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More and More Adenovirus
Lower respiratory tract infections remain an important cause of morbidity and mortality globally, especially among school- and pre-school-age children in Africa.
Although respiratory viruses are recognized as a major cause of both acute and chronic respiratory diseases, the prevalence and especially the impact of Human Adenovirus infections (HAdV, one of the most common pathogens in children under five years of age) are have been underestimated for a long time.
In this recent review, the data provided suggest that African children, particularly those under 5 years of age, are at risk of serious consequences from HAdV respiratory infections. Long-term sequelae, including bronchiectasis and especially post-infectious bronchiolitis obliterans, further highlight the significant impact of such infections.
Furthermore, studies show that Adenovirus is currently the third most common viral pathogen in fatal pneumonia among children under 5 years of age in low- and middle-income African countries, contributing to 5.5% of all pneumonia deaths and ranking second place among nosocomial viral pneumonia deaths.
However, the lack of complete data (molecular diagnostics are not always available) hinders a full understanding of the impact this infection on the health of African children.
The authors recommend broader surveillance of HAdV, ensuring its systematic inclusion in the diagnostic profiles (molecular genetics and culture on swabs and possible research on broncho-alveolar fluid) and stratification into groups for the early recognition of African children with more high risk of developing chronic sequelae.
A better understanding of the epidemiology of the virus, its clinical impact and the availability of therapeutic options are essential to implement informed public health strategies and subsequent medical care interventions.
Finally, it is hypothesized that the recent COVID-19 pandemic has led to changes in the epidemiology of respiratory viruses and the intrinsic resistance of HAdV to common disinfectants may have led to an increase in these infections.
Last but not least, it is necessary to highlight that predominant HAdV serotypes associated with lung disease differ from country to region and have changed over time. This last data should not alarm, but certainly raise awareness and raise the threshold of attention to Adenovirus infections in Europe, also taking into consideration the increasingly frequent cases of post-infectious bronchiolitis obliterans in our continent.
BIBLIOGRAPHY
Marieke M. van der Zalm, Nadia A. Sam-Agudu and Lilly M. Verhagen. Respiratory adenovirus infections in children: a focus on Africa. Review. Curr Opin Pediatr. 2024 Jun 1;36(3):342-348.
