Main sources of infection in 145 cases of epidemic keratoconjunctivitis

Epidemic keratoconjunctivitis (EKC) is a combination of conjunctivitis and keratitis induced by an adenovirus that is found especially in eye clinics and in eye hospitals. In Bavaria, EKC represents a common eye disease and occurs in epidemics in the spring and early autumn. We report on 145 patients who presented with EKC in our hospital between March 17 and September 12, 1991, and who were evaluated prospectively (67 men and 78 women ranging in age from 4 to 85 years). The recent patient history was noted using a standardized protocol to analyze possible sources and pathways of the infection. Overall, 44 of the EKC patients (30%) remembered having undergone eye treatment during the incubation period of 2 weeks before the onset of symptoms. In all, 18 patients (12%) recalled that a family member had also had conjunctivitis during that time, and 4 patients (3%) reported the infection of a workmate during the 2 weeks prior to the onset of symptoms. In 82 patients (55%), no presumed source of infection was apparent. A total of 24 patients (17%) presumably acquired the infection during examination or treatment in our hospital. The main cause was the removal of foreign body, followed by cataract operation. In all, 20 patients (14%) had been treated in private practice during the incubation period; 14 of these remembered having had tonometry, and 4 patients had undergone contact-lens fitting. In 18 patients, virus isolation and serotyping from a conjunctival smear was conducted. In 12 of these patients an adenovirus could be isolated; in all cases it proved to be serotype 8.(ABSTRACT TRUNCATED AT 250 WORDS)