medical treatment, such as chemotherapy, or from an underlying health condition,” says Andi Shane, MD, who specializes in pediatric infectious diseases at Emory University School of Medicine and Children’s Healthcare of Atlanta.
The New Jersey children who died had serious medical conditions and weak immune systems. “It’s the worst combination at Wanaque, where you have severe type 7 and immunocompromised children with a lot of medical needs,” says Shereef Elnahal, MD, the New Jersey state health commissioner.
Similarly, the University of Maryland student who died took immune-suppressing drugs to treat her Crohn’s disease, according to news reports.
“Once the virus gets into the body of someone who can’t control it well, it triggers respiratory failure,” says Shane. “If the virus gets into the lung cells, it can destroy those air cells. It makes air exchange difficult.”
People with weakened immune systems are not only more vulnerable to the virus themselves, but they may also carry and spread adenovirus after their symptoms have gone away, which can make it more difficult to contain an outbreak. “They don’t know that they are shedding the virus, so if they come into contact with someone and don’t use good hand[-washing] hygiene, it’s possible for them to infect the other person and not know it,” says Shane.
There is a vaccine for type 7 and type 4 adenovirus. But right now it can only be given to military recruits.
For the civilian population, preventive measures are most effective. The virus, which is resistant to disinfectants, can live on surfaces, such as doorknobs and countertops. You can get sick when you touch a surface with adenovirus on it and then touch your eyes, nose, or mouth without washing your hands. Parents and caregivers of babies with adenovirus may contract the virus if they touch the baby’s stool, for example, when changing a diaper.
“Wash your hands often,” says Shane. “Hand hygiene isn’t very exciting, but it’s the best way to protect yourself.”
You can also get the virus through close contact with an infected person or through the air after a cough or a sneeze. “Distance yourself from someone who has symptoms as much as possible to protect yourself,” says Shane. “Sometimes that’s hard if you’re a parent or health care worker taking care of a child with adenovirus.”
Living in close quarters makes it more likely to spread the virus.
The New Jersey outbreak happened at a residential nursing facility, where separating sick children from the others was a challenge at first. But now, staff are separating patients into three groups: Those who tested positive for the virus; those who had symptoms but hadn’t tested positive; and those with no sign of the virus. Since then, “there has not been an additional child who’s contracted adenovirus, which makes us optimistic that we will be able to declare the end of the outbreak in mid-December,” says Elnahal.
In Maryland, the students lived close to each other in dorms.
For most people, adenovirus is mild. After the infection runs its course, the symptoms go away. Because it’s a virus, there’s no specific treatment for it, says Shane. “Just stay hydrated, control the fever if that’s part of the symptoms, isolate yourself, and wash your hands.”
Andi Shane, MD, associate professor of pediatrics and interim chief, Division of Pediatric Infectious Diseases; Marcus Professor of Hospital Epidemiology and Infection Control, Emory University School of Medicine and Children’s Healthcare of Atlanta.
Shereef Elnahal, MD, New Jersey state health commissioner.
New Jersey Department of Health.
World Health Organization: “Water Recreation and Disease. Plausibility of Associated Infections: Acute Effects, Sequelae and Mortality.”
CDC.gov: “Adenovirus,” “Adenovirus VIS.”
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Adenovirus Kills 12 in 2 States, But What Is It?
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