Not to be outdone by bacteria “superbugs” in the news lately (see GERMBlog posts of 10/17/07 and 10/28/07), a usually benign “common cold” virus has taken upon itself to become more potent and even deadly. Adenoviruses are well known causes of the common cold and other respiratory (and gastrointestinal) infections in kids and adults. While we can blame the bacteria “superbugs” on overuse of antibiotics and the “learned” resistance by bacteria to those antibiotics (see GERMBlog post of 10/17/07), this mutated adenovirus is not the result of overtreatment – we don’t have medicines for the adenoviruses, and so we haven’t been able to overuse them! Rather, this virus illustrates the natural ability of germs to change for the worse, something we fear with other viruses as well, such as those that cause Bird Flu and AIDS (see Chapter 3 in Germ Proof Your Kids – The Complete Guide to Protecting (without Overprotecting) Your Family from Infections (ASM Press, Washington, D.C., 2008).
Adenoviruses are not the most common of the common cold viruses – rhinoviruses hold that distinction (see Chapters 1-3 in Germ Proof Your Kids – The Complete Guide to Protecting (without Overprotecting) Your Family from Infections). But adenoviruses also cause this benign and ever-present infection and up until recently, that hasn’t been of great interest or concern – a cold is a cold is a cold, right? Well, that was true until May, 2006 when a 2 week old baby died of adenovirus type 14. This past spring (2007), 140 additional cases of adenovirus 14 infection were diagnosed across 3 states (Oregon, Washington, and Texas). More than one-third of those patients were hospitalized and one in 6 required intensive care; nine of the patients died – not your typical common cold, by any means. Pneumonia was the cause of the severe disease and deaths in most of the cases; numerous cases have been in kids; one large cluster of cases in Texas occurred among trainees at an air force base.
Even though there has been no clear contact between the first patient in NY in 2006 or the subsequent outbreaks in OR, WA, and TX, genetic analysis shows that all of the viruses from these patients are identical. It is adenovirus 14, indeed, but it has mutated from the benign common cold version of adenovirus 14 that has been known about for more than 50 years.
Once infected, there is no specific (that is antiviral drug) treatment for adenoviruses – the best that can be done is to provide good supportive care to ill patients. That includes supporting their breathing requirements, fluid requirements, and nutrition. Prevention of respiratory virus infections like adenovirus 14 is discussed extensively in Chapters 9-11 of Germ Proof Your Kids – The Complete Guide to Protecting (without Overprotecting) Your Family from Infections
For further reading, see the November 16 issue of the CDC’s Morbidity and Mortality Weekly at www.cdc.gov/mmwr.