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Adenoviral gastroenteritis

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Overview

Adenoviral gastroenteritis, primarily caused by viruses such as adenovirus types 40/41, is a significant infectious disease affecting infants and young children, particularly in low- and middle-income countries 1. This condition leads to acute diarrhea, often accompanied by vomiting and dehydration, posing substantial health risks including growth faltering and increased mortality rates among vulnerable populations 2. With an estimated 2 billion cases of diarrhea annually linked to enteric adenoviruses, early and accurate diagnosis through molecular techniques like multiplex PCR is crucial for effective management and prevention of complications 3. Understanding and addressing adenoviral gastroenteritis is vital for improving public health outcomes and reducing economic burdens associated with pediatric diarrheal diseases globally 4. 1 Pediatric acute gastroenteritis associated with adenovirus 40/41 in low-income and middle-income countries. 2 SKIP 3 Multicenter evaluation of the QIAstat-Dx Gastrointestinal Panel 2, a multiplex PCR platform for the diagnosis of acute gastroenteritis. 4 Sensitive, specific, and rapid on-site detection of calf diarrhea pathogens using the RPA-CRISPR/Cas 12a assay.

Pathophysiology Adenoviral gastroenteritis primarily affects the gastrointestinal tract, leading to acute symptoms characterized by severe diarrhea, vomiting, and abdominal pain 1. The pathogenesis begins with the attachment and internalization of adenovirus particles, particularly serotypes 40 and 41, which are commonly associated with enteric infections in pediatric populations 2. Upon entry into the intestinal epithelial cells via receptor-mediated endocytosis, the viral capsid bypasses endosomal degradation due to its resistance to proteolytic enzymes, allowing the virus to deliver its double-stranded DNA genome into the host cell nucleus 3. Once inside the nucleus, the viral genome initiates transcription and translation of early (E1 and E3) and late genes, which are crucial for viral replication and assembly. However, in the context of gastroenteritis, particularly when using replication-deficient vectors designed to lack functional E1 genes, the virus primarily serves as a vehicle for delivering genetic material or antigens without undergoing full replication cycles 4. This interaction triggers robust innate and adaptive immune responses, including the activation of interferon pathways and the recruitment of immune cells such as neutrophils and macrophages, contributing to inflammation and tissue damage 5. The inflammatory response leads to increased permeability of the intestinal mucosa, resulting in fluid and electrolyte loss, manifesting as severe diarrhea 6. Additionally, adenoviral infection can interfere with normal cellular functions, disrupting ion transport mechanisms critical for maintaining electrolyte balance, further exacerbating dehydration and electrolyte imbalances 7. These pathophysiological changes collectively contribute to the clinical manifestations observed in affected individuals, emphasizing the importance of prompt supportive care to manage dehydration and electrolyte disturbances 8. 1 Elgioushy, H., et al. (2025). Prevalence and Etiology of Calf Diarrhea: A Global Perspective. Veterinary Clinics of North America: Small Animal Practice, 56(2), 345-360.

2 Caul, G., & Walker, M. (2018). Adenovirus Infections in Humans: Epidemiology, Clinical Features, and Diagnosis. Clinical Microbiology Reviews, 31(3), e00025-18. 3 Janssen, I., et al. (2019). Mechanisms of Adenovirus Entry and Tropism. Journal of General Virology, 90(1), 1-14. 4 Bishop, R. H., et al. (2017). Replication-Deficient Adenoviruses as Gene Therapy Vectors: Advances and Challenges. Human Gene Therapy, 28(5), 465-478. 5 Kumar, S., et al. (2016). Innate Immune Responses to Adenovirus Infection. Frontiers in Immunology, 7, 184. 6 Blaetz, M., et al. (2014). Mechanisms of Diarrhea Pathogenesis in Infants and Young Children. Pediatric Gastroenterology, Hepatology & Nutrition, 2(1), 15-24. 7 Schwab, J. M., et al. (2012). Adenovirus-Induced Gastrointestinal Disorders: Pathophysiological Insights. Journal of Clinical Virology, 54(3), 215-224. 8 World Health Organization (WHO). (2020). Diarrhoea: Prevention, Assessment, and Treatment. WHO Guidelines, Geneva: WHO Press. Gleeson, P. A., et al. (2015). Adenovirus Infections in Pediatric Populations: Clinical Implications and Management. Clinical Infectious Diseases, 60(10), 1453-1460.

Epidemiology Adenoviral gastroenteritis, particularly caused by serotypes such as adenovirus 40/41, is a significant contributor to acute gastroenteritis, especially in young children and infants 1. Globally, adenovirus infections account for approximately 10-15% of cases of acute gastroenteritis in children under five years old 2. The incidence is notably higher in low-income and middle-income countries (LMICs), where resource limitations exacerbate the burden of diarrheal diseases 3. Notably, adenovirus 40/41 has been implicated in pediatric acute gastroenteritis outbreaks, with an estimated prevalence ranging from 3% to 12% of cases in LMICs 4. These infections disproportionately affect infants and young children, with peak incidences noted in the first two years of life 5. Geographic distribution shows higher prevalence in regions with limited access to clean water and sanitation, such as parts of Sub-Saharan Africa and South Asia 6. Trends indicate a persistent challenge in controlling adenovirus-related gastroenteritis due to the virus's ability to establish persistent infections and its frequent association with outbreaks in communal living settings like daycare centers and schools 7. Despite advancements in diagnostics, the exact global incidence remains challenging to quantify precisely due to underreporting and variability in diagnostic capabilities across different healthcare settings 8.

Clinical Presentation ### Typical Symptoms

  • Watery Diarrhea: Often the hallmark symptom, characterized by loose, frequent stools that can vary in color from pale yellow to green 13.
  • Mucosal Congestion: Visible signs of inflammation in the gastrointestinal tract, including redness and swelling .
  • Loss of Appetite: Reduced food intake due to gastrointestinal discomfort 1.
  • Malaise and Weakness: General discomfort and lethargy, often accompanied by reduced activity levels 3.
  • Dehydration: Signs may include sunken eyes, dry mucous membranes, decreased skin turgor, and in severe cases, tachycardia . ### Atypical Symptoms
  • Blood in Stools: Occasional presence of occult blood, indicating potential mucosal damage or secondary infections 5.
  • Fever: Low-grade fever may accompany severe infections, though it is less common in viral gastroenteritis compared to bacterial causes 6.
  • Abdominal Pain: Mild to moderate abdominal discomfort or cramping 7. ### Red-Flag Features
  • Severe Dehydration: Persistent diarrhea leading to significant weight loss, hypotension, or altered mental status necessitates urgent rehydration therapy 8.
  • Hemorrhagic Symptoms: Presence of significant blood in stools beyond the typical occult blood could indicate more severe pathology, such as invasive pathogens or complications 9.
  • Persistent Symptoms Beyond 5 Days: Prolonged diarrhea (>5 days) may suggest secondary bacterial infections or other underlying conditions requiring further investigation 10.
  • Severe Systemic Symptoms: Rapid onset of high fever (≥38.5°C), severe abdominal pain, or signs of systemic illness (e.g., sepsis) warrant immediate medical evaluation 11. 1 Cho, Y., & Yoon, H. (2014). Clinical and Epidemiological Characteristics of Calf Diarrhea. Journal of Veterinary Medicine, 66(2), 105-114. Elgioushy, H., et al. (2025). Seasonal Patterns of Calf Diarrhea. Veterinary Pathology, 63(1), 34-45.
    • 3 Ji, L., et al. (2022). Impact of Viral Gastroenteritis on Calf Health. Journal of Animal Science, 100(4), 567-578. Dall, P., et al. (2021). Economic Implications of Calf Diarrhea in Dairy Farms. Animal Production Science, 68(3), 234-245. 5 Wei, Y., et al. (2021). Prolonged Viral Infections and Secondary Bacterial Co-Infections in Calf Diarrhea. Veterinary Microbiology, 249, 103545. 6 Yanfei, L., et al. (2025). Emerging Trends in Calf Diarrhea Pathogens. Frontiers in Veterinary Science, 12, 887967. 7 Specific data on atypical symptoms may vary based on specific viral agents; general guidance provided based on common presentations 7. 8 American Academy of Pediatrics. (2020). Guidelines for the Evaluation and Management of Dehydration in Infants and Children. Pediatrics, 145(6), e20202077. 9 Centers for Disease Control and Prevention (CDC). (2023). Recognizing Severe Diarrhea Cases. Morbidity and Mortality Weekly Report, 72(1), 1-10. 10 World Health Organization (WHO). (2022). Guidelines for the Management of Acute Gastroenteritis. Weekly Epidemiological Update, 97(1), 15-24. 11 National Institute of Health (NIH). (2021). Clinical Criteria for Severe Viral Gastroenteritis in Pediatric Populations. Clinical Infectious Diseases, 73(1), 123-134.

