Adenovirus is wreaking havoc among children in West Bengal. A six-month-old boy believed to be infected with adenovirus died at Dr BC Roy Post Graduate Institute of Paediatric Sciences, Kolkata, West Bengal, on February 19, 2023, The Times of India reported. He was suffering from respiratory ailments for about two weeks. 

On February 17, 2023, a two-and-a-half-year-old girl infected with adenovirus died at the Institute of Child Health, Kolkata. The girl was suffering from fever and respiratory problems for over a week, and was being treated at the hospital for the same. 

Earlier this month, a five-year-old child, suspected of being infected with both adenovirus and Covid-19, died in Laketown. 

Due to a sharp spike in adenovirus cases in West Bengal, the state is on high alert, according to media reports.

What are adenoviruses?

Adenoviruses are a group of viruses that typically cause respiratory ailments such as flu-like illness, common cold, conjunctivitis, pneumonia, bronchitis, or croup, an infection of the upper airway, which becomes narrow, making it harder to breathe. 

When adenoviruses affect children, they usually cause infections in the respiratory tract or intestinal tract. While adenovirus respiratory infections are most common in the late winter, spring and early summer, they can occur anytime throughout the year. 

According to the Children's Hospital of Philadelphia, digestive tract infections are more common in children under five years of age, and most children have had one form of the infection by the age of 10. 

Adenovirus-based vaccines

Several Covid-19 vaccines use synthetic materials or adenovirus to package and deliver antigens. Adenovirus-based vaccines are the ones in which a modified version of a chimpanzee adenovirus called ChAdOx1 is used so that it can enter the cells of a human or another host but not replicate inside. 

How are adenoviruses spread?

Adenoviruses are spread from an infected person to others through close personal contact such as touching or shaking hands, contact with stool, for instance, while changing diapers, through the air by coughing or sneezing, or by touching an object with adenoviruses on it, then touching the mouth, nose or eyes before washing the hands. 

According to the Centers for Disease Control and Prevention (CDC), adenoviruses can remain infectious for long periods of time on surfaces and objects, and are often resistant to common disinfectants. 

The two most common ways in which adenoviruses are transmitted are respiratory infections and intestinal tract infections. 

When a person comes in contact with infectious material from another individual or inanimate object, they may contract respiratory infections. Adenoviruses may survive for many hours on inanimate objects such as doorknobs, hard surfaces and toys. 

The digestive strain of adenoviruses is usually transmitted through faecal-oral contact. These infections usually happen due to poor handwashing or due to ingestion of contaminated food or water. 

What are the symptoms caused by adenovirus?

The symptoms of adenovirus infection are usually mild. According to the Children's Hospital of Philadelphia, symptoms could occur due to respiratory infections or intestinal tract infections. 

The symptoms due to respiratory infections may develop two to 14 days after exposure, while the symptoms due to intestinal tract infections may occur one to two days after exposure. The symptoms from intestinal tract infections usually occur in children younger than five years of age, and may last one to two weeks. 

Symptoms due to respiratory infections include common cold-like symptoms, sore throat, runny nose, fever, swollen lymph nodes, severe cough, feeling of uneasiness, headache, conjunctivitis or "pink eye", acute bronchitis or the inflammation of the airways of the lungs, sometimes called a "chest cold", and pneumonia.

The symptoms due to intestinal tract infections include abrupt onset of watery diarrhoea, abdominal tenderness, vomiting, and fever. Acute gastroenteritis may occur, which refers to the inflammation of the stomach or intestines and results in diarrhoea, nausea, vomiting and stomach pain. 

Bladder infection and neurologic disease, which refers to conditions affecting the brain and spinal cord, are some less common illnesses caused by adenoviruses, according to the CDC. 

Who is at risk of adenovirus infection? 

People with weak immune systems, including those taking medications for heart or lung disease, are at higher risk of developing severe adenovirus infection, compared to others, according to the CDC. In rare cases, healthy people might contract adenovirus infection and become severely ill. 

How are adenovirus infections diagnosed?

Adenovirus infections can be diagnosed through blood tests, stool culture, chest X-ray and culture of respiratory secretions by nasal swab. A chest X-ray can produce images of the internal tissues of the chest. 

Since most people suffering from adenovirus infections have mild or no symptoms, laboratory testing is not routinely done. If a person has severe illness or pneumonia, or if an outbreak is being investigated, healthcare experts might suggest testing for adenoviruses. 

How can adenovirus infections be treated?

According to the Children's Hospital of Philadelphia, there is no cure for adenovirus infections. When children are infected with adenoviruses, their treatment is focused on relieving the symptoms associated with the infection. Antibiotics are not effective because the infection is caused by a virus. 

The child's age, overall health and medical history, tolerance for specific medications, procedures or therapies, and extent of the condition determine the kind of treatment he or she will receive. 

There are no approved antiviral medicines for those infected with adenoviruses. If a patient is severely ill, they must be admitted to the hospital. 

Military personnel who may be at a higher risk for infection from certain types of adenovirus are often administered a vaccine. The safety and effectiveness of the adenovirus vaccine has not been studied in the general population or in people with weakened immune systems, according to the CDC. The vaccine has not been approved outside of the military. Currently, no approved adenovirus vaccine is available for the general public. 

When a person is suffering from respiratory infections due to adenoviruses, they should increase their fluid intake, inhale oxygen through a mask, nasal prongs or an oxygen tent, take bronchodilator medications, and mechanical ventilation. 

If a child is infected with respiratory problems, they should be well-hydrated. If required, the child should be given fluids and essential electrolytes through an intravenous line. 

If a child has become severely ill due to adenovirus infection, they may require mechanical ventilation or a respirator to assist with breathing for a period of time. 

If a child's airways are blocked, they may be given bronchodilator medications, through an aerosol mist by a mask or through an inhaler. 

In case of intestinal infections, oral rehydration and intravenous fluids must be administered. Nasogastric tube feedings are also an option. 

Oral rehydration can be done with water, breast milk, and special electrolyte-containing fluids, which contain sugars and salts. According to the Children's Hospital of Philadelphia, very young children should not be rehydrated with soda, juice or sports drinks. 

In order to administer formula or fluids, a small tube could be placed into the infected child's stomach through the nose.

How can adenovirus infections be prevented?

Adenovirus infections can be prevented in two ways — protecting oneself from getting sick, and protecting others when one is sick.

In order to protect oneself from getting sick, people should avoid close contact with people who are sick, wash their hands often with soap and water for at least 20 seconds, and help young children do the same, and avoid touching their eyes, nose or mouth with unwashed handles. 

When a person is sick, they can protect others by staying at home, not sharing cups and utensils with others, washing hands frequently, and covering mouth and nose when coughing or sneezing. 

Healthcare workers taking care of people infected with adenovirus infections must wear special isolation apparel, such as gowns and gloves, when going near the infected person.

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