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Traveler Summary

Key Points

  • Adenoviruses are viral infections of the lungs and intestines acquired through the inhalation of aerosolized respiratory droplets or contact with contaminated objects or infected stool.
  • Risk is highest for children and those living in crowded conditions, such as military recruits.
  • Symptoms are usually mild and include common cold symptoms and possibly diarrhea, pink eye, or fever.
  • Rare consequences of infection include brain inflammation, severe pneumonia, and death.
  • Prevention includes good respiratory hygiene (cough and sneeze etiquette) and frequent, thorough handwashing, especially after using the bathroom or changing diapers.
  • Adenovirus vaccine (live) is routinely given to military recruits as 1 dose during initial training but is not approved for routine use or for travel.
  • Vaccine side effects are usually mild and include cold symptoms, headache, and gastrointestinal symptoms.
  • Duration of vaccine protection is unknown; no booster dose is recommended.

Introduction

Adenoviruses are a common cause of mild respiratory illnesses (e.g., colds, croup, pneumonia), primarily in children, but can also cause diarrhea, pink eye, bladder infection, rash, and, less commonly, neurological disease.

Risk Areas

Adenoviruses are present in human and animal populations worldwide and can survive for long periods outside the host. Outbreaks of adenovirus-associated respiratory disease occur most commonly in late winter, spring, and early summer.

Transmission

Adenoviruses are predominately transmitted person to person via aerosolized respiratory droplets (e.g., by coughing or sneezing) or contact with contaminated objects. Some adenoviruses are also transmitted through stool (e.g., during diaper changing) and occasionally through contaminated water.

Risk Factors

Risk is highest for children and military recruits (due to close living quarters, hygiene, and fatigue), although all ages are susceptible to infection. Infants, the elderly, and persons with underlying medical conditions are at high risk for severe illness.

Symptoms

Symptoms are usually mild, most commonly appearing 2 to 14 days following exposure, and include common cold symptoms (e.g., runny nose, nasal congestion, sore throat, and cough). Some adenoviruses can also cause diarrhea, pink eye, fever, or bladder infection.

Consequences of Infection

Serious illness rarely occurs, but complications can include brain inflammation, severe pneumonia, and death (higher risk in transplant patients).

Need for Medical Assistance

Most infections are mild, but persons who have trouble breathing should seek immediate medical attention. Persons who are severely dehydrated from vomiting and diarrhea should also seek medical attention. Antivirals are generally ineffective against adenovirus infection.

Prevention

Nonvaccine

Observe good respiratory hygiene (cough and sneeze etiquette) and frequent, thorough handwashing, especially after using the bathroom, changing diapers, and before preparing or eating food.

Vaccine

Adenovirus vaccine (live) is given routinely to military recruits but is not approved for routine use or for travel. Live viruses are shed in the stool for up to 28 days after vaccination. Therefore, handwashing is especially important for those who will be in close contact with children younger than 7 years, pregnant women, or persons with a weakened immune system.

Side Effects

The most common vaccine side effects are mild and include cold symptoms (e.g., nasal congestion, sore throat, and cough), headache, muscle aches, nausea, abdominal pain, diarrhea, and vomiting, occurring within 2 weeks after vaccination. Serious side effects are rare but can include blood in the urine or stool, stomach or intestinal inflammation, and pneumonia within 6 months after vaccination.

Persons with underlying medical conditions or who have concerns about the vaccine should speak to their health care provider before vaccine administration.

Timing

Adenovirus vaccine is given in 1 dose (2 tablets). The tablets should be swallowed whole and not chewed or crushed. Duration of vaccine protection is unknown. A booster dose is not recommended.