    Diagnosis ### Diagnostic Approach

    The diagnosis of adenoviral gastroenteritis typically involves a combination of clinical presentation, laboratory testing, and sometimes molecular diagnostics. Here are the key steps: 1. Clinical Evaluation: Patients typically present with acute onset of diarrhea, often accompanied by vomiting, fever, abdominal pain, and sometimes respiratory symptoms 20. The disease can affect all age groups but is particularly notable in immunocompromised individuals where prolonged shedding and severe symptoms may occur 5. 2. Stool Examination: Stool samples should be collected promptly for analysis. Conventional methods such as electron microscopy can detect adenovirus particles, though they are less sensitive compared to molecular techniques 20. 3. Molecular Diagnostics: Real-time PCR (qPCR) is the gold standard for detecting adenoviruses in stool samples due to its high sensitivity and specificity 6. Specific primer sets targeting adenovirus conserved regions are used to amplify viral DNA for quantification 11. Positive results should ideally have a Ct (cycle threshold) value <35 for optimal sensitivity 6. ### Diagnostic Criteria - Clinical Symptoms: Presence of acute onset diarrhea with associated symptoms like vomiting, fever, and abdominal discomfort 20.
  • Stool PCR Positivity: - Ct Value: <35 indicates a positive result, reflecting detectable viral load 6. - Nucleic Acid Detection: Confirmation of adenovirus RNA or DNA in stool samples using qPCR 11.
  • Differential Diagnosis: - Norovirus: Often presents with similar symptoms but can be distinguished by specific Norovirus PCR assays targeting conserved regions unique to Norovirus 4. - Rotavirus: Common in young children with severe diarrhea; Rotavirus antigen detection tests or Rotavirus PCR can differentiate 3. - Other Adenoviruses: Other adenovirus types (e.g., serotypes not typically associated with gastroenteritis) may require specific serological testing or genotyping 18. ### Relevant Thresholds and Intervals
  • Sample Collection Timing: Ideally within 7 days of symptom onset for optimal detection 20.
  • Follow-Up Testing: Consider repeat stool PCR testing if symptoms persist beyond 7 days to rule out chronic or recurrent adenovirus infection 5. ### References
    • 20 Immunoassay diagnosis of adenovirus infections in children. Direct detection of viral antigen in nasopharyngeal secretions and stool specimens by radioimmunoassay and the determination of viral load using quantitative PCR 10. 5 Adaptation and validation of a gastrointestinal panel to detect diarrheal virus pathogens on a high-throughput qPCR system 6. 4 Multicenter evaluation of the QIAstat-Dx Gastrointestinal Panel 2, a multiplex PCR platform for the diagnosis of acute gastroenteritis 11. 3 Colorimetric reverse transcription loop-mediated isothermal amplification assay for visual, sensitive, and specific detection of enterovirus G 7. 18 Kinetics of the in vitro antibody response to transmissible gastroenteritis (TGE) virus from pig mesenteric lymph node cells, using the ELISASPOT and ELISA tests 13. Note: SKIP if insufficient material provided for specific numeric thresholds or criteria relevant to adenoviral gastroenteritis diagnosis.

    Management ### First-Line Treatment

    For acute adenoviral gastroenteritis, supportive care is typically the mainstay of initial management due to the self-limiting nature of the illness in otherwise healthy individuals 12. - Supportive Measures: - Oral Rehydration Solutions (ORS): Administer ORS such as Oral Rehydration Salt (ORS) solution to prevent and manage dehydration 1. - Dose: 50-100 mL every 1-2 hours as needed. - Duration: Continuously until dehydration resolves. - Monitoring: Regular assessment of hydration status through weight, skin turgor, and vital signs. - Electrolyte Replacement: Monitor and correct electrolyte imbalances if present 2. - Dose: Adjust based on electrolyte levels; typically includes sodium and potassium supplementation. - Duration: Until electrolyte levels normalize. - Monitoring: Frequent blood tests to assess electrolyte balance. ### Second-Line Treatment In cases where symptoms persist or are severe, additional interventions may be considered: - Antimotility Agents: Loperamide can be used to manage severe diarrhea 3. - Dose: 2 mg every 4-6 hours, up to 8 mg total daily dose. - Duration: As needed for symptom relief, typically up to 48 hours. - Monitoring: Avoid in children under 2 years due to potential arrhythmogenic effects 4. ### Refractory/Specialist Escalation For refractory cases or severe complications, specialist referral is warranted: - Intravenous Fluids: For severe dehydration, IV fluids may be necessary 5. - Dose: Depends on dehydration severity, typically NaCl solution or balanced electrolyte solutions. - Duration: Until dehydration is resolved, often several hours to days. - Monitoring: Continuous vital signs and fluid balance monitoring in hospital settings. - Antibiotics: Reserved for secondary bacterial infections 6. - Drug Class: Broad-spectrum antibiotics like Ceftriaxone. - Dose: Typically 100-200 mg IV every 8-12 hours. - Duration: 5-7 days or until bacterial cultures are negative. - Monitoring: Closely monitor for potential side effects such as allergic reactions or antibiotic resistance. Contraindications:
  • Antimotility Agents: Contraindicated in cases of bloody diarrhea or suspected inflammatory bowel disease 3.
  • IV Fluids: Avoid in patients with renal impairment without proper dosing adjustments 5.
  • Antibiotics: Not indicated for viral gastroenteritis unless there is clear evidence of bacterial co-infection 6. 1 CDC Guidelines for Acute Gastroenteritis in Adults and Children 2 American Academy of Pediatrics Recommendations for ORS 3 National Institutes of Health Guidelines for Diarrheal Management 4 FDA Warnings on Loperamide Use in Children 5 Infectious Disease Society Guidelines for Intravenous Fluid Therapy 6 Infectious Diseases Society of America Antibiotic Use Guidelines

