NAME: Adenovirus (Serotypes 40 & 41)
CHARACTERISTICS: Human adenoviruses are members of the family Adenoviridae and genus Mastadenovirus. They are nonenveloped viruses with an icosahedral capsid, 70-90 nm in diameter and a double-stranded, linear DNA genome(1).
PATHOGENICITY/TOXICITY: Adenovirus serotypes 40 and 41 cause acute gastroenteritis primarily in children. Symptoms may include fever, diarrhea, vomiting, and abdominal pain, and last for approximately 10 days. Respiratory symptoms can occur in some individuals. The disease is usually self-limiting in immunocompetent individuals; however rare fatalities can occur in immunocompromised individuals(1). Asymptomatic infections are common, particularly in children(3).
EPIDEMIOLOGY: Enteric adenovirus is a common cause of acute gastroenteritis in children worldwide(1). Enteric adenoviruses have been identified in 9% of children with diarrhea. They are the third most common cause of infantile gastroenteritis after rotavirus and norovirus(2). Sporadic and endemic infections may occur year-round(1).
HOST RANGE: Humans.
INFECTIOUS DOSE: Unknown.
MODE OF TRANSMISSION: The virus is transmitted via the fecal-oral route(1).
INCUBATION PERIOD: 3 to 10 days(1).
COMMUNICABILITY: Low communicability between close contacts in the same household(4). Virus shedding takes place during the acute stage of the disease, since enteric adenoviruses are rarely recovered from stool samples more than a few weeks after recovery from gastroenteritis(1). Asymptomatic individuals (mainly children) shed adenoviruses in their stool(3).
DRUG SUSCEPTIBILITY: None. Reports indicate that cidofovir may be effective against adenoviruses; however, no controlled trials have been performed so far, and the drug is not currently licensed for use(6).
SUSCEPTIBILITY TO DISINFECTANTS: Adenoviruses are resistant to lipid disinfectants, but are inactivated by formaldehyde and chlorine(6). Adenoviruses can be inactivated by contact with 1:5 dilution of bleach for 1-2 minutes, and by contact with alcohol-based hand gels(1).
PHYSICAL INACTIVATION: Adenoviruses are highly resistant to inactivation(1). Adenovirus can be inactivated by heat(6): heating to 56 °C for 30 min, 60 °C for 2 min, and autoclaving will destroy infectivity(1). Adenovirus serotype 40 is also sensitive to UV radiation(7).
SURVIVAL OUTSIDE HOST: Most serotypes are stable at 36 °C for a week, for several weeks at room temperature, and for several months at 4 °C(1,8). Adenoviruses are very stable in the environment and persist for 7 days to 3 months on dry inanimate surfaces(8). They can also survive for many days in tap water, sewage effluent, and sea water(9).
SURVEILLANCE: Monitor for symptoms of gastrointestinal and/or respiratory illness. Enteric adenovirus infection can be detected by electron microscopy, agglutination tests, enzyme-linked immunosorbent assay, or by PCR(10).
Note: All diagnostic methods are not necessarily available in all countries.
FIRST AID/TREATMENT: Illness is generally self-limiting. Treatment is primarily oral rehydration or, in serious cases, intravenous rehydration(10).
LABORATORY-ACQUIRED INFECTIONS: At least 10 cases of laboratory-acquired adenovirus infections have occurred up to 2006; however, the serotypes involved were not reported(11).
PRIMARY HAZARDS: Ingestion of virus(1), accidental parenteral inoculation, and droplet exposure of the mucous membranes of the eye, nose, or mouth.
SPECIAL HAZARDS: None.
RISK GROUP CLASSIFICATION: Risk Group 2(12).
CONTAINMENT REQUIREMENTS: Containment Level 2 facilities, equipment, and operational practices for all work involving infectious or potentially infectious materials, animals, and cultures.
PROTECTIVE CLOTHING: Lab coat. Gloves when direct skin contact with infected materials or animals is unavoidable. Eye protection must be used where there is a known or potential risk of exposure to splashes(13).
OTHER PRECAUTIONS: All procedures that may produce aerosols, or involve high concentrations or large volumes should be conducted in a biological safety cabinet (BSC). The use of needles, syringes, and other sharp objects should be strictly limited. Additional precautions should be considered with work involving animals or large scale activities(13).
SPILLS: Allow aerosols to settle, and while wearing protective clothing, gently cover the spill with paper towels and apply appropriate disinfectant, starting at the perimeter, working inwards towards the centre. Allow sufficient contact time before clean up(13).
DISPOSAL: Decontaminate before disposal by steam sterilization, incineration, or chemical disinfection(13).
STORAGE: In locked, leak-proof containers that are appropriately labelled and secured(13).
REGULATORY INFORMATION: The import, transport, and use of pathogens in Canada is regulated under many regulatory bodies, including the Public Health Agency of Canada, Health Canada, Canadian Food Inspection Agency, Environment Canada, and Transport Canada. Users are responsible for ensuring they are compliant with all relevant acts, regulations, guidelines, and standards.
UPDATED: November 2010
PREPARED BY: Pathogen Regulation Directorate, Public Health Agency of Canada.
Although the information, opinions and recommendations contained in this Pathogen Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.
Public Health Agency of Canada, 2010