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PubMed1983

Acute hemorrhagic conjunctivitis Investigation of a large-scale community outbreak in Dade County, Florida.

An outbreak of acute hemorrhagic conjunctivitis (AHC) due to enterovirus type 70 occurred in Dade County, Florida, from September to December 1981. Younger age groups, members of larger households, and the poor were at significantly greater risk of acquiring AHC than others in the community. Schoolchildren were most likely to introduce AHC into the household. After exclusion of all affected children from school, there was a dramatic reduction in reported cases, with attack ratesups, members of larger households, and the poor were at significantly greater risk of acquiring AHC than others in the community. Schoolchildren were most likely to introduce AHC into the household. After exclusion of all affected children from school, there was a dramatic reduction in reported cases, with attack ratesups, members of larger households, and the poor were at significantly greater risk of acquiring AHC than others in the community. Schoolchildren were most likely to introduce AHC into the household. After exclusion of all affected children from school, there was a dramatic reduction in reported cases, with attack rates declining more rapidly for school-aged children than for other age groups. Although AHC spread readily among family members, a retrospective study of 124 affected households showed an association between lower attack rates and simple hygienic measures. Should outbreaks of AHC recur, measures to reduce transmission should include exclusion of affected schoolchildren and educating the public about hygienic precautions.

Acute Disease↗
PubMed1986

Genome analysis of species 3 adenoviruses isolated during summer outbreaks of conjunctivitis and pharyngoconjunctival fever in the Glasgow and London areas in 1981.

Genome analysis was performed on 125 adenovirus isolates from conjunctival swabs of patients with conjunctivitis obtained in Glasgow between 1981 and 1984. A summer outbreak in 1981 was mainly due to species 3 adenoviruses, of which genotype 3GB and five different genotypic variants cocirculated. Three species 3 variants were also observed in 1982. The genome changes of variants were located on physical maps of the Ad3 reference strain and found to be clustered near the ends of the adenovirus DNA (including the fiber area), whereas the hexon coding region was unaltered. In contrast to the genome heterogeneity observed among the species 3 adenoviruses collected in Glasgow in 1981 it was found that all 69 Ad3 isolates obtained from an outbreak of pharyngoconjunctival fever in a boarding school near London during the summer of 1981 possessed the 3GB genotype.

Adenoviridae Infections↗
PubMed1988

Spread of acute hemorrhagic conjunctivitis due to enterovirus-70: effect of air temperature and relative humidity on virus survival on fomites.

Enterovirus 70 (EV-70) has caused at least two pandemics and several major epidemics of acute hemorrhagic conjunctivitis (AHC) in the past 18 years, with the largest number of cases occurring in the coastal areas of the tropics. The exact means of its spread are not known, but fomites and hands contaminated by them are the most likely vehicles. We, therefore, tested EV-70 survival under different environmental conditions using stainless steel disks (1 cm diameter). Each disk received 10 microliter of the virus in phosphate-buffered saline (PBS). The disks were held at various temperatures with the relative humidity (RH) at the low (20 +/- 5%), medium (50 +/- 5%), high (80 +/- 5%), or ultrahigh (95 +/- 5%) level. The virus was eluted from the disks with tryptose phosphate broth and the eluate assayed in LLC-MK2cells. Inactivation rates (Ki), expressed as hourly loss of virus plaque forming units (PFU) in log10, were then calculated. At 20 degrees C, virus survival was proportional to the RH level, with the highest virus survival at the ultrahigh RH; at this level nearly 5% of the input virus was detectable even after 24 hr. Virus inactivation rates were only slightly higher at the ultrahigh RH when the temperature was raised to 33 degrees C or 35 degrees C. However, at 80% RH, increasing the temperature from 20 degrees C to 33 degrees C resulted in a dramatic rise in virus inactivation. The finding that high levels of RH prolong EV-70 survival on fomites may help explain the epidemiology of AHC resulting from EV-70.

