American Journal of Epidemiology Vol. 105, No. 4: 362-386
Copyright © 1977 by The Johns Hopkins University School of Hygiene and Public Health
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THE SEATTLE VIRUS WATCH
VII. OBSERVATIONS OF ADENOVIRUS INFECTIONS1
2Department of Epidemiology, School of Public Health and Community Medicine, University of Washington Seattle, WA 98195
3Department of Pathobiology, School of Public Health and Community Medicine, University of Washington Seattle
The following findings were made from observations of adenovirus (AV) infections in Seattle VW families, 1965–1969, which extended the 1961–1965 New York VW studies: That infections are predominantly enteric, may be abortive or invasive and followed by persistent intermittent excretion was confirmed. That such excretion is most characteristic of types 1, 2, 3 and 5 viruses may explain why these types were usually endemic. However, since observed duration of excretion was not increased despite a longer average observation period, persistent excretion appears not to continue indefinitely and generation-to-generation transmission now seems improbable. Unlike New York, alternate cycling of types 1 and 2 viruses was not seen. Among homotypic susceptibles, infection rates for the endemic types were highest in infants (>90% for types 1 and 2), decreased with age in older children but increased in parents, perhaps because of closer contact with infants. Development of serum neutralizing antibody was most frequent (about 90%) after types 1 and 2 infection; in all cases, titers decayed over time. While delayed virus spread related to persistent intermittent excretion did occur, spread closely following new or renewed (after 
3 months) excretion was more important. Sibling introducers were more effective spreaders than infants, and duration of excretion was more important than mode. These data indicate that homotypic immunity is 85% protective against infection. A protective effect of heterotypic immunity could not be shown. Illness (chiefly respiratory and often febrile) was associated with 49% of infections in susceptibles and with 65% when respiratory shedding occurred. The contribution of AV to all infectious illness, based on virus-positive infections only, was 5% in infants and 3% in the 2–4-year age group; for febrile illness, the corresponding contributions were about 10% and 5%. Inclusion of infections discovered only by serology (49% of all infections) would greatly increase the contribution of AV to illness.
adenovirus infections; antibodies; viral; epidemiology; immunity; infection; longitudinal studies; virus diseases
1This research was aided by grant AI 07062 from the National Institute of Allergy and Infectious Diseases.
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