- State Health Department: http://www.cdph.ca.gov/Pages/DEFAULT.aspx
- OC: Public Health: http://ochealthinfo.com/phs/
- NSW: Health: http://www.health.nsw.gov.au/Infectious/factsheets/Pages/Epidemic-Keratoconjunctivitis.aspx
- NCBI: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147286/
- CDC: http://www.cdc.gov/mmwr/pdf/wk/mm6232.pdf
Adenovirus type 8 epidemic keratoconjunctivitis in an eye clinic: risk factors and control.
Epidemic keratoconjunctivitis (EKC) due to adenovirus type 8 affected 126 (7%) of 1870 ophthalmology clinic patients during an outbreak. Risk factors and mode of transmission were studied by comparing cases (n = 58) and controls (n = 200) for exposure to risk factors. Pneumotonometry (odds ratio [OR], 10.5; 95% confidence interval [CI], 4.0-27.7), multiple clinic visits (OR, 5.9; 95% CI, 3.3-10.6), and contact with an infected physician (OR, 3.3; 95% CI, 1.2-9.0) were significant risk factors for infection. The hands of 3 patients and 3 physicians with EKC were cultured before and after hand washing to assess adenovirus removal; 3 had hand cultures positive for adenovirus after hand washing. In conclusion, this outbreak appeared to be due to inadequate disinfection of instruments, especially pneumotonometers, and finger-to-eye transmission by health care workers. Hand washing did not reliably remove adenovirus from contaminated fingers. Gloving for exam of eyes with EKC may help prevent transmission. Ophthalmologists with EKC were a significant risk factor for patients and should be furloughed for the duration of communicability.
Courtesy of NCBI:
Surveillance and control of epidemic keratoconjunctivitis.
The purpose of this study was to determine if the implementation of a formal set of infection-control policy and procedures (ICPPs) can reduce the number of outbreaks of epidemic keratoconjunctivitis (EKC) and the number of nosocomially infected patients in a large teaching eye institute.
A retrospective and prospective study of the incidence of EKC and the number of affected patients was performed for the years 1984 through 1991. Infection-control measures (ICPPs) were formulated in 1992 with regulations implemented for patient control and management, hand washing, instrument disinfection, medication distribution, and employee furloughs. Two levels of ICPPs were established on the basis of nonepidemic or epidemic conditions. After implementation of ICPPs, a prospective 4-year study (1992 through 1995) and statistical analysis were performed to determine whether the number of outbreaks of EKC and affected patients significantly decreased.
The incidence of institutional EKC epidemics per year was at least one and as many as three from 1984 through 1991. After implementation of a formal set of ICPPs, no epidemics occurred in 2 of 4 years studied. The number of epidemics and affected patients was significantly less when the years before and after implementation of ICPPs were compared by chi-square analysis (P < .01 and P <. 01, respectively).
In this first prospective study of institutional outbreaks of EKC, the implementation of ICPPs was demonstrated to be an effective means to decrease the number of EKC outbreaks and nosocomially infected patients for this particular institution. Although several reports of institutional outbreaks of EKC have described infection-control measures that eventually controlled an outbreak well under way, this study provides policies and procedures that may effectively decrease the number and size of nosocomial epidemics of adenoviral conjunctivitis in large teaching eye institutions.
Courtesy of NCBI: