Chapter 26 : Adenoviruses

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The human adenoviruses comprise 51 distinct serotypes that are grouped into six subgroups (A to F) based on various immunologic, biological, and biochemical characteristics. The infection cycle takes approximately 30 h in tissue culture cells and results in the production of approximately 50,000 to 100,000 new virus particles per cell. The infectious cycle can be divided into four stages: entry, early events, late events, and virus assembly. Chloramine-T (p-toluenesulfonchloramide) at 5% for 15 min or at 0.6% for 30 min or 500 ppm of sodium hypochlorite for 10 min can be used to inactivate adenoviruses. Phenylmercuric borate, isopropyl alcohol, ether, cetrimide, and chlorhexidine gluconate do not inactivate adenoviruses. Approximately 10 to 20% of childhood pneumonias are attributed to adenoviruses. Adenoviral pneumonia in military conscripts was originally classified as atypical pneumonia until the viral etiology was discovered. Clinically and radiologically adenoviral pneumonia may resemble pneumonia. Recent observations on detection of adenoviruses by PCR in air and on surfaces suggest that proper cleaning, isolation of patients with suspected or confirmed cases of adenovirus infection, and restriction of new admissions may be essential in limiting the risk of nosocomial spread. At present there is no specific antiviral treatment of proven value for adenovirus infections. Ribavirin, ganciclovir, and cidofovir are variably active against adenoviruses in vitro and thus potentially effective for treatment.

Citation: Ruuskanen O, Metcalf J, Meurman O, Akusjärvi G. 2009. Adenoviruses, p 559-579. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch26
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Image of FIGURE 1

Schematic model illustrating the architecture of the adenovirus particle. The tentative location and copy number of polypeptides are indicated for the core and capsid proteins. (Adapted from reference with permission.)

Citation: Ruuskanen O, Metcalf J, Meurman O, Akusjärvi G. 2009. Adenoviruses, p 559-579. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch26
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Image of FIGURE 2

Adenovirus transcription map, here exemplified with human adenovirus type 2. Note that the alternatively sliced structures of individual mRNAs expressed from the different early and late units are not shown (see reference for a detailed transcription map). White arrows indicate early transcription units, and black arrows indicate late transcription units. The functions of the nonstructural proteins expressed from respective transcription units are summarized in Table 2 .

Citation: Ruuskanen O, Metcalf J, Meurman O, Akusjärvi G. 2009. Adenoviruses, p 559-579. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch26
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Image of FIGURE 3

Diagram of adenovirus replication cycle. The approximate time scale for the different steps in the adenovirus life cycle is indicated at the bottom. See text for further details. For more extensive reviews, see references and .

Citation: Ruuskanen O, Metcalf J, Meurman O, Akusjärvi G. 2009. Adenoviruses, p 559-579. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch26
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Image of FIGURE 4

Monthly distribution of 1,958 adenovirus infections diagnosed by rapid antigen detection from nasopharyngeal aspirates at the Department of Virology, University of Turku, Turku, Finland, from 1985 to 2000. The peak in 1988 to 1989 was partly caused by a nationwide epidemic of adenovirus type 3.

Citation: Ruuskanen O, Metcalf J, Meurman O, Akusjärvi G. 2009. Adenoviruses, p 559-579. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch26
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Image of FIGURE 5

Pulmonary histopathology from a patient with a fatal case of adenoviral pneumonia. Characteristic epithelial smudge cells (arrow) show remarkedly enlarged nuclei containing inclusion bodies surrounded by thin rims of cytoplasm. Inclusion bodies are basophilic or amphophilic when stained with hemotoxylin and eosin. Unlike with herpesvirus infections, no syncytia or multinucleated giant cells are present.

Citation: Ruuskanen O, Metcalf J, Meurman O, Akusjärvi G. 2009. Adenoviruses, p 559-579. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch26
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Image of FIGURE 6

Use of adenovirus vaccines and febrile respiratory illness and adenovirus infection rates among U.S. Army trainees from 1994 to 1999. (Reprinted from reference with permission.)

Citation: Ruuskanen O, Metcalf J, Meurman O, Akusjärvi G. 2009. Adenoviruses, p 559-579. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch26
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Classification of human adenoviruses

Citation: Ruuskanen O, Metcalf J, Meurman O, Akusjärvi G. 2009. Adenoviruses, p 559-579. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch26
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Adenovirus early and late nonstructural proteins

Citation: Ruuskanen O, Metcalf J, Meurman O, Akusjärvi G. 2009. Adenoviruses, p 559-579. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch26
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Prevalence of serum neutralizing antibodies against adenoviruses in different age groups

Citation: Ruuskanen O, Metcalf J, Meurman O, Akusjärvi G. 2009. Adenoviruses, p 559-579. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch26
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Clinical features of conjunctivitis caused by three different pathogens

Citation: Ruuskanen O, Metcalf J, Meurman O, Akusjärvi G. 2009. Adenoviruses, p 559-579. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch26
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Epidemic keratoconjunctivitis preventive measures

Citation: Ruuskanen O, Metcalf J, Meurman O, Akusjärvi G. 2009. Adenoviruses, p 559-579. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch26

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