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Das AV, Basu S. Epidemic keratoconjunctivitis in India: electronic medical records-driven big data analytics report IV. Br J Ophthalmol 2020; 106:331-335. [PMID: 33229346 DOI: 10.1136/bjophthalmol-2020-317330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/17/2020] [Accepted: 11/07/2020] [Indexed: 11/03/2022]
Abstract
AIMS To describe the clinical profile of epidemic keratoconjunctivitis (EKC) in patients presenting to a multitier ophthalmology hospital network in India. METHODS This retrospective hospital-based study included 2 408 819 patients presenting between August 2010 and February 2020. Patients with a clinical diagnosis of EKC in at least one eye with a recent onset (≤1 week) were included as cases. The data were collected using the eyeSmart electronic medical record system. RESULTS Overall, 21 196 (0.9%) new patients were diagnosed with EKC, of which 19 203 (90.6%) patients reported a recent onset (≤1 week) and were included for analysis. The median age was 32 (IQR: 22-45) years and adults (84.5%) were commonly affected. Most of the patients were male (62.1%) and unilateral (53.4%) affliction was commoner. The most common presenting symptom was redness (63.7%), followed by watering (42.1%). Preauricular lymphadenopathy or tenderness was documented in 1406 (7.3%) cases at presentation. A minority of the eyes had visual impairment worse than 20/200 (7.8%) due to associated ocular comorbidities. The involvement of the cornea was seen in 7338 (38.2%) patients and corneal signs included subepithelial infiltrates (26.3%), epithelial defect (1.4%), corneal oedema (0.9%) and filaments (0.4%). Of the patients who had corneal involvement, 496 (2.6%) patients had a chronic course beyond 1 month of which 105 (0.5%) had a course beyond 1 year. CONCLUSION EKC is a self-limiting condition that is commonly unilateral and predominantly affects males. About one-third of the patients have corneal involvement which rarely has a chronic course.
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Affiliation(s)
- Anthony Vipin Das
- Department of eyeSmart EMR & AEye, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sayan Basu
- The Cornea Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
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Li J, Lu X, Jiang B, Du Y, Yang Y, Qian H, Liu B, Lin C, Jia L, Chen L, Wang Q. Adenovirus-associated acute conjunctivitis in Beijing, China, 2011-2013. BMC Infect Dis 2018; 18:135. [PMID: 29558885 PMCID: PMC5859447 DOI: 10.1186/s12879-018-3014-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 02/28/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human adenovirus (HAdV)-associated acute conjunctivitis is a common infectious disease and causes significant morbidity among residents in Beijing, China. However, little is known about the epidemiology and type distribution of acute adenoviral conjunctivitis in Beijing. METHODS Acute conjunctivitis surveillance was conducted in 18 hospitals in Beijing from July through October during 2011-2013. HAdVs were detected by PCR from eye swab and types were determined by partial hexon and fiber gene sequencing. Risk factors associated with adenoviral conjunctivitis were analyzed. RESULTS Of 876 conjunctivitis cases, 349 (39.8%) were HAdV positive. HAdV detection was most common in conjunctivitis patients aged 18-40 years; patients with contact history with a conjunctivitis case; patients with specimen collected on days 4-6 post symptom onset and patients who worked in food service as catering attendants. Fifteen types were identified among adenoviral conjunctivitis cases. Five HAdV types (HAdV-4, - 37, - 53, - 64 and - 8) accounted for 81.1% of all adenoviral conjunctivitis cases. HAdV-37, - 4 and - 53 were the most common types associated with adenoviral conjunctivitis in 2011, 2012 and 2013, respectively. CONCLUSION Multiple HAdV types were associated with acute conjunctivitis in Beijing. Predominant types associated with adenoviral conjunctivitis circulating in Beijing varied from year to year.
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Affiliation(s)
- Jie Li
- Beijing Center for Disease Prevention and Control, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China.,Research Centre for Preventive Medicine of Beijing, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China
| | - Xiaoyan Lu
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Baoming Jiang
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Yiwei Du
- Beijing Center for Disease Prevention and Control, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China.,Research Centre for Preventive Medicine of Beijing, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China
| | - Yang Yang
- Beijing Center for Disease Prevention and Control, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China.,Research Centre for Preventive Medicine of Beijing, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China
| | - Haikun Qian
- Beijing Center for Disease Prevention and Control, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China.,Research Centre for Preventive Medicine of Beijing, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China
| | - Baiwei Liu
- Beijing Center for Disease Prevention and Control, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China.,Research Centre for Preventive Medicine of Beijing, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China
| | - Changying Lin
- Beijing Center for Disease Prevention and Control, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China.,Research Centre for Preventive Medicine of Beijing, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China
| | - Lei Jia
- Beijing Center for Disease Prevention and Control, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China.,Research Centre for Preventive Medicine of Beijing, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China
| | - Lijuan Chen
- Beijing Center for Disease Prevention and Control, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China. .,Research Centre for Preventive Medicine of Beijing, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China.
| | - Quanyi Wang
- Beijing Center for Disease Prevention and Control, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China. .,Research Centre for Preventive Medicine of Beijing, No.16, Hepingli Middle Road, Beijing, 100013, People's Republic of China.
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Molecular identification of viral agents associated with acute conjunctivitis: a prospective controlled study. Braz J Infect Dis 2017; 21:391-395. [PMID: 28535396 PMCID: PMC9427797 DOI: 10.1016/j.bjid.2017.03.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 01/31/2017] [Accepted: 03/29/2017] [Indexed: 12/29/2022] Open
Abstract
Background Viral conjunctivitis are the most frequent infections in ophthalmology clinics. The diagnosis is usually relying on clinical findings and medical history. However, topical antibiotics are often used unnecessarily addition to symptomatic treatment because of unsure agents. We aimed to detect the Adenovirus, Coxsackievirus and Enterovirus from conjunctiva and pharyngeal samples of patients. Methods The conjunctiva and pharyngeal samples of the patients with conjunctivitis were taken by Virocult transport media and kept at −80 ̊C up to study day. Adenovirus spp, Enterovirus 70 and Enterovirus 71, Coxsackie A24 and Coxsackie A16 were detected by real-time PCR. Samples from healthy health care workers of ophthalmology clinic were used for control group. Results A total of 176 samples (conjunctival and pharyngeal samples of 62 patient and 26 healthy subjects) were included. The mean age of 34 (55.7%) male and 27 (44.3%) female patients was 34 ± 17. Twenty five (40.3%) of the patients were receiving antibiotic drops at first visit. The main etiologic agent in conjunctival samples was found to be Adenovirus (46/62, 74.2%) followed by Enterovirus 70 (4/62, 6.4%) and Enterovirus 71 (4/62, 6.4%). Coxsackievirus 16 and 24 were also found in 2 patients (1/62 each, 1.6%). Pharyngeal samples were also positive for Adenovirus (20/62, 32.3%), Enterovirus 70 and 71 (7/62, 11.3% and 5/62, 8.1% respectively), Coxsackievirus 16 and 24 (2/62, 3.2% and 1/61, 1.6%). Conclusions It is very difficult in viral conjunctivitis to make clinical differentiation caused by different agents because of common clinical signs and symptoms. In routine clinical work, the viral conjunctivitis usually related with Adenovirus. But almost one fourth of the patients’ conjunctivitis were not related to Adenovirus, which shows the importance of the laboratory diagnostics. True diagnosis plays an important role on prevention of contamination and unnecessary use of antibiotics in viral conjunctivitis.
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