Keratoconjunctivitis due to adenovirus type 8: report on a large outbreak

A large nosocomial, community-acquired outbreak of keratoconjunctivitis due to adenovirus type 8 at a large military teaching hospital is described. One hundred thirty-two cases were identified with initial case confirmation by viral isolation and subsequent case confirmation based on clinical findings. Infection usually presented as a severe keratoconjunctivitis with 35% of infected patients developing subepithelial corneal infiltrates. Most infections were acquired by hand-to-eye contact or by tonometry while visiting the military eye service for other ophthalmologic reasons. Intrafamilial transmission of the virus occurred in 22% of cases with rare disease spread outside the family or hospital environments. The peak incidence occurred from April to August 1986 but was not confirmed by viral isolation until May 1986 when appropriate control measures were instituted. The delay in application of appropriate control measures was a major factor accounting for both the prolonged duration and epidemic nature of this kerato-conjunctivitis outbreak.