ADENOVIRUS
INTRODUCTION
The year of 1953 saw the isolation of
adenovirus,which was soon recognised as an
invaluable tool for investigating mammalian
molecular biology.several distinguishing features
of adenovirus have made it the preferred vehicle
for gene transfer and transgene expression in
mammalian cells.adenoviruses have relatively
resistant to common disinfectants, Adenoviruses
most commonly cause respiratory illness.the
illness can range from the common cold to
pneumonia and bronchitis
ADENOVIRUSES
Adenovirus are group of medium-sized,non-enveloped, double-stranded DNA
viruses that share a common complement fixing antigen.They infect
humans,animals,and birds, showing strict host specificity
In 1953,Rowe & associates grew surgically removed human adenoid tissue in
plasma clot cultures and noticed that the epithelial outgrowths underwent
spontaneous degeneration resembling viral cytopathic change.This was
neutralized by human sera.A viral agent was shown to be responsible for this
degeneration
Over 50 serotype of adenoviruses have been isolated from human sources
Most of the recent serotype were recovered from AIDS patients
Adenovirus infections are common worldwide mostly in children.Many
infections are asymptomatic
Adenovirus cause infections if the respiratory tract & eyes & less often in the
intestine & urinary tract
MORPHOLOGY
Adenoviruses are 70-75nm in size
The capsid is composed of 252 capsomers arranged as an icosahedron with 20
triangular facets and 12 vertices
Of the 252 capsomers,240 have six neighbours and are called hexons
While the 12 capsomers at the vertices have five neighbours and are called
pentons
The virion has the appearance of a space vehicle
RESISTANCE
Adenoviruses are relatively stable remaining viable for about a week at 37°C
They are readily inactivated at 50°C
They resist ether and bile salts
PATHOGENESIS
Adenovirus cause infections of the respiratory tract, eye, bladder and
intestine.More than one type of virus may produce the same clinical syndrome
and one type of virus may cause clinically different diseases.persistent infection
occurs in tonsils.Some adenovirus types are oncogenic in newborn rodents and
can transform cells.following syndromes have been recognised:
1. PHARYNGITIS:
Adenoviruses are the major cause of non-bacterial pharyngitis and tonsillitis
Cause febrile common cold
Type 1-7 are common cold
2.PNEUMONIA:
Adenovirus pnuemonia occasionally occurs in immuno compromised hosts
Adenovirus type 3&7 are associated with pnuemonia in adults resembling
primary atypical pneumonia
In infants and young children type 7 may lead to more serious and even fatal
pnuemonia
3.DIARRHEA:
Adenoviruses can be often be isolated from feces but their connection to
intestinal disease has not been conclusively established.
Adenoviruses have been isolated from mesenteric lymphnodes in cases of
mesenteric adentitis and intussusception in childrens
LABORATORY DIAGNOSIS
Diagnosis can be established by isolation of the virus from the throat,eye, urine
or feces.The materials are inoculated tissue cultures.preliminary identification is
possible by noting the cytopathic effects & by complement fixation tests with
adenovirus antiserum
For serological diagnosis, rise in titre of antibodies should be demonstrated
in paired sera.exanimation of single sample of serum is inconclusive as
adenovirus antibodies are so common in the population. Electron microscopy for
fecal virus and immunofluorescence for viral antigen detection in nasopharyngeal
and ocular infections are useful
OCULAR DISEASES
1.ADENOVIRAL CONJUNCTIVITIS:
Adenoviruses are the commonest cause of viral conjunctivitis.These are non
enveloped,double stranded DNA viruses,which replicate within nucleus of host
cells.General reservoir of adenoviruses is only human
*Types of adenoviral conjunctivitis include:
Epidemic keratoconjunctivitis (EKC)
Non specific acute follicular conjunctivitis
Pharyngoconjuctival fever(PCF)
Chronic relapsing adenoviral conjunctivitis
EPIDEMIC KERATOCONJUNCTIVITIS
It is a type of acute follicular conjunctivitis mostly associated with superficial
punctate keratitis and usually occurs in epidemics,hence the name EKC.EKC is
mostly caused by adenoviruses type 8 &19.the condition is markedly contagious
and spreads through contact with contaminated fingers, solutions,and
tonometers
SYMPTOMS
Redness (pinkeyes)
Swelling of the eyelids
Sensitivity to light (photophobia)
Clear,watery discharge
Blurred vision
Eyepain,or a feeling that something is in your eyes
SIGNS
Eyelids are swollen causing narrowing of palpebral aperture, conjunctival
signs are:
1. Hyperaemia is usually marked and prominent
2. Chemosis of conjunctiva often present
3. Follicles of small to moderate size typically involving the lower fornix and
palpebral conjunctiva
DIAGNOSIS
EKC can usually be diagnosed by the red and swollen appearance of the eye,
although there are newer tests able to detect the virus by taking a swab of eye
fluid.Although there are no antiviral drug known to effectively treat EKC,
although certain eye drops and topical agents may provide some relief
TREATMENT:
1. Supportive treatment for amelioration of symptoms is the only treatment
required and includes:
Cold comprises,& sun glasses to decrease glare
Decongestant & lubricant tear drop to decrease discomfort
2. Topical antibiotics help to prevent superadded bacterial infections
3. Topical steroids should not be used during active inflammation
PREVENTION
It is very important as the adenoviral conjunctivitis is highly contagious &
patients may be infections for up to 11 days after onset
1.Transmission usually occurs:
From eye to fingers to eyes & Tonometers, Contact lenses,Eye drops are other
routes of transmission
2. Preventive measures includes:
Frequent handwashing
Relative isolation of infected individual
Avoiding eye rubbing and common use of towel or handkerchief sharing
ADENOVIRAL KERATITIS
Adenoviral keratitis is painful,can compromise vision,and develop
following an episode of conjunctivitis.it typically presents in the
setting of acute viral follicular conjunctivitis,EKC,PCF &
chronic/relapsing adenoviral conjunctivitis
SYMPTOMS
1. Eye rednes,eye pain
2. Blurred vision
3. Excess tears or other discharge from your eyes
4. Decreased vision
5. Difficulty opening your eyelids because of pain or irritation
DIAGNOSIS
EYE EXAM: although it may be uncomfortable to open your eyes for the
exam,it’s important to have your eye care provider examine your eyes
PENLIGHT EXAM: your eye doctor may examine your eye using a penlight,to
check your pupils reaction,size and other factor.A stain may be applied to the
surface of your eye.Used with the light,this stain makes it easier to damage
the surface of the cornea.
LABORATORY ANALYSIS: you’re eye care provider may take a sample of tears
or some cells from your cornea for laboratory analysis to determine the cause
of keratitis & to help develop a treatment plan for you!
∆ TREATMENT:
If a virus causing infection, antiviral eyedrops and oral antiviral medications may
be effective
THANKYOU!