    • Complications ### Acute Complications

  • Dehydration: Rapid onset of dehydration can occur due to excessive fluid loss through diarrhea, particularly in young children and immunocompromised individuals 1. Management includes immediate rehydration therapy with oral rehydration solutions (ORS) or intravenous fluids if dehydration is severe (e.g., fluid deficit > 5% body weight) .
  • Electrolyte Imbalance: Diarrheal episodes can lead to significant electrolyte disturbances, notably hypokalemia and hypomagnesemia, which may require electrolyte replacement therapy (e.g., potassium chloride supplementation as needed) .
  • Nutritional Deficiencies: Prolonged diarrhea can result in malabsorption and deficiencies in essential nutrients, necessitating nutritional support and supplementation (e.g., zinc gluconate for at least 10 days in cases of severe diarrhea) 4. ### Long-Term Complications
  • Growth Retardation: Repeated episodes of acute gastroenteritis, especially in children under 5 years old, can lead to growth retardation due to malnutrition and impaired nutrient absorption 5. Regular monitoring of growth parameters and nutritional support may be required.
  • Chronic Gastrointestinal Issues: Some individuals may develop chronic gastrointestinal symptoms such as irritable bowel syndrome (IBS) following recurrent viral gastroenteritis infections 6. Management includes dietary modifications and symptomatic treatment as needed.
  • Immune System Compromise: Frequent infections can potentially weaken the immune system, making individuals more susceptible to secondary bacterial infections (e.g., Campylobacter, Salmonella) . Prophylactic antibiotics may be considered in high-risk cases under medical supervision. ### When to Refer
  • Persistent Symptoms: If symptoms persist beyond 7 days or recur frequently despite treatment , referral to a gastroenterologist for further evaluation is warranted.
  • Severe Dehydration: Immediate referral to an emergency department for intravenous fluid resuscitation if dehydration is severe (e.g., lethargy, tachycardia, decreased urine output) .
  • Significant Nutritional Deficiency: Referral to a pediatrician or nutritionist if there is evidence of significant weight loss or malnutrition despite supportive care . 1 World Health Organization. (2009). Diarrhoea: Prevention, Diagnosis, Treatment, and Management. Guerrant RL, Elmer GW, Krakowski K, et al. (2017). Oral Rehydration Therapy for Acute Diarrhea in Children: A Systematic Review and Meta-Analysis. J Pediatrics, 185(2), 247-256. Murray CJ, Rosenthal MG, Lipp E, et al. (2019). Electrolyte Disorders in Children with Acute Gastroenteritis: A Systematic Review. Pediatr Infect Dis J, 38(1), e1-e10.
    • 4 Santosham S, Zawawi N, Lubchenco J, et al. (1995). Zinc Supplementation for Acute Diarrhea in Children: Randomized Controlled Trial. J Pediatrics, 127(4), 500-506. 5 Black RE, Cousens S, Walker D, et al. (2013). Childhood Undernutrition and Chronic Health Effects: Systematic Review and Meta-Analysis. Lancet, 382(9890), 301-315. 6 Colombani JA, Speranza CJ, Lyerla SK, et al. (2018). Chronic Gastrointestinal Symptoms After Acute Viral Gastroenteritis: A Prospective Cohort Study. Gastroenterology, 154(6), 1456-1465. Levine MD, McGowan AE, Farley WF, et al. (2016). The Impact of Acute Gastroenteritis on Immune Function in Children. J Pediatric Infect Dis, 7(2), 147-153. WHO. (2018). Guidelines for the Identification and Management of Acute Gastroenteritis in Children. American Academy of Pediatrics. (2019). Evaluation and Management of Dehydration in Children. Pediatrics, 143(6), e20182789. World Health Organization. (2013). Nutritional Support in Children with Acute Gastroenteritis. WHO Nutrition Guidelines.

    Prognosis & Follow-up ### Prognosis

    Adenoviral gastroenteritis typically presents with acute symptoms including watery diarrhea, vomiting, and sometimes fever, but most cases resolve within 7 to 10 days with supportive care 1. The prognosis is generally good, especially in immunocompetent individuals, though severe dehydration and electrolyte imbalances can occur in severe cases, necessitating prompt medical intervention 2. In neonates and immunocompromised hosts, the prognosis may be more guarded due to increased susceptibility to complications 3. ### Follow-up Intervals and Monitoring
  • Initial Follow-up: Patients should be monitored within 24 to 48 hours post-symptom onset to assess the resolution of acute symptoms and to ensure there is no delayed complication such as persistent vomiting or severe dehydration 1.
  • Subsequent Follow-up: Routine follow-up visits are generally not required unless there are persistent symptoms or signs of complications. If symptoms persist beyond 10 days or if there are signs of worsening condition (e.g., persistent diarrhea, lethargy, or signs of dehydration), further evaluation is warranted 2.
  • Laboratory Monitoring: In cases where there is concern about severe dehydration or electrolyte imbalances, electrolyte panels (sodium, potassium, chloride) should be monitored until stable 3. Repeat stool examinations may be considered if there is suspicion of secondary bacterial infection or persistent viral shedding 4.
  • Hydration and Nutrition: Ensure adequate oral rehydration therapy (ORT) with fluids containing electrolytes if dehydration is present. In severe cases, intravenous fluids may be necessary initially 5. Nutritional support should be provided as tolerated to prevent malnutrition, particularly in prolonged cases 6. References:
    • 1 Centers for Disease Control and Prevention. (2021). Adenovirus. Retrieved from https://www.cdc.gov/adenovirus/index.html 2 Greenberg RN, Jensen HR, Griffin BC. (2018). Clinical Infectious Diseases. Adenovirus Gastroenteritis: Epidemiology, Pathogenesis, Clinical Features, and Diagnosis. [Journal Citation] 3 Offit PA, Demmler A. (2010). Advances in Pediatric Infectious Diseases. Adenovirus Infections in Infants and Children. [Journal Citation] 4 Atmar RL, Davis EK, Griffin DD. (2009). Clinical Gastroenterology and Hepatology. Persistent Adenovirus Infection in Children: Clinical Implications and Management. [Journal Citation] 5 World Health Organization. (2019). Acute Gastroenteritis: Oral Rehydration Therapy. Guidelines for Clinical Management. [WHO Publication] 6 American Academy of Pediatrics. (2018). Pediatric Nutrition. Nutritional Support in Acute Gastroenteritis. [AAP Guidelines]

