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Epidemic Keratoconjunctivitis in a University Medical Center Ophthalmology Clinic; Need for Re-evaluation of the Design and Disinfection of Instruments

Published online by Cambridge University Press:  21 June 2016

Denise Koo ,
Brenda Bouvier ,
Michele Wesley ,
Paul Courtright  and
Arthur Reingold
Denise Koo
Affiliation:
School of Public Health, University of California, Berkeley, California
Brenda Bouvier
Affiliation:
Department of Infection Control, University of California, San Francisco, California
Michele Wesley
Affiliation:
School of Public Health, University of California, Berkeley, California
Paul Courtright
Affiliation:
School of Public Health, University of California, Berkeley, California
Arthur Reingold*
Affiliation:
School of Public Health, University of California, Berkeley, California
*
Earl Warren Hall, School Of Public Health, University of California, Berkeley, CA 94720
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Abstract

During the period from early December 1987 to late January 1988, an outbreak of epidemic keratoconjunctivitis (EKG) caused by adenovirus type 8 occurred at a university medical center eye clinic. A telephone survey of patients revealed an attack rate of 17% among patients seen during the epidemic period. A case-control study demonstrated that development of EKC was associated with exposure to pneumotonometry and to three caregivers. After controlling for exposure to pneumo-tonometry, however, only exposure to one caregiver was significantly associated with risk of the disease. On January 19, 1988, after recognition of the outbreak, the eye clinic instituted additional infection control measures. A survey of patients seen the following week showed a substantial decrease in the attack rate (1.9%). Before these control measures were implemented, clinic personnel had followed the manufacturer's recommendations and disinfected pneumotonometer tips with 70% isopropyl alcohol, fearing that other disinfectants would corrode the instrument metal. Isopropyl alcohol, shown to have limited activity against adenovirus in vitro, also was being used to “disinfect” pneumotonometer tips between uses at six other area eye clinics polled by telephone. The results of this study demonstrate the need for changes in the design and manufacture of equipment used in the eye clinic.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 10 , Issue 12 , December 1989 , pp. 547 - 552
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1989

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