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Human adenovirus (HAdV) belongs to
the Mastadenovirus genus of the
family Adenoviridae. HAdVs have a
linear, double-stranded DNA genome that is 34–37 kb in size 1. On the basis of biological and
genetic characteristics, HAdVs are classified into 7 subgenera (HAdV-A to
HAdV-G) which are sub-divided into at least 78 serotypes (HAdV-1 to HAdV-78) 2-5. Depending on the tropism, HAdVs can cause a
multitude of diseases including gastroenteritis (HAdV-A, -F and -G), respiratory
diseases (HAdV-B, -C, and -E), keratoconjunctivitis (HAdV-D) 3,
6-8. Among 7 subgenera, subgenus HAdV-F representing type
40 and 41 is associated with acute gastroenteritis; the incidence ratio is higher
in low- or middle-income countries (2-31%) compared to the high-income
countries (1-8%) 9-12. Other subgenera such as HAdV-A (types 12, 18 and 31)
13, HAdV-C (types 1, 2 and 5) and HAdV-D
(types 28, 29, 30, 32, 37, 43 to 46) 14-16, and HAdV-G (type 52) 17 have also been identified
sporadically in patients with gastroenteritis, however, their role in causing
diarrhea remains unclear.

Enteric adenoviruses can spread
predominantly by the fecal-oral route 12,
18. Usually, after an incubation period of 8-10 days,
periodic diarrhea occurs with low grade fever, vomiting, abdominal pains, and mild
dehydration 19. The clinical course is usually mild
and self-limiting and usually lasts 1-2 weeks. A distinct feature of HAdV-40
and -41 infections is the protracted diarrhea. Until now, no drugs or vaccines
are available but oral rehydration saline is recommended like other diarrhea
patient management.

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In Bangladesh, the epidemiology of HAdV associated
diarrhea remains poorly understood. Earlier studies reported 1.9 to 3.9% prevalence
among diarrhea patients, which failed to depict the true scenario of HAdV
burden as because these studies were conducted with limited sample size over a short
time-frame 20-22. The present study was carried out between 2012 and
2015 among diarrhea patients who admitted to an urban hospital situated in Dhaka,
the capital city of Bangladesh. Herein, we describe (a) the prevalence of HAdVs
in diarrheal patients over a 4-year time period; (b) clinical spectrum
associated with HAdV gastroenteritis; (c) genetic diversity of HAdVs and (d) co-pathogens
with HAdVs and their association towards the disease severity.

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