Animals↗
PubMed1988

Genome types of adenovirus types 19 and 37 isolated from patients with conjunctivitis in Hiroshima City.

A total of 74 strains out of 33 strains of adenovirus type 19 (Ad19) plus 103 strains of type 37 (Ad37) isolated from patients with conjunctivitis at two ophthalmology clinics in Hiroshima City during the period March 1983 to December 1986 were analyzed by eight DNA restriction endonucleases in comparison with their prototype strains. All 27 Ad19 isolates examined displayed identical DNA cleavage patterns with all enzymes used (HindIII, KpnI, PstI, XhoI, BamHI, SacI, EcoRI, and SmaI), but their cleavage patterns were different from those of the prototype except with HindIII. The genome type of these isolates was tentatively named Ad19a. Forty-seven Ad37 isolates examined were divided into three genome types. They were tentatively named Ad37p, Ad37a, and Ad37b: 16 isolates (Ad37p) displayed DNA cleavage patterns identical with those of the prototype with all eight enzymes described above. Thirty isolates (Ad37a) showed the same patterns as the prototype except with EcoRI. One isolate (Ad37b) showed the same patterns as the prototype except with SmaI. The most frequently isolated genome type during the period studied was Ad37a, but the change of the predominant genome type in yearly incidences was observed.

Adenoviridae Infections↗
PubMed1990

Acute haemorrhagic conjunctivitis: seroepidemiology of coxsackievirus A24 variant and enterovirus 70 in Singapore.

Epidemics of acute haemorrhagic conjunctivitis caused by a variant of coxsackievirus A24 (CA24v) and enterovirus 70 (EV70) have occurred periodically in Singapore. A seroepidemiological survey conducted before the CA24v epidemic in 1985 and in the midst of the EV70 epidemic in 1983 showed a neutralising antibody prevalence (greater than or equal to 1:4) of 19.1% and 66.9% to CA24v and EV70, respectively. The seropositivity rate to both viruses was highest in children 10-14 years of age, but no sex or ethnic difference was noted. It appears from the data that an epidemic could be triggered when the herd immunity of the population falls below a critical level. There was a significant correlation in seroprevalence between CA24v and EV70 (P = 7.75 x 10(-3).

Adolescent↗
PubMed2005

From suspicion to action: the chemical conjunctivitis and silver nitrate connexion example in Brazilian hospitals.

BACKGROUND: During the 20th century, silver nitrate (SN) eye drops instillation to newborns had been the best prophylaxis against ophthalmia neonatorum (ON) caused by Neisseria gonorrheae, the most frequent cause of ocular infections leading to blindness. At present, this treatment has been questioned because there is a growing prevalence of other pathogens such as Chlamydia trachomatis, and SN is associated with chemical conjunctivitis (ChC). In addition, SN could present some conservation problems in tropical climates. Among other alternative drugs, 2.5% povidone-iodine has a proven efficacy, not only against Neisseria, but also against Chlamydia, has no conservation problems, has not been associated with ChC and is cheap. METHODS: The recently created Setor de Farmacovigilãncia (SF) of the São Paulo State in Brazil has created a pharmacovigilance network of 11 big public hospitals. During a periodical signal searching process, the SF found a cluster of 33 ChC reports from one of the network hospitals. RESULTS: The problem was discussed with the remaining participant hospitals and this signal was used as a way to strengthen the network. Thirteen months later, 622 ChC reports were received from six hospitals. DISCUSSION: Thus, this well-known side-effect in the literature was highlighted as a 'real' problem in Brazil, and some participant hospitals began a discussion period together with the delivery and newborn care professionals in order to switch SN by povidone-iodine. This is an example of both, how a simple pharmacovigilance exercise could improve the implication of health professionals with their own therapeutic problems and how a pharmacovigilance network could be strengthened.

