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Epidemic Keratoconjunctivitis: Report of an Outbreak in an Ophthalmology Practice and Recommendations for Prevention

Published online by Cambridge University Press:  02 January 2015

James W. Buehler ,
Robert J. Finton ,
Richard A. Goodman ,
Keewhan Choi ,
John C. Hierholzer ,
R. Keith Sikes  and
William R. Elsea
James W. Buehler*
Affiliation:
Division of Field Services, Epidemiology Program Office, Centers for Disease Control, the Office of Epidemiology, Georgia Department of Human Resources, Atlanta, Georgia Fulton County Health Department; Consolidated Surveillance and Communications Activities, Epidemiology Program Office, Centers for Disease Control, Atlanta, Georgia Respiratory Virology Branch, Viral Diseases Division, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
Robert J. Finton
Affiliation:
Division of Field Services, Epidemiology Program Office, Centers for Disease Control, the Office of Epidemiology, Georgia Department of Human Resources, Atlanta, Georgia Fulton County Health Department; Consolidated Surveillance and Communications Activities, Epidemiology Program Office, Centers for Disease Control, Atlanta, Georgia Respiratory Virology Branch, Viral Diseases Division, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
Richard A. Goodman
Affiliation:
Division of Field Services, Epidemiology Program Office, Centers for Disease Control, the Office of Epidemiology, Georgia Department of Human Resources, Atlanta, Georgia Fulton County Health Department; Consolidated Surveillance and Communications Activities, Epidemiology Program Office, Centers for Disease Control, Atlanta, Georgia Respiratory Virology Branch, Viral Diseases Division, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
Keewhan Choi
Affiliation:
Division of Field Services, Epidemiology Program Office, Centers for Disease Control, the Office of Epidemiology, Georgia Department of Human Resources, Atlanta, Georgia Fulton County Health Department; Consolidated Surveillance and Communications Activities, Epidemiology Program Office, Centers for Disease Control, Atlanta, Georgia Respiratory Virology Branch, Viral Diseases Division, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
John C. Hierholzer
Affiliation:
Division of Field Services, Epidemiology Program Office, Centers for Disease Control, the Office of Epidemiology, Georgia Department of Human Resources, Atlanta, Georgia Fulton County Health Department; Consolidated Surveillance and Communications Activities, Epidemiology Program Office, Centers for Disease Control, Atlanta, Georgia Respiratory Virology Branch, Viral Diseases Division, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
R. Keith Sikes
Affiliation:
Division of Field Services, Epidemiology Program Office, Centers for Disease Control, the Office of Epidemiology, Georgia Department of Human Resources, Atlanta, Georgia Fulton County Health Department; Consolidated Surveillance and Communications Activities, Epidemiology Program Office, Centers for Disease Control, Atlanta, Georgia Respiratory Virology Branch, Viral Diseases Division, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
William R. Elsea
Affiliation:
Division of Field Services, Epidemiology Program Office, Centers for Disease Control, the Office of Epidemiology, Georgia Department of Human Resources, Atlanta, Georgia Fulton County Health Department; Consolidated Surveillance and Communications Activities, Epidemiology Program Office, Centers for Disease Control, Atlanta, Georgia Respiratory Virology Branch, Viral Diseases Division, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
*
Division of Field Services, Epidemiology Program Office, Centers for Disease Control, Atlanta, GA 30333
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Abstract

In Fall 1981, an outbreak of acute infectious conjunctivitis with keratitis (EKC) occurred in patients who had visited a private ophthalmology clinic just prior to onset of illness. Among an estimated 2,200 patient visits to the office from August 10 to October 15, 1981 for problems unrelated to infectious conjunctivitis, 39 (1.8%) persons subsequently developed EKC. The median incubation period was 6.5 days (range, 1 to 14 days). A case-control study was done to identify risk factors associated with contracting EKC; patients with EKC were more likely than control patients to have been examined by one or the other of two of the four ophthalmologists at the clinic and to have undergone procedures such as tonometry or foreign body removal. Adenovirus was isolated from conjunctival swabs from four of five persons with conjunctivitis; three were type 8 and one was type 7. Recognition of the problem and improved handwashing practices were associated with terminating the outbreak. This outbreak illustrates the potential for transmission of adenovirus infection during the provision of eye care. Infection control practitioners should be familiar with measures for the prevention of such infections among ophthalmology patients.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 5 , Issue 8 , August 1984 , pp. 390 - 394
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1984

