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Epidemic kerato-conjunctivitis--do outbreaks have to be epidemic?
D Cheung1, J Bremner, J T K Chan
1Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, UK. dmwc@bigfoot.com
Eye (London, England)
|May 2, 2003
Summary
Adenoviral keratoconjunctivitis outbreaks in hospitals are a significant concern, with many cases acquired internally. Early diagnosis is crucial, especially for unilateral disease, to prevent further spread and improve patient outcomes.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Public Health
Background:
- Adenoviral keratoconjunctivitis outbreaks pose a significant challenge in healthcare settings.
- Understanding transmission patterns and diagnostic efficiency is crucial for effective management.
Purpose of the Study:
- To investigate the epidemiology of adenoviral keratoconjunctivitis outbreaks in a UK teaching hospital.
- To assess disease presentation, diagnostic efficiency, and transmission patterns.
- To evaluate the effectiveness of infection control measures.
Main Methods:
- Prospective/retrospective clinical audit of viral culture results.
- Analysis of patient case records to determine infection sources and risk factors.
- Retrospective audit of infection control procedures and adenovirus serotyping.
Main Results:
- A 217% increase in adenoviral keratoconjunctivitis cases during the study period.
- 63% of infections were acquired within the hospital, often linked to invasive procedures.
- Unilateral disease presentation was associated with a higher misdiagnosis rate (42%).
Conclusions:
- Hospital-acquired adenoviral keratoconjunctivitis is a substantial issue in ophthalmic departments.
- Multiple adenovirus serotypes can contribute to outbreaks.
- Standard viral culture may be insufficient for definitive diagnosis in some cases.