Anti-Infective Agents, Local↗
PubMed2001

Pulmonary involvement in a child with ligneous conjunctivitis and homozygous type I plasminogen deficiency.

Ligneous conjunctivitis (LC) is a rare disorder characterized by a chronic course of recurrent membranous lesions at conjunctivae. Pseudomembranes of other mucous membranes have been reported in patients with LC, but to the best of our knowledge, no case with alveolar involvement has been described. Here, we report a 2.5-year-old girl with LC who had tracheoaveolar involvement and homozygous type I plasminogen deficiency. Tracheal involvement was diagnosed by bronchoscopic biopsy and alveolar involvement with postmortem biopsy. She was shown to be homozygous for frameshift mutation in plasminogen exon 14 (Gly565ins-G) with molecular genetic examination of DNA which was obtained from parafin embedded postmortem lung tissue. Ligneous inflammation of the upper and lower respiratory tract must be considered in children with LC and recurrent respiratory tract problems.

Conjunctivitis↗
PubMed2006

Modelling the transmission dynamics of acute haemorrhagic conjunctivitis: application to the 2003 outbreak in Mexico.

We model an outbreak of acute haemorrhagic conjunctivitis (AHC) using a simple epidemic model that includes susceptible, infectious, reported, and recovered classes. The model's framework considers the impact of underreporting and behaviour changes on the transmission rate and is applied to a recent epidemic of AHC in Mexico, using a fit to the cumulative number of cases to estimate model parameters, which agree with those derived from clinical studies. The model predicts a 'mean time from symptomatic onset to diagnosis' of 1.43 days (95 per cent CI: 1-2.5) and that the final size of the Mexican epidemic was underreported by 39 per cent. We estimate that a primary infectious case generates approximately 3 secondary cases (R0* = 2.64, SD 0.65). We explore the impact of interventions on the final epidemic size, and estimate a 36 per cent reduction in the transmission rate due to behaviour changes. The effectiveness of the behaviour changes in slowing the epidemic is evident at 21.90 (SD 0.19) days after the first reported case. Results therefore support current public health policy including expeditious announcement of the outbreak and public health information press releases that instruct individuals on avoiding contagion and encourage them to seek diagnosis in hospital clinics.

Adenoviridae↗
PubMed1989

HPLC analysis of tear proteins in giant papillary conjunctivitis.

Giant papillary conjunctivitis (GPC) is a well defined entity seen in patients with deposits on their lenses. High performance liquid chromatography (HPLC) tear protein analysis was performed on 17 GPC patients and compared with healthy controls with and without contact lenses. The IgA levels are somewhat lower in GPC patients as compared with healthy controls not wearing lenses (P less than 0.05). A similar decrease was also seen in the control group wearing contact lenses. We were not able to identify a specific HPLC tear protein profile in GPC patients as compared with controls. The HPLC profile therefore gives no explanation for the lens deposits and is not suitable as a diagnostic or prognostic tool.

Adult↗
PubMed1994

Levocabastine eye drops in the treatment of vernal conjunctivitis.

The efficacy and tolerability of levocabastine eye drops in vernal conjunctivitis (VC) were evaluated in a double-blind, placebo-controlled trial involving 46 patients over a period of 4 weeks. After 1 week of treatment, therapeutic efficacy was considered to be excellent or good for 70% of the levocabastine-treated patients compared with only 33% of patients in the placebo group (p < 0.009). Levocabastine patients experienced significantly greater relief of their individually severest symptom than placebo-treated patients both after 1 week and at the end of the trial (p < 0.04). The reduction in symptom severity was significantly greater in the levocabastine group than in the control group for photophobia (p < 0.003) after 1 week, and for photophobia (p < 0.008), irritation (p = 0.05) and itchy eyes (p = 0.05) at the end of the trial. The percentage of days on which patients were completely symptom-free was significantly higher in the levocabastine group than in the placebo group (28% versus 4%; p < 0.02). Eight placebo-treated patients withdrew from the trial due to treatment inefficacy compared with only four levocabastine-treated patients (p = 0.013). Two of the three levocabastine, and all five placebo patients who elected to continue on open-label levocabastine had an excellent or good overall response after 1 to 3 weeks of treatment. All reported adverse reactions were mild and their incidence was equal in the two treatment groups. Levocabastine eye drops are effective and well tolerated in the treatment of VC.

