Owing to the diverse epidemiology of the wide spectrum of human adenoviruses, exposure and infection are possible by a variety of routes. Person-to-person contact plays a major role in the transmission of illness; depending on the nature of the illness, this can include faecal–oral, oral–oral and hand–eye contact transmission, as well as indirect transfer through contaminated surfaces or shared utensils. There have been numerous outbreaks associated with hospitals, military establishments, childcare centres and schools. Symptoms recorded in most outbreaks were acute respiratory disease, keratoconjunctivitis and conjunctivitis. Outbreaks of gastroenteritis have also been reported. The consumption of contaminated food or water may be an important source of enteric illness, although there is no substantial evidence supporting this route of transmission. Eye infections may be contracted by the exposure of eyes to contaminated water, the sharing of towels at swimming pools or the sharing of goggles, as in the case of “shipyard eye”. Confi rmed outbreaks of adenovirus infections associated with water have been limited to pharyngitis or conjunctivitis, with exposure arising from use of swimming pools.