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References

1.Jawetz, E, The story of shipyard eye. Br Med J 1959;1:873–876.CrossRefGoogle ScholarPubMed
2.Pellitteri, OJ, Fried, JJ, Epidemic keratoconjunctivitis, report of a small office outbreak. Am J Ophthalmol 1950;33:1596–1599.CrossRefGoogle ScholarPubMed
3.Leopold, IH, Characteristics of hospital epidemics of epidemic keratoconjunctivitis. Am J Ophthalmol 1957;43:93–97.CrossRefGoogle ScholarPubMed
4.Thygeson, P, Office and dispensary transmissions of epidemic keratoconjunctivitis. Am J Ophthalmol 1957;43:98–101.CrossRefGoogle ScholarPubMed
5.Dawson, C, Darrell, R, Infections due to adenovirus type 8 in the United States. I. An outbreak of epidemic keratoconjunctivitis originating in a physician's office. N Engl J Med 1963;268:1031–1034.CrossRefGoogle Scholar
6.Davidson, SI, Epidemic kerato-conjunctivitis, report of an outbreak which resulted in ward cross-infection. Br J Ophthalmol 1964;48:573–580.CrossRefGoogle ScholarPubMed
7.Laibson, PR, Ortolan, G, Dupre-Strachan, S, Community and hospital outbreak of epidemic keratoconjunctivitis. Arch Ophthalmol 1968;80:467–473.CrossRefGoogle ScholarPubMed
8.Dawson, CR, Hanna, L, Wood, TR, et al: Adenovirus type 8 conjunctivitis in the United States. III. Epidemiologic, clinical, and microbiologic features. Am J Ophthalmol 1970;69:473–480.CrossRefGoogle Scholar
9.Wegman, DH, Guinee, VF, Millian, SJ, Epidemic keratoconjunctivitis. Am J Public Health 1970;60:1230–1237.CrossRefGoogle ScholarPubMed
10.Barnard, DL, Hart, JCD, Marmion, VJ, et al: Outbreak in Bristol of conjunctivitis caused by adenovirus type 8, and its epidemiology and control. Br Med J 1973;2:165–169.CrossRefGoogle ScholarPubMed
11.Sprague, JB, Hierholzer, JC, Currier, RW, et al: Epidemic keratoconjunctivitis, a severe industrial outbreak due to adenovirus type 8. N Engl J Med 1973;289:1341–1346.CrossRefGoogle ScholarPubMed
12.Centers for Disease Control: Keratoconjunctivitis due to adenovirus type 19—Canada. MMWR 1974;23:185–186.Google Scholar
13.D'Angelo, LJ, Hierholzer, JC, Holman, RC, et al: Epidemic keratoconjunctivitis caused by adenovirus type 8: Epidemiologic and laboratory aspects of a large outbreak. Am J Epidemiol 1981;113:44–49.CrossRefGoogle ScholarPubMed
14.Keenlyside, RA, Hierholzer, JC, D'Angelo, LJ, et al: Keratoconjunctivitis associated with adenovirus type 37: An extended outbreak of keratoconjunctivitis in an ophthalmologist's office. J Infect Dis 1983;147:191–198.CrossRefGoogle Scholar
15.Guyer, B, O'Day, DM, Hierholzer, JC, et al: Epidemic keratoconjunctivitis: A community outbreak of mixed adenovirus type 8 and type 19 infection. J Infect Dis 1975;132:142–150.CrossRefGoogle ScholarPubMed
16.O'Day, DM, Guyer, B, Hierholzer, JC, et al: Clinical and laboratory evaluation of epidemic keratoconjunctivitis due to adenovirus types 8 and 19. Am J Ophthalmol 1976;81:207–215.CrossRefGoogle ScholarPubMed
17.Hierholzer, JC, Suggs, MT, Hall, EC, Standardized viral hemag-glutination-inhibition tests. II. Description and statistical evaluation. Appl Microbiol 1969;18:824–833.CrossRefGoogle ScholarPubMed
18.Hierholzer, JC, Atuk, NO, Gwaltney, JM, New human adenovirus isolated from a renal transplant recipient: Description and characterization of candidate adenovirus type 34. J Clin Microbiol 1975;1:366–376.CrossRefGoogle ScholarPubMed
19.Cox, DR, Analysis of Binary Data. London, Methueen, 1969.Google Scholar
20.Breslow, NE, Day, NE, Statistical Methods in Cancer Research. The Analysis of Case-Control Studies. Lyon, France, International Agency for Research on Cancer. 1980, vol 1.Google Scholar
21.Dawson, C, Darrell, R, Hanna, L, et al: Infections due to adenovirus type 8 in the United States. II. Community-wide infection with adenovirus type 8. N Engl J Med 1963;268:1034–1037.CrossRefGoogle ScholarPubMed
22.Zweighaft, RM, Hierholzer, JC, Bryan, JA, Epidemic keratoconjunctivitis at a Vietnamese refugee camp in Florida. Am J Epidemiol 1977;106:399–407.CrossRefGoogle Scholar
23.Bietti, GB, Bruna, F, Epidemic keratoconjunctivitis in Italy. Am J Ophthalmol 1956;43 (suppl):50–57.CrossRefGoogle Scholar
24.Hierholzer, JC, Sprague, JB, Five-year analysis of adenovirus 8 antibody levels in an industrial community following an outbreak of keratoconjunctivitis. An J Epidemiol 1979;110:132–140.CrossRefGoogle Scholar
25.Knopf, HLS, Hierholzer, JC, Clinical and immunological responses in patients with viral keratoconjunctivitis. Am J Ophthalmol 1975;80:661–672.CrossRefGoogle ScholarPubMed
26.Mitusi, Y, Hanna, L, Hanabusa, J, et al: Association of adenovirus type 8 with epidemic keratoconjunctivitis. Arch Ophthalmol 1959;61:891–98.CrossRefGoogle Scholar
27.Wood, RM, Prevention of infection during tonometry. Arch Ophthalmol 1962;68:202–218.CrossRefGoogle ScholarPubMed
28.Clarke, SKR, Hart, JCD, Barnard, DC, The disinfection of instruments and hands during outbreaks of epidemic keratoconjunctivitis. Trans Ophthalmol Soc UK 1972;92:613–618.Google ScholarPubMed
29.Corboy, JM, Goucher, Cr, Dames, CA, Mechanical sterilization of the applanation tonometer. Part 2. Viral study. Am J Ophthalmol 1971;71:891–893.CrossRefGoogle Scholar
30.Centers for Disease Control: Guidelines for the Prevention and Control of Nosocomial Infections. Washington, DC, US Public Health Service, 1981.Google Scholar
31.Hendley, JO, Epidemic keratoconjunctivitis and handwashing. N Engl J Med 1973;289:1368–1369.CrossRefGoogle Scholar