Arch Pediatr Infect Dis. 2014 April; 2(2): e15930. DOI: 10.5812/pedinfect.15930 Published online 2014 February 24. Research Article Detection of Adenovirus Infection Among Children With Acute Respiratory Disease During 2010-2012 in Shiraz, Iran Afagh Moattari 1,* ; Amir Emami 1 ; Neda Pirbonyeh 1 ; Ramin Yaghoobi 2 1 Bacteriology and Virology Department, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran 2 Shiraz Transplant Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran *Corresponding author: Afagh Moattari, Bacteriology and Virology Department, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-9173136844, Fax: +98-7112304356, E-mail: moattaria@yahoo.com Received: November 2, 2013; Revised: December 4, 2013; Accepted: January 15, 2014 Background: Acute respiratory viral infection (ARVI) is a common cause of morbidity and mortality especially in pediatric patients. Among important respiratory pathogens, adenovirus is a most prevalent cause of upper and lower respiratory tract infection. Objectives: The aim of the present study was to determine the prevalence of adenovirus infection in pediatric patients with respiratory symptoms. Patients and Methods: This cross-sectional study was conducted from November 2010 to February 2012. An in-house nested-PCR was used to detect adenovirus in nasopharyngeal swabs from 328 children with 19 years of age or younger with acute upper respiratory tract symptoms referred to the hospitals affiliated with Shiraz University of Medical Sciences. Results: In this study, 150 (45.73%) and 178 (54.26%) patients were male and female, respectively. Among the patients, 243 (74.08%) patients were hospitalized in Shiraz teaching hospitals with ARVI related symptoms. The most common detected symptoms were fever, cough, and muscular pain. Most infected patients were children older than 5-year-old. According to the statistical analysis by using SPSS software, we did not find significant association between adenovirus infection and the risk factors such as age and sex, except an association with the seasonal time. Conclusions: The results of this study showed that the acute respiratory infection due to adenovirus in Shiraz mostly occurred during November 2011 to February 2012. In contrast to other studies, human adenovirus infection was more prevalent in children aged older than five-year-old. In addition, the infection rate in females was higher than in males. Keywords:Adenoviridae Infections; Respiratory Tract Infection; Pediatrics; Iran Implication for health policy/practice/research/medical education: With Regard to the high prevalence of respiratory infections especially Influenza worldwide, all of the attentions are focused on this viral agent. Hence, that many other agents like adenovirus, which is another important agent among respiratory acute infection, are neglected, we tried to identify this important agent beside influenza virus and other viral agents as a potential cause of respiratory infection. Copyright © 2014, Pediartric Infections Research Center; Published by Kowsar Corp. This is an open-access article distributed under the terms of the Creative Com- mons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 1. Background Acute respiratory tract infections (ARTI) are regarded as important causes of morbidity and mortality in pediat- ric patients. This refers to both outpatient visits and 20- 40% of hospitalized patients (1, 2). The significant impact of these infections on developing countries is based on the fact that nearly 50% of pediatric consultations are re- lated to the respiratory tract infection (RTI) (3). The world health organization (WHO) ranks the lower RTIs as the leading cause of disease worldwide, which accounts for 4 million deaths per year (2, 4). RTI can be life-threatening depending on the causative agent and host condition. A high incidence of RTI in children is due to increasing exposure of young children to siblings and friends with RTI, childcare centers, and environmental factors. Addi- tionally, susceptibility to ARTI may be due to inherited disorders of the immune system, which are responsible for 45-60% of all acute respiratory diseases in infants and young children (2, 3). Most of these infections are caused by respiratory syncytial virus (RSV), influenza virus A or B (FluV), parainfluenza virus (PIV), rhinovirus (RV), and hu- man adenovirus (HAdV). Several recently discovered vi- ruses such as human metapneumovirus (HMPV), human bocavirus (HBoV), and human coronaviruses (HCoV) have been identified as potential respiratory pathogens (5). Adenoviruses, first isolated in the 1950s from explanted adenoid tissue, are double-stranded non-enveloped DNA viruses that naturally infect many vertebrates including human and non-human primates (6). Human adenovi- ruses (HAdV) are grouped into seven species of A to G and to date, 56 different types (HAdV-1 to HAdV-56) have been described based on serology, whole genome sequencing, or phylogenomics (7-9). Adenovirus accounts for 5-15% of upper and lower RTIs in infants and children hospital- ized for respiratory disease (2, 10). Clinical signs of an AdV infection are rather nonspecific and variable and include tonsillopharyngitis, conjunctivitis, pneumonia, gastro- Archive of SID www.SID.ir