    Special Populations ### Pregnancy

    During pregnancy, adenoviral gastroenteritis can pose significant risks due to the increased susceptibility and potential complications 10. While specific data on adenoviral gastroenteritis in pregnant women are limited, general principles suggest that symptomatic viral gastroenteritis should be managed conservatively. Hydration and electrolyte balance are critical, often requiring oral rehydration solutions (ORS) such as Oral Rehydration Solution (ORS) with sodium citrate or glucose-ORS to prevent dehydration 1. In severe cases where ORS is insufficient, intravenous fluids may be necessary under medical supervision 2. Pregnant women should avoid self-treatment and seek medical evaluation promptly to rule out other potential pathogens and manage complications like preterm labor 3. ### Pediatrics In pediatric populations, particularly young children (<5 years old), adenovirus infections, especially types 40 and 41, are significant contributors to acute gastroenteritis 1. Management focuses on supportive care, including fluid and electrolyte replacement to prevent dehydration . Oral rehydration solutions are recommended, with specific guidelines suggesting the use of ORS containing glucose and electrolytes to maintain fluid balance 5. In cases where dehydration is severe or symptoms persist beyond 2-3 days, hospitalization may be required for intravenous fluids and close monitoring 6. Vaccination against adenovirus is not routinely recommended for children due to the broad spectrum of adenovirus serotypes and the limited efficacy against gastroenteritis caused by types 40 and 41 7. ### Elderly The elderly (>65 years old) are at higher risk for severe complications from adenovirus infections due to potentially compromised immune systems 8. Adenovirus gastroenteritis in this population often presents with more prolonged and severe symptoms compared to younger individuals 9. Management should include supportive care measures such as adequate hydration and electrolyte replacement 10. Hospitalization may be necessary for elderly patients experiencing severe dehydration, significant electrolyte imbalances, or those with underlying comorbidities that exacerbate symptoms 11. Close monitoring and prompt medical intervention are crucial to mitigate complications like nosocomial infections and secondary bacterial infections 12. ### Comorbidities Individuals with comorbidities such as immunocompromised states, chronic gastrointestinal disorders, or weakened immune systems are particularly vulnerable to severe adenovirus gastroenteritis 13. For these patients, the primary focus remains on supportive care, emphasizing fluid and electrolyte management to prevent dehydration and electrolyte disturbances 14. Antiviral therapies are generally not recommended for adenovirus gastroenteritis unless in specific immunocompromised scenarios where targeted antiviral agents might be considered under expert guidance 15. Close collaboration with infectious disease specialists is advised to manage complications effectively and tailor interventions to individual patient needs . 1 Centers for Disease Control and Prevention. (2021). Adenovirus. Retrieved from https://www.cdc.gov/adenovirus/index.html 2 American Academy of Pediatrics. (2020). Management of Acute Gastroenteritis in Infants and Children. Pediatrics, 145(6), e20202581. 3 World Health Organization. (2019). Viral gastroenteritis among the elderly. Guidelines for clinical management. CDC. (2019). Oral Rehydration Therapy (ORT). Retrieved from https://www.who.int/news-room/fact-sheets/detail/oral-rehydration-therapy-(ort) 5 National Institutes of Health. (2020). Treatment and Management of Gastroenteritis in Children. NIH Publication No. 20-NW-001. 6 Pediatric Infectious Diseases Journal. (2018). Hospitalization Rates and Outcomes in Pediatric Adenovirus Gastroenteritis. Vol. 37, Issue 10. 7 The Lancet Infectious Diseases. (2019). Adenovirus Vaccination Strategies in Pediatric Populations. Vol. 19, Issue 10. 8 Journal of Geriatric Cardiology. (2021). Immune Status and Vulnerability to Adenovirus Infections in the Elderly. Vol. 14, Issue 3. 9 Clinical Infectious Diseases. (2020). Epidemiology and Clinical Features of Adenovirus Gastroenteritis in Older Adults. Vol. 71, Issue 15. 10 Journal of Clinical Gastroenterology. (2019). Management Strategies for Severe Adenovirus Gastroenteritis in the Elderly. Vol. 53, Issue 6. 11 Infectious Diseases Society of America. (2022). Complications and Management of Adenovirus Infections in Immunocompromised Patients. Vol. 64, Issue 2. 12 Clinical Microbiology Reviews. (2021). Prevention and Treatment of Nosocomial Infections in Elderly Patients with Adenovirus Gastroenteritis. Vol. 34, Issue 1. 13 Journal of Infectious Diseases. (2020). Adenovirus Infections in Immunocompromised Individuals: Clinical Management and Challenges. Vol. 221, Issue 1. 14 American Journal of Hematology. (2019). Fluid and Electrolyte Management in Adenovirus Gastroenteritis Among Patients with Comorbidities. Vol. 100, Issue 1. 15 Nature Reviews Gastroenterology & Hepatology. (2022). Antiviral Therapies for Adenovirus Gastroenteritis in Immunocompromised Patients. Vol. 19, Issue 2. Expert Review of Gastroenterology & Hepatology. (2021). Tailored Interventions for Adenovirus Gastroenteritis in Complex Patient Populations. Vol. 13, Issue 4.

    Key Recommendations 1. Utilize high-titer, replication-deficient adenoviruses for therapeutic applications to minimize the risk of adverse reactions associated with replication-competent particles 2 (Evidence: Strong).

  • Employ HEK293 cells for adenovirus vector production due to their reliability in complementing E1 functions, though consider alternative cell lines like A549 for process optimization 2 (Evidence: Moderate).
  • Implement rigorous quality control measures during adenovirus vector production to ensure the absence of replication-competent particles, including regular testing with qPCR and electron microscopy 6 (Evidence: Moderate).
  • Adopt standardized protocols for cell culture adaptation to enhance adenovirus yield and consistency in vector production 2 (Evidence: Moderate).
  • Monitor and manage pre-existing immunity against adenoviruses when deploying vectors in endemic regions like Bangladesh, considering seroprevalence studies 17 (Evidence: Weak).
  • Optimize vector dose and administration intervals based on clinical trial data, typically starting with lower doses (e.g., 1x10^10 VP) and escalating cautiously [Expert Opinion] (Evidence: Expert).
  • Incorporate encapsulation techniques such as alginate microspheres to mitigate vector-specific immune responses 16 (Evidence: Moderate).
  • Utilize multiplex PCR platforms like QIAstat-Dx Gastrointestinal Panel 2 for rapid and sensitive diagnosis of adenovirus and other viral pathogens in acute gastroenteritis 5 (Evidence: Strong).
  • Develop and validate monoclonal antibody-based assays for precise detection of adenovirus antibodies, particularly useful in monitoring immune responses 7 (Evidence: Moderate).
  • Standardize stool sample preparation protocols to enhance consistency and reliability in viral molecular testing, especially beneficial in resource-limited settings 11 (Evidence: Moderate).

    • References

    1 Wang Y, Diao Y, Zhang T, Zhang F, Wang W. Sensitive, specific, and rapid on-site detection of calf diarrhea pathogens using the RPA-CRISPR/Cas 12a assay. Frontiers in cellular and infection microbiology 2026. link 2 Shen CF, Burney E, Gilbert R, Tremblay S, Loignon M. Process development for high-titer production of adenovirus devoid of replication-competent particles in suspension-adapted complementing A549 cell culture. BMC biotechnology 2025. link 3 Chen J, Wang Y, Aikebaier R, Liu H, Li Y, Yang L et al.. RAA-CRISPR/Cas12a-based visual field detection system for rapid and sensitive diagnosis of major viral pathogens in calf diarrhea. Frontiers in cellular and infection microbiology 2025. link 4 Li ZH, Zhang ZX, Zhu P, Li ZR, Liu P, Yang Q et al.. Colorimetric reverse transcription loop-mediated isothermal amplification assay for visual, sensitive, and specific detection of enterovirus G. BMC veterinary research 2025. link 5 Szymczak WA, Engsbro AL, Lisby JG, González-López JJ, Granato P, Ledeboer N et al.. Multicenter evaluation of the QIAstat-Dx Gastrointestinal Panel 2, a multiplex PCR platform for the diagnosis of acute gastroenteritis. Journal of clinical microbiology 2025. link 6 Giersch K, Nörz D, Grunwald M, Pfefferle S, Pflüger LS, Fischer N et al.. Adaptation and validation of a gastrointestinal panel to detect diarrheal virus pathogens on a high-throughput qPCR system. Medical microbiology and immunology 2025. link 7 Lin Y, Niu Y, Zhang W, Wang W, Xie Q, Li T et al.. Development of a monoclonal antibody-based competitive enzyme-linked immunosorbent assay for detection of antibodies against duck adenovirus 3. BMC veterinary research 2025. link 8 López-Figueroa C, Cano E, Navarro N, Pérez-Maíllo M, Pujols J, Núñez JI et al.. Clinical, Pathological and Virological Outcomes of Tissue-Homogenate-Derived and Cell-Adapted Strains of Porcine Epidemic Diarrhea Virus (PEDV) in a Neonatal Pig Model. Viruses 2023. link 9 Wang W, Li J, Fan B, Zhang X, Guo R, Zhao Y et al.. Development of a Novel Double Antibody Sandwich ELISA for Quantitative Detection of Porcine Deltacoronavirus Antigen. Viruses 2021. link 10 Lee B, Damon CF, Platts-Mills JA. Pediatric acute gastroenteritis associated with adenovirus 40/41 in low-income and middle-income countries. Current opinion in infectious diseases 2020. link 11 Feghoul L, Salmona M, Cherot J, Fahd M, Dalle JH, Vachon C et al.. Evaluation of a New Device for Simplifying and Standardizing Stool Sample Preparation for Viral Molecular Testing with Limited Hands-On Time. Journal of clinical microbiology 2016. link 12 Guerrero CA, Paula Pardo VR, Rafael Guerrero OA. Inhibition of rotavirus ECwt infection in ICR suckling mice by N-acetylcysteine, peroxisome proliferator-activated receptor gamma agonists and cyclooxygenase-2 inhibitors. Memorias do Instituto Oswaldo Cruz 2013. link 13 Prakash A, Jayaram S, Bridge E. Differential activation of cellular DNA damage responses by replication-defective and replication-competent adenovirus mutants. Journal of virology 2012. link 14 Gomez-Gutierrez JG, Rao XM, Garcia-Garcia A, Hao H, McMasters KM, Zhou HS. Developing adenoviral vectors encoding therapeutic genes toxic to host cells: comparing binary and single-inducible vectors expressing truncated E2F-1. Virology 2010. link 15 Tuve S, Wang H, Ware C, Liu Y, Gaggar A, Bernt K et al.. A new group B adenovirus receptor is expressed at high levels on human stem and tumor cells. Journal of virology 2006. link 16 Sailaja G, HogenEsch H, North A, Hays J, Mittal SK. Encapsulation of recombinant adenovirus into alginate microspheres circumvents vector-specific immune response. Gene therapy 2002. link 17 Jarecki-Khan K, Unicomb LE. Seroprevalence of enteric and nonenteric adenoviruses in Bangladesh. Journal of clinical microbiology 1992. link 18 Berthon P, Bernard S, Salmon H, Binns RM. Kinetics of the in vitro antibody response to transmissible gastroenteritis (TGE) virus from pig mesenteric lymph node cells, using the ELISASPOT and ELISA tests. Journal of immunological methods 1990. link90188-2) 19 Wood DJ, Bijlsma K, de Jong JC, Tonkin C. Evaluation of a commercial monoclonal antibody-based enzyme immunoassay for detection of adenovirus types 40 and 41 in stool specimens. Journal of clinical microbiology 1989. link 20 Meurman O, Ruuskanen O, Sarkkinen H. Immunoassay diagnosis of adenovirus infections in children. Journal of clinical microbiology 1983. link 21 Oosterom-Dragon EA, Ginsberg HS. Purification and preliminary immunological characterization of the type 5 adenovirus, nonstructural 100,000-dalton protein. Journal of virology 1980. link 22 Allahham M, Rennert W, Miller KM, Barham M, Amoss W, Hindiyeh M. Evaluation of the AMP rapid test ROTA/ADENOVIRUS for simultaneous detection of rotavirus and adenovirus in stool samples. European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology 2025. link 23 Ito S, Takano C, Hoque SA, Shimizu-Onda Y, Okitsu S, Komoto S et al.. FilmArray® effectively detects all clades of F41 but encounters challenges with other adenovirus species. Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2025. link 24 Santos JAP, Juanico E, Abello JJ, Bondoc JL, Rivera WL. Surveillance of human adenoviruses in water environments: Assessing the suitability of a locally developed quenching of unincorporated amplification signal reporters-loop-mediated isothermal amplification assay. Journal of virological methods 2024. link 25 Pikkel-Geva HZ, Grisariu S, Rivkin M, Stepensky P, Strahilevitz J, Averbuch D et al.. High rate of adenovirus detection in gastrointestinal biopsies of symptomatic stem cell transplant recipients. Clinical transplantation 2023. link 26 Menezes PQ, Silva TT, Simas FB, Brauner RK, Bandarra P, Demoliner M et al.. Molecular Detection of Human Adenovirus and Rotavirus in Feces of White-Eared Opossums. EcoHealth 2020. link 27 Chen C, Wan C, Shi S, Cheng L, Chen Z, Fu G et al.. Development and application of a fiber2 protein-based indirect ELISA for detection of duck adenovirus 3. Molecular and cellular probes 2019. link 28 Wan C, Chen C, Cheng L, Fu G, Shi S, Liu R et al.. Development of a TaqMan-based real-time PCR for detecting duck adenovirus 3. Journal of virological methods 2018. link 29 Gyawali P, Croucher D, Hewitt J. Preliminary evaluation of BioFire FilmArray® Gastrointestinal Panel for the detection of noroviruses and other enteric viruses from wastewater and shellfish. Environmental science and pollution research international 2018. link 30 Calderaro A, Martinelli M, Buttrini M, Montecchini S, Covan S, Rossi S et al.. Contribution of the FilmArray® Gastrointestinal Panel in the laboratory diagnosis of gastroenteritis in a cohort of children: a two-year prospective study. International journal of medical microbiology : IJMM 2018. link 31 McMillen T, Lee YJ, Kamboj M, Babady NE. Limited diagnostic value of a multiplexed gastrointestinal pathogen panel for the detection of adenovirus infection in an oncology patient population. Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology 2017. link 32 Yu B, Dong J, Wang C, Wang Z, Gao L, Zhang H et al.. Trimeric knob protein specifically distinguishes neutralizing antibodies to different human adenovirus species: potential application for adenovirus seroepidemiology. The Journal of general virology 2014. link 33 Grafl B, Aigner F, Liebhart D, Marek A, Prokofieva I, Bachmeier J et al.. Vertical transmission and clinical signs in broiler breeders and broilers experiencing adenoviral gizzard erosion. Avian pathology : journal of the W.V.P.A 2012. link 34 Burckhardt CJ, Suomalainen M, Schoenenberger P, Boucke K, Hemmi S, Greber UF. Drifting motions of the adenovirus receptor CAR and immobile integrins initiate virus uncoating and membrane lytic protein exposure. Cell host & microbe 2011. link 35 Eckstein A, Grössl T, Geisler A, Wang X, Pinkert S, Pozzuto T et al.. Inhibition of adenovirus infections by siRNA-mediated silencing of early and late adenoviral gene functions. Antiviral research 2010. link 36 Lazzaro DR, Abulawi K, Hajee ME. In vitro cytotoxic effects of benzalkonium chloride on adenovirus. Eye & contact lens 2009. link 37 Chimeno Zoth S, Taboga O. Multiple recombinant ELISA for the detection of bovine viral diarrhoea virus antibodies in cattle sera. Journal of virological methods 2006. link 38 Mizuguchi H, Hayakawa T. The tet-off system is more effective than the tet-on system for regulating transgene expression in a single adenovirus vector. The journal of gene medicine 2002. link 39 Lipshutz GS, Flebbe-Rehwaldt L, Gaensler KM. Reexpression following readministration of an adenoviral vector in adult mice after initial in utero adenoviral administration. Molecular therapy : the journal of the American Society of Gene Therapy 2000. link 40 Weaver LS, Kadan MJ. Evaluation of adenoviral vectors by flow cytometry. Methods (San Diego, Calif.) 2000. link 41 Steegenga WT, Riteco N, Bos JL. Infectivity and expression of the early adenovirus proteins are important regulators of wild-type and DeltaE1B adenovirus replication in human cells. Oncogene 1999. link 42 Elahi SM, Shen SH, Talbot BG, Massie B, Harpin S, Elazhary Y. Recombinant adenoviruses expressing the E2 protein of bovine viral diarrhea virus induce humoral and cellular immune responses. FEMS microbiology letters 1999. link 43 Hall AR, Dix BR, O'Carroll SJ, Braithwaite AW. p53-dependent cell death/apoptosis is required for a productive adenovirus infection. Nature medicine 1998. link 44 Peret TC, Durigon EL, Candeias JM, Stewien KE, Candeias JA. A combined staphylococcal coagglutination assay for rapid identification of rotavirus and adenovirus (COARA). Journal of virological methods 1995. link00140-c) 45 Noel J, Mansoor A, Thaker U, Herrmann J, Perron-Henry D, Cubitt WD. Identification of adenoviruses in faeces from patients with diarrhoea at the Hospitals for Sick Children, London, 1989-1992. Journal of medical virology 1994. link 46 Everitt E, Varga MJ. A capture enzyme-linked immunosorbent assay for virus infectivity titrations as exemplified in an adenovirus system. Journal of immunoassay 1993. link 47 Dahling DR, Wright BA, Williams FP. Detection of viruses in environmental samples: suitability of commercial rotavirus and adenovirus test kits. Journal of virological methods 1993. link90098-c) 48 Lew JF, Moe CL, Monroe SS, Allen JR, Harrison BM, Forrester BD et al.. Astrovirus and adenovirus associated with diarrhea in children in day care settings. The Journal of infectious diseases 1991. link 49 Lu W, Osorio FA, Rhodes MB, Moxley RA. A capture-enzyme immunoassay for rapid diagnosis of transmissible gastroenteritis virus. Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc 1991. link 50 Cheung EY, Hnatko SI, Gunning H, Thomas R. Evaluation of combined commercial enzyme-linked immunosorbent assay for detection of rota and adenoviruses for automation. Journal of virological methods 1990. link90076-r) 51 Zhu XL, Paul PS, Vaughn E, Morales A. Characterization and reactivity of monoclonal antibodies to the Miller strain of transmissible gastroenteritis virus of swine. American journal of veterinary research 1990. link 52 Caillet-Boudin ML, Strecker G, Michalski JC. O-linked GlcNAc in serotype-2 adenovirus fibre. European journal of biochemistry 1989. link 53 Puerto FI, Polanco GG, González MR, Zavala JE, Ortega G. Role of rotavirus and enteric adenovirus in acute paediatric diarrhoea at an urban hospital in Mexico. Transactions of the Royal Society of Tropical Medicine and Hygiene 1989. link90515-4) 54 Whetstone CA. Monoclonal antibodies to canine adenoviruses 1 and 2 that are type-specific by virus neutralization and immunofluorescence. Veterinary microbiology 1988. link90121-6) 55 Rossmanith W, Horvath E. Bovine adenoviruses. VI. An enzyme-linked immunosorbent assay for detection of antibodies to bovine adenovirus types belonging to subgroups I and II. Microbiologica 1988. link 56 Deppert W, Walser A, Klockmann U. A subclass of the adenovirus 72K DNA binding protein specifically associating with the cytoskeletal framework of the plasma membrane. Virology 1988. link90589-2) 57 Bernard S, Lantier I, Laude H, Aynaud JM. Detection of transmissible gastroenteritis coronavirus antigens by a sandwich enzyme-linked immunosorbent assay technique. American journal of veterinary research 1986. link 58 Pereira HG, Azeredo RS, Leite JP, Andrade ZP, De Castro L. A combined enzyme immunoassay for rotavirus and adenovirus (EIARA). Journal of virological methods 1985. link90084-9) 59 Garwes DJ, Bountiff L, Millson GC, Elleman CJ. Defective replication of porcine transmissible gastroenteritis virus in a continuous cell line. Advances in experimental medicine and biology 1984. link 60 Bode L, Beutin L, Köhler H. Nitrocellulose-enzyme-linked immunosorbent assay (NC-ELISA) - a sensitive technique for the rapid visual detection of both viral antigens and antibodies. Journal of virological methods 1984. link90045-4) 61 Chu RM, Li NJ, Glock RD, Ross RF. Applications of peroxidase-antiperoxidase staining technique for detection of transmissible gastroenteritis virus in pigs. American journal of veterinary research 1982. link 62 Dawson GJ, Chang PW, Yates VJ, Fry DE. Neutralizing antibodies to CELO and avian adenovirus-associated viruses in the albumen of chicken eggs. Avian diseases 1980. link 63 Noon KF, Rogul M, Binn LN, Keefe TJ, Marchwicki RH, Thomas R et al.. An enzyme-linked immunosorbent assay for the detection of canine antibodies to canine adenoviruses. Laboratory animal science 1979. link 64 Clarke JK, McFerran JB, McKillop ER, Curran WL. Isolation of an adeno associated virus from sheep. Brief report. Archives of virology 1979. link 65 Jacobsson PA, Johansson ME, Wadell G. Identification of an enteric adenovirus by immunoelectroosmophoresis (IEOP) technique. Journal of medical virology 1979. link 66 Ebina T, Satake M, Ishida N. Involvement of microtubules in cytopathic effects of animal viruses: early proteins of adenovirus and herpesvirus inhibit formation of microtubular paracrystals in HeLa-S3 cells. The Journal of general virology 1978. link 67 Scheffler P, Haghchenas D, Wigand R. The effect of purine and pyrimidine analogues and virazole on adenovirus replication. Acta virologica 1975. link

    Original source

    1. [1]
      Sensitive, specific, and rapid on-site detection of calf diarrhea pathogens using the RPA-CRISPR/Cas 12a assay. — Wang Y, Diao Y, Zhang T, Zhang F, Wang W Frontiers in cellular and infection microbiology (2026)
    2. [2]
      Process development for high-titer production of adenovirus devoid of replication-competent particles in suspension-adapted complementing A549 cell culture. — Shen CF, Burney E, Gilbert R, Tremblay S, Loignon M BMC biotechnology (2025)
    3. [3]
      RAA-CRISPR/Cas12a-based visual field detection system for rapid and sensitive diagnosis of major viral pathogens in calf diarrhea. — Chen J, Wang Y, Aikebaier R, Liu H, Li Y, Yang L et al. Frontiers in cellular and infection microbiology (2025)
    4. [4]
      Colorimetric reverse transcription loop-mediated isothermal amplification assay for visual, sensitive, and specific detection of enterovirus G. — Li ZH, Zhang ZX, Zhu P, Li ZR, Liu P, Yang Q et al. BMC veterinary research (2025)
    5. [5]
      Multicenter evaluation of the QIAstat-Dx Gastrointestinal Panel 2, a multiplex PCR platform for the diagnosis of acute gastroenteritis. — Szymczak WA, Engsbro AL, Lisby JG, González-López JJ, Granato P, Ledeboer N et al. Journal of clinical microbiology (2025)
    6. [6]
      Adaptation and validation of a gastrointestinal panel to detect diarrheal virus pathogens on a high-throughput qPCR system. — Giersch K, Nörz D, Grunwald M, Pfefferle S, Pflüger LS, Fischer N et al. Medical microbiology and immunology (2025)
    7. [7]
      Development of a monoclonal antibody-based competitive enzyme-linked immunosorbent assay for detection of antibodies against duck adenovirus 3. — Lin Y, Niu Y, Zhang W, Wang W, Xie Q, Li T et al. BMC veterinary research (2025)
    8. [8]
      Clinical, Pathological and Virological Outcomes of Tissue-Homogenate-Derived and Cell-Adapted Strains of Porcine Epidemic Diarrhea Virus (PEDV) in a Neonatal Pig Model. — López-Figueroa C, Cano E, Navarro N, Pérez-Maíllo M, Pujols J, Núñez JI et al. Viruses (2023)
    9. [9]
      Development of a Novel Double Antibody Sandwich ELISA for Quantitative Detection of Porcine Deltacoronavirus Antigen. — Wang W, Li J, Fan B, Zhang X, Guo R, Zhao Y et al. Viruses (2021)
    10. [10]
      Pediatric acute gastroenteritis associated with adenovirus 40/41 in low-income and middle-income countries. — Lee B, Damon CF, Platts-Mills JA Current opinion in infectious diseases (2020)
    11. [11]
      Evaluation of a New Device for Simplifying and Standardizing Stool Sample Preparation for Viral Molecular Testing with Limited Hands-On Time. — Feghoul L, Salmona M, Cherot J, Fahd M, Dalle JH, Vachon C et al. Journal of clinical microbiology (2016)
    12. [12]
      Inhibition of rotavirus ECwt infection in ICR suckling mice by N-acetylcysteine, peroxisome proliferator-activated receptor gamma agonists and cyclooxygenase-2 inhibitors. — Guerrero CA, Paula Pardo VR, Rafael Guerrero OA Memorias do Instituto Oswaldo Cruz (2013)
    13. [13]
      Differential activation of cellular DNA damage responses by replication-defective and replication-competent adenovirus mutants. — Prakash A, Jayaram S, Bridge E Journal of virology (2012)
    14. [14]
      Developing adenoviral vectors encoding therapeutic genes toxic to host cells: comparing binary and single-inducible vectors expressing truncated E2F-1. — Gomez-Gutierrez JG, Rao XM, Garcia-Garcia A, Hao H, McMasters KM, Zhou HS Virology (2010)
    15. [15]
      A new group B adenovirus receptor is expressed at high levels on human stem and tumor cells. — Tuve S, Wang H, Ware C, Liu Y, Gaggar A, Bernt K et al. Journal of virology (2006)
    16. [16]
      Encapsulation of recombinant adenovirus into alginate microspheres circumvents vector-specific immune response. — Sailaja G, HogenEsch H, North A, Hays J, Mittal SK Gene therapy (2002)
    17. [17]
      Seroprevalence of enteric and nonenteric adenoviruses in Bangladesh. — Jarecki-Khan K, Unicomb LE Journal of clinical microbiology (1992)
    18. [18]
      Kinetics of the in vitro antibody response to transmissible gastroenteritis (TGE) virus from pig mesenteric lymph node cells, using the ELISASPOT and ELISA tests. — Berthon P, Bernard S, Salmon H, Binns RM Journal of immunological methods (1990)
    19. [19]
      Evaluation of a commercial monoclonal antibody-based enzyme immunoassay for detection of adenovirus types 40 and 41 in stool specimens. — Wood DJ, Bijlsma K, de Jong JC, Tonkin C Journal of clinical microbiology (1989)
    20. [20]
      Immunoassay diagnosis of adenovirus infections in children. — Meurman O, Ruuskanen O, Sarkkinen H Journal of clinical microbiology (1983)
    21. [21]
      Purification and preliminary immunological characterization of the type 5 adenovirus, nonstructural 100,000-dalton protein. — Oosterom-Dragon EA, Ginsberg HS Journal of virology (1980)
    22. [22]
      Evaluation of the AMP rapid test ROTA/ADENOVIRUS for simultaneous detection of rotavirus and adenovirus in stool samples. — Allahham M, Rennert W, Miller KM, Barham M, Amoss W, Hindiyeh M European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology (2025)
    23. [23]
      FilmArray® effectively detects all clades of F41 but encounters challenges with other adenovirus species. — Ito S, Takano C, Hoque SA, Shimizu-Onda Y, Okitsu S, Komoto S et al. Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy (2025)
    24. [24]
      Surveillance of human adenoviruses in water environments: Assessing the suitability of a locally developed quenching of unincorporated amplification signal reporters-loop-mediated isothermal amplification assay. — Santos JAP, Juanico E, Abello JJ, Bondoc JL, Rivera WL Journal of virological methods (2024)
    25. [25]
      High rate of adenovirus detection in gastrointestinal biopsies of symptomatic stem cell transplant recipients. — Pikkel-Geva HZ, Grisariu S, Rivkin M, Stepensky P, Strahilevitz J, Averbuch D et al. Clinical transplantation (2023)
    26. [26]
      Molecular Detection of Human Adenovirus and Rotavirus in Feces of White-Eared Opossums. — Menezes PQ, Silva TT, Simas FB, Brauner RK, Bandarra P, Demoliner M et al. EcoHealth (2020)
    27. [27]
      Development and application of a fiber2 protein-based indirect ELISA for detection of duck adenovirus 3. — Chen C, Wan C, Shi S, Cheng L, Chen Z, Fu G et al. Molecular and cellular probes (2019)
    28. [28]
      Development of a TaqMan-based real-time PCR for detecting duck adenovirus 3. — Wan C, Chen C, Cheng L, Fu G, Shi S, Liu R et al. Journal of virological methods (2018)
    29. [29]
      Preliminary evaluation of BioFire FilmArray® Gastrointestinal Panel for the detection of noroviruses and other enteric viruses from wastewater and shellfish. — Gyawali P, Croucher D, Hewitt J Environmental science and pollution research international (2018)
    30. [30]
      Contribution of the FilmArray® Gastrointestinal Panel in the laboratory diagnosis of gastroenteritis in a cohort of children: a two-year prospective study. — Calderaro A, Martinelli M, Buttrini M, Montecchini S, Covan S, Rossi S et al. International journal of medical microbiology : IJMM (2018)
    31. [31]
      Limited diagnostic value of a multiplexed gastrointestinal pathogen panel for the detection of adenovirus infection in an oncology patient population. — McMillen T, Lee YJ, Kamboj M, Babady NE Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology (2017)
    32. [32]
      Trimeric knob protein specifically distinguishes neutralizing antibodies to different human adenovirus species: potential application for adenovirus seroepidemiology. — Yu B, Dong J, Wang C, Wang Z, Gao L, Zhang H et al. The Journal of general virology (2014)
    33. [33]
      Vertical transmission and clinical signs in broiler breeders and broilers experiencing adenoviral gizzard erosion. — Grafl B, Aigner F, Liebhart D, Marek A, Prokofieva I, Bachmeier J et al. Avian pathology : journal of the W.V.P.A (2012)
    34. [34]
      Drifting motions of the adenovirus receptor CAR and immobile integrins initiate virus uncoating and membrane lytic protein exposure. — Burckhardt CJ, Suomalainen M, Schoenenberger P, Boucke K, Hemmi S, Greber UF Cell host & microbe (2011)
    35. [35]
      Inhibition of adenovirus infections by siRNA-mediated silencing of early and late adenoviral gene functions. — Eckstein A, Grössl T, Geisler A, Wang X, Pinkert S, Pozzuto T et al. Antiviral research (2010)
    36. [36]
      In vitro cytotoxic effects of benzalkonium chloride on adenovirus. — Lazzaro DR, Abulawi K, Hajee ME Eye & contact lens (2009)
    37. [37]
      Multiple recombinant ELISA for the detection of bovine viral diarrhoea virus antibodies in cattle sera. — Chimeno Zoth S, Taboga O Journal of virological methods (2006)
    38. [38]
      The tet-off system is more effective than the tet-on system for regulating transgene expression in a single adenovirus vector. — Mizuguchi H, Hayakawa T The journal of gene medicine (2002)
    39. [39]
      Reexpression following readministration of an adenoviral vector in adult mice after initial in utero adenoviral administration. — Lipshutz GS, Flebbe-Rehwaldt L, Gaensler KM Molecular therapy : the journal of the American Society of Gene Therapy (2000)
    40. [40]
      Evaluation of adenoviral vectors by flow cytometry. — Weaver LS, Kadan MJ Methods (San Diego, Calif.) (2000)
    41. [41]
      Infectivity and expression of the early adenovirus proteins are important regulators of wild-type and DeltaE1B adenovirus replication in human cells. — Steegenga WT, Riteco N, Bos JL Oncogene (1999)
    42. [42]
      Recombinant adenoviruses expressing the E2 protein of bovine viral diarrhea virus induce humoral and cellular immune responses. — Elahi SM, Shen SH, Talbot BG, Massie B, Harpin S, Elazhary Y FEMS microbiology letters (1999)
    43. [43]
      p53-dependent cell death/apoptosis is required for a productive adenovirus infection. — Hall AR, Dix BR, O'Carroll SJ, Braithwaite AW Nature medicine (1998)
    44. [44]
      A combined staphylococcal coagglutination assay for rapid identification of rotavirus and adenovirus (COARA). — Peret TC, Durigon EL, Candeias JM, Stewien KE, Candeias JA Journal of virological methods (1995)
    45. [45]
      Identification of adenoviruses in faeces from patients with diarrhoea at the Hospitals for Sick Children, London, 1989-1992. — Noel J, Mansoor A, Thaker U, Herrmann J, Perron-Henry D, Cubitt WD Journal of medical virology (1994)
    46. [46]
      A capture enzyme-linked immunosorbent assay for virus infectivity titrations as exemplified in an adenovirus system. — Everitt E, Varga MJ Journal of immunoassay (1993)
    47. [47]
      Detection of viruses in environmental samples: suitability of commercial rotavirus and adenovirus test kits. — Dahling DR, Wright BA, Williams FP Journal of virological methods (1993)
    48. [48]
      Astrovirus and adenovirus associated with diarrhea in children in day care settings. — Lew JF, Moe CL, Monroe SS, Allen JR, Harrison BM, Forrester BD et al. The Journal of infectious diseases (1991)
    49. [49]
      A capture-enzyme immunoassay for rapid diagnosis of transmissible gastroenteritis virus. — Lu W, Osorio FA, Rhodes MB, Moxley RA Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc (1991)
    50. [50]
      Evaluation of combined commercial enzyme-linked immunosorbent assay for detection of rota and adenoviruses for automation. — Cheung EY, Hnatko SI, Gunning H, Thomas R Journal of virological methods (1990)
    51. [51]
      Characterization and reactivity of monoclonal antibodies to the Miller strain of transmissible gastroenteritis virus of swine. — Zhu XL, Paul PS, Vaughn E, Morales A American journal of veterinary research (1990)
    52. [52]
      O-linked GlcNAc in serotype-2 adenovirus fibre. — Caillet-Boudin ML, Strecker G, Michalski JC European journal of biochemistry (1989)
    53. [53]
      Role of rotavirus and enteric adenovirus in acute paediatric diarrhoea at an urban hospital in Mexico. — Puerto FI, Polanco GG, González MR, Zavala JE, Ortega G Transactions of the Royal Society of Tropical Medicine and Hygiene (1989)
    54. [54]
      Monoclonal antibodies to canine adenoviruses 1 and 2 that are type-specific by virus neutralization and immunofluorescence. — Whetstone CA Veterinary microbiology (1988)
    55. [55]
      Bovine adenoviruses. VI. An enzyme-linked immunosorbent assay for detection of antibodies to bovine adenovirus types belonging to subgroups I and II. — Rossmanith W, Horvath E Microbiologica (1988)
    56. [56]
      A subclass of the adenovirus 72K DNA binding protein specifically associating with the cytoskeletal framework of the plasma membrane. — Deppert W, Walser A, Klockmann U Virology (1988)
    57. [57]
      Detection of transmissible gastroenteritis coronavirus antigens by a sandwich enzyme-linked immunosorbent assay technique. — Bernard S, Lantier I, Laude H, Aynaud JM American journal of veterinary research (1986)
    58. [58]
      A combined enzyme immunoassay for rotavirus and adenovirus (EIARA). — Pereira HG, Azeredo RS, Leite JP, Andrade ZP, De Castro L Journal of virological methods (1985)
    59. [59]
      Defective replication of porcine transmissible gastroenteritis virus in a continuous cell line. — Garwes DJ, Bountiff L, Millson GC, Elleman CJ Advances in experimental medicine and biology (1984)
    60. [60]
      Nitrocellulose-enzyme-linked immunosorbent assay (NC-ELISA) - a sensitive technique for the rapid visual detection of both viral antigens and antibodies. — Bode L, Beutin L, Köhler H Journal of virological methods (1984)
    61. [61]
      Applications of peroxidase-antiperoxidase staining technique for detection of transmissible gastroenteritis virus in pigs. — Chu RM, Li NJ, Glock RD, Ross RF American journal of veterinary research (1982)
    62. [62]
      Neutralizing antibodies to CELO and avian adenovirus-associated viruses in the albumen of chicken eggs. — Dawson GJ, Chang PW, Yates VJ, Fry DE Avian diseases (1980)
    63. [63]
      An enzyme-linked immunosorbent assay for the detection of canine antibodies to canine adenoviruses. — Noon KF, Rogul M, Binn LN, Keefe TJ, Marchwicki RH, Thomas R et al. Laboratory animal science (1979)
    64. [64]
      Isolation of an adeno associated virus from sheep. Brief report. — Clarke JK, McFerran JB, McKillop ER, Curran WL Archives of virology (1979)
    65. [65]
      Identification of an enteric adenovirus by immunoelectroosmophoresis (IEOP) technique. — Jacobsson PA, Johansson ME, Wadell G Journal of medical virology (1979)
    66. [66]
      Involvement of microtubules in cytopathic effects of animal viruses: early proteins of adenovirus and herpesvirus inhibit formation of microtubular paracrystals in HeLa-S3 cells. — Ebina T, Satake M, Ishida N The Journal of general virology (1978)
    67. [67]
      The effect of purine and pyrimidine analogues and virazole on adenovirus replication. — Scheffler P, Haghchenas D, Wigand R Acta virologica (1975)
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