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Adenovirus: Morphology, Lab Diagnosis, Clinical features

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    Introduction of Adenovirus                                 

    Rowe and associates in 1953. The adenovirus is isolated from adenoids originally. Adenovirus shares a common complement-fixing antigen. The virus infects humans, birds, and animals, and infections are most common in children.  

    Morphology of Adenovirus

    It is a non-enveloped, icosahedral symmetry, linear Double-stranded DNA virus. The size of a virus is 70-90nm and contains 252 capsomers and 240 hexagons. The virus has 12 fibrillar pentons, and it was space vehicle shaped appearance. 

    Resistance

    It is a heat-stable virus and readily inactivated at 50◦C. They resist ether and bile salts. 

    Epidemiology

    It is an endemic disease and is transmitted through droplets, Direct contact, Feco-oral transmission. Its 1/3rd of human serotypes cause human illness. 

    Virus effects on cells:

    It saws in marked rounding, enlargement, and aggregation of affected cells which are grape-like clusters. Rounded intra-nuclear inclusion containing DNA present in the cells.

    Pathogenesis

    • It generally causes infection of the respiratory tract, eye, GIT & UTI.
    • Infection occurs through conjunctiva or nasal mucosa.
    • Children- fecal-oral transmission.
    • Incubation period: 5-7 days
    • Multiply initially in the conjunctiva, pharynx, or small intestine and spread to draining L.nodes
    • Serotype 1- 8 most common
      • Subgenus(SPS) C – Acute febrile pharyngitis
      • Subgenus B- Acute respiratory disease
      • Serotype 40 and 41 – infantile gastroenteritis
      • Serotype- 8, 19, 37- eye infection
      • Serotype 19,37- genital infection
      • Serotype 3, 4, 11 – acute follicular conjunctivitis

    Immunity

    • Induces long-lasting immunity
    • Maternal antibodies protect infant

    Lab Diagnosis of Adenovirus

    Specimen

    • Throat swab
    • Nasopharyngeal aspirates
    • Bronchial lavage
    • Conjunctival swab
    • Corneal scraping
    • Urine
    • An anal swab
    • Genital secretions
    • Feces, rectal swab, and biopsy

    Microscopy

    • Virus particles in stool by EM
    • Virus isolation:
      • Primary human embryonic kidney cell line and A549 cell line. 
      • HEp-2, HeLa, and KB cell lines

    Viral growth

    • Can be detected through the Cytopathic effect: Rounding and grape-like clustering of swollen cells.
    • Antigen detection by Direct-IF test.
    • Shell vial technique
    • Explant culture: It can grow on adenoid explants. However, it is no longer in use now.

    Serotyping

    •  By Hemagglutination test and Neutralization test
    •  PCR for the gene coding for type-specific antigens, More sensitive and rapid.

    Direct –IF test 

    • Detect the adenoviral antigens from clinical samples such as the throat or conjunctival secretions by using 
      • fluorescent-tagged anti-hexon antibody
      • Fastidious enteric serotypes such as 40 and 41 from stool: Can be detected by EM or by antigens detection by ELISA
      • Serum antibody detection: 
        • CFT
        • Neutralization test
        • ELISA
        • HAI (Hemagglutination inhibition test)-for few hemagglutinating serotypes.

    Clinical Findings

    • Pharyngitis-acute febrile
    • Pneumonia
    • Conjunctivitis-Acute follicular conjunctivitis, Epidemic keratoconjunctivitis
    • Infantile Gatroenteritis
    • Acute hemorrhagic cystitis

    Diarrhea

    • Enteric type adenovirus-serotypes 40, 41
    • Not grown in routine cell culture
    • Trypsinised MK cells or transformed HEK cells
    • Can be identified by stool ELISA

    Transformation of cells

    • Heubner reported types 12 and 18 produced sarcoma in baby hamsters-1962
    • Types 12, 18, and 31 –induce tumors only in animals.
    • In culture, all types of cells transform

    Gene Therapy

    • They have a spare capacity to carry DNA inserts
    • Potential vectors in gene therapy
    • Used in cancer therapy and gene therapy

    Prevention and control

    • Hand washing
    • Chlorination of swimming pools
    • Environmental surfaces disinfected by sodium hypochlorite
    • A live vaccine to 4, 7 –applied to military recruits

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