Adolescent↗
PubMed1993

N-acetyl-aspartyl glutamic acid (NAAGA) topical eyedrops in the treatment of giant papillary conjunctivitis (GPC).

Giant Papillary Conjunctivitis (GPC) is a conjunctival inflammatory condition associated with contact lens wear. The etiology is still unknown and no adequate treatment is found. Mastcell stabilizing drugs are useful in the treatment of chronic inflammatory processes. The effect of 6% N-acetyl-aspartyl glutamic acid (NAAGA), a mastcell stabilizing agent, in a double-masked comparative trial with placebo in the treatment of GPC is reported. Seventeen patients with symptomatic GPC were treated over a four week period, eyes were randomized to receive NAAGA or placebo. A decrease in symptoms was found for both eyes. No significant difference of clinical symptoms and signs were observed between NAAGA or placebo treated eyes. These results suggest a wash effect of placebo in GPC. Tear C3a showed a increased level compared to normals but no statistically significance was observed in our study. The results of this study indicate that mastcell stabilization in GPC has little effect and treatment should be focused more on inflammatory mediators released because of mechanical stimuli.

Administration, Topical↗
PubMed1992

The complete nucleotide sequence of a variant of Coxsackievirus A24, an agent causing acute hemorrhagic conjunctivitis.

The complete nucleotide sequence was determined for the cDNAs that represent the RNA genome of the standard strain of a variant of coxsackievirus A24, the EH24/70, one of the agents causing acute hemorrhagic conjunctivitis. The genome is 7461 nucleotide long and is polyadenylated at the 3'-end terminus. Following a 750-nucleotide 5'-noncoding region, there was a long open reading frame of 6642 nucleotides, which serve to encode a viral polyprotein consisting of 2214 amino acids. Comparison of the deduced amino acid sequence of the polyprotein with those of known enteroviruses allowed us to predict the possible cleavage sites. The overall structure and the organization of the RNA genome is typical for an enterovirus. Based on the similarity of the nucleotide sequence of the 5' and 3' noncoding regions, together with the amino-acid sequence of the encoded proteins, EH24/70 appeared to be closely related to polioviruses and coxsackievirus A21.

Amino Acid Sequence↗
PubMed1990

Use of blocking reagent to confirm enzyme immunoassay results in chlamydial conjunctivitis.

A blocking reagent (Abbott) was used to test 153 conjunctival and nasopharyngeal samples from children with signs of early trachoma and from neonates and adults with conjunctivitis caused by Chlamydia trachomatis in whom positive results had been obtained on at least one occasion in an enzyme immunoassay (EIA) (Abbott). EIA and cycloheximide-treated McCoy cell cultures of the eye sample were equally often positive in the non-trachoma cases (70 versus 71), the EIA results being confirmed by the blocking reagent test in these cases. The corresponding figures for the nasopharyngeal samples were 31 versus 25. There was full agreement between the results of the EIA and blocking reagent tests, except in two eye samples and one nasopharyngeal sample where the blocking reagent test was negative. Three EIA results were within the equivocal zone around the cutoff point, two of which were positive and one negative in the blocking test.

Adolescent↗
PubMed1985

Tear histamine during allergic conjunctivitis challenge.

Tear histamine was measured in 14 patients with allergic conjunctivitis during a challenge test performed at a symptom-free point in time. The allergen challenge caused a rapid increase in the amount of tear histamine in only two-thirds of the patients, but there was a clinical reaction in all. The increase in the tear histamine content occurred in both the challenged and contralateral non-challenged eye, and the increase was also equally high in both. It is probable that the histamine release in the challenged eye takes place in the conjunctiva, whereas in the contralateral eye it is possibly induced by some sympathetic mechanism in the lacrimal gland.

