Adenovirus Infection

Causative agent

Adenoviruses are a group of viruses that infect the mucous membranes of humans. Depending on the serotypes of virus, they may cause respiratory illness and also diarrhoea, eye infection and rashes. The infection can occur all year round.

Clinical features

Symptoms caused by adenoviruses vary with the serotypes of virus, such as cough, runny nose, sore throat and fever in the respiratory tract; abdominal pain and diarrhoea in the gastrointestinal tract; and eye infection commonly known as 'red eye disease'. Young children, elderly and immunocompromised patients are more susceptible to this infection.

Mode of transmission

The infection mainly spreads through droplets (e.g. by coughing or sneezing), direct contact with oro-nasal secretions of patients (e.g. by shaking hands or contact with contaminated surfaces), or ingestion of contaminated food or water; and may cause outbreaks of acute respiratory or eye infections in institutional settings such as schools and hospitals.

Incubation period

The incubation period is usually 2 - 14 days.

Management

No specific antiviral therapy is available. In general, patients are given supportive treatment with adequate fluid replacement.

Prevention

• The wearing of mask is advised for the following situations - 
  1. any persons with fever or respiratory symptoms;
  2. any persons who are visiting or working in high risk places such as residential care homes for the elderly, residential care homes for persons with disabilities, and clinical areas of healthcare facilities; and
  3. high risk persons (e.g. persons with underlying medical conditions or persons who are immunocompromised) who are going to crowded places such as public transport.
  4. When an increasing trend in activity of respiratory viruses is expected, high risk persons are recommended to wear a surgical mask when visiting public places, while the public should also wear a surgical mask when taking public transportations or staying at crowded places.
• It is important to wear a mask properly, including hand hygiene before wearing and after removing a mask. For details on proper mask wearing, please visit CHP website at www.chp.gov.hk/files/pdf/use_mask_properly.pdf;
• Perform hand hygiene frequently, especially before touching the mouth, nose or eyes, after touching public installations such as handrails or door knobs or when hands are contaminated by respiratory secretion after coughing or sneezing. Wash hands with liquid soap and water, and rub for at least 20 seconds. Then rinse with water and dry with a disposable paper towel or hand dryer. If hand washing facilities are not available, or when hands are not visibly soiled, hand hygiene with 70 to 80% alcohol-based handrub is an effective alternative.
• Wear gloves and a surgical mask while disposing of or handling vomitus and faeces, and wash hands thoroughly afterwards.
• Cover your mouth and nose with tissue paper when sneezing or coughing. Dispose of soiled tissues into a lidded rubbish bin, then wash hands thoroughly.
• When having respiratory symptoms, wear a surgical mask, refrain from work or attending class at school, avoid going to crowded places and seek medical advice promptly.
• Avoid sharing eye medicines, eye make-ups and other items that may come into contact with the eyes.
• Maintain a balanced diet, exercise regularly, take adequate rest, do not smoke and avoid alcohol consumption.

• Regularly clean and disinfect frequently touched surfaces such as furniture, toys and commonly shared items with 1:99 diluted household bleach (mixing 1 part of 5.25% bleach with 99 parts of water), leave for 15 – 30 minutes, and then rinse with water and keep dry. For metallic surface, disinfect with 70% alcohol.
• Use absorbent disposable towels to wipe away obvious contaminants such as respiratory secretions, and then disinfect the surface and neighbouring areas with 1:49 diluted household bleach (mixing 1 part of 5.25% bleach with 49 parts of water), leave for 15 – 30 minutes and then rinse with water and keep dry. For metallic surface, disinfect with 70% alcohol.
• Maintain good indoor ventilation. Avoid going to crowded or poorly ventilated public places; high-risk individuals may consider putting on surgical masks while in such places.