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Killer Cold Virus: Questions, Answers

Despite New Ad14 Bug's Fatal Potential, Most Get Mild Illness

Let's say my spouse or my child gets cold or flu symptoms. When is it time to call a doctor?

Anderson: "The things to watch out for are persistent fever, a fever that keeps getting higher, or any trouble breathing. It is a matter of symptoms getting more severe -- and when you reach the point of needing medical attention depends on the age and underlying physical condition of the person who is ill."

The earliest victim of this new virus was a baby. What's the message to parents in terms of watching a child with a runny nose or a cold?

Anderson: "Small children always have a runny nose. And there is a whole host of things that can become more severe in the infant; Ad14 is just one of those. Particularly in a young infant, the criteria that you use to decide whether to check with a doctor are different in different situations. For example, in this New York child that died, lethargy and poor feeding were an indication of a more severe illness.

"Really, it is hard to tell. But a mother knows when her child is sick. If you think your child is sick, consult a doctor. It does no harm for a new mother who is not experienced just to call a doctor when she's not sure, just to check in."

How can you know if you have an Ad14 infection?

Anderson: "If you have a serious case of pneumonia, it could be Ad14. Then your doctor should check with the local health department. Ad14 needs to be included in the list of possible causes of severe pneumonia -- but it is not the situation where you have a test and are scared because it's Ad14. Because if you had Ad14 and a cold, you would not do anything different unless you got sicker. So you treat and monitor a flu-like illness based on the severity of clinical symptoms. Suspecting that is it Ad14 doesn't tell you your illness is bad. But if it is bad, your doctor may suspect Ad14 as one of several possible causes."

Is there any particular treatment for Ad14 illness?

Anderson: "There is no antiviral drug licensed or known to be effective for adenovirus infections. Treatment is specific to the symptoms. If a person is having trouble breathing, that patient may be intubated in really severe cases."

Who is most at risk of Ad14 infection and severe illness?

Anderson: "Adenoviruses have been a problem for military recruits for a long time. Ad3, Ad4, Ad7, sometimes Ad21, now Ad14. That appears to be a problem because of crowding together in open-floor dorms, and it is possibly related to stress and physical exertion. But this has been going on for a long time.

"Otherwise we don't know a lot about Ad14. We have not been watching it that long. What we do know, if we look at the individuals that had more severe disease, it is the young infant and the older patient. Infants are at risk of a number of infections because they are small, they have immature immune systems, and they are not as good as adults are at fighting off infections. But non-military cases were in older patients. So this gets down to the same groups that would be at risk for flu or other respiratory pathogens.

"The real message is that clinician and public-health folks, when they thinking about patients with pneumonia for which they don't know the cause, to keep Ad14 on the suspect list of pathogens that may be causing the illness. This is important not so much for the individual person as for public health measures."

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