Adolescent↗
PubMedDate not supplied

Single dose of ketotifen fumarate .025% vs 2 weeks of cromolyn sodium 4% for allergic conjunctivitis.

This single-masked, contralateral-eye, active-controlled allergen-challenge study compared ketotifen fumarate .025% and cromolyn sodium 4% ophthalmic solutions in the prevention of ocular itching, tearing, and redness induced by allergen challenge. After a confirmatory conjunctival provocation test (CPT), 56 patients randomly received masked study medication (placebo in one eye, cromolyn in the other eye) four times daily for 2 weeks. At visit 3, patients received one drop of ketotifen in the eye previously treated with placebo and cromolyn in the other eye. Ocular comfort was assessed 30 seconds postinstillation, and a CPT was conducted 15 minutes and 4 hours postinstillation to evaluate ocular itching, tearing, and redness. Forty-seven patients were analyzed for efficacy. At the 15-minute and 4-hour challenges, ketotifen was superior to cromolyn in preventing itching (P < .001) at all assessments and redness (ciliary, conjunctival, and episcleral) (P < or = .001) at most assessments. Tearing scores were higher in cromolyn-treated eyes than in ketotifen-treated eyes. Patients reported greater comfort in the ketotifen-treated than in the cromolyn-treated eye (P = .066). The most common adverse event was burning/stinging with cromolyn. A single dose of ketotifen was superior to a 2-week four-times-daily regimen of cromolyn in alleviating symptoms of allergic conjunctivitis in the conjunctival allergen-challenge model.

Adult↗
PubMedDate not supplied

Twice-daily and once-daily nedocromil sodium 2% ophthalmic solution for the treatment of seasonal allergic conjunctivitis.

In this 8-week open-label, prospective study, 30 patients with grass pollen allergy and ocular itching instilled nedocromil sodium 2% ophthalmic solution twice daily for a 5-day baseline period, followed by once-daily dosing thereafter. Physicians assessed clinical signs after the twice-daily period and after weeks 1 and 3 of the once-daily period; patients rated ocular symptoms daily. Use of specified rescue medication was permitted. Symptom scores for ocular itching, stinging, redness, swelling, burning, tearing, and light sensitivity did not differ significantly between the dosage periods. Scores for erythema, edema, conjunctival injection, and the entire conjunctiva decreased slightly during once-daily administration; discharge scores were unchanged. Of the 20 patients who used rescue medication, only 5 increased their usage by more than two doses per week during the once-daily period. Eighty-three percent of patients were willing to continue the once-daily regimen during the next allergy season. Physicians rated overall control of seasonal allergic conjunctivitis with once-daily administration as "good" or "moderate" in 100% of the patients; 93% of patients applied those ratings themselves. Nedocromil sodium 2% ophthalmic solution instilled once daily maintains control of symptoms in patients who are established on a twice-daily regimen.

Adolescent↗
PubMedDate not supplied

Ketotifen fumarate and olopatadine hydrochloride in the treatment of allergic conjunctivitis: a real-world comparison of efficacy and ocular comfort.

This 3-week prospective, randomized, double-masked, parallel-group study compared ketotifen fumarate 0.025% ophthalmic solution and olopatadine hydrochloride 0.1% ophthalmic solution in 66 patients with seasonal allergic conjunctivitis. The drugs were instilled twice daily. Signs and symptoms were assessed on days 5 (visit 2) and 21 (visit 3). Other efficacy variables were the responder rate (patients with excellent or good global efficacy on days 5 and 21) and patient and investigator ratings of global efficacy. Comfort was evaluated immediately after instillation of the first drop and at each follow-up visit. The frequency of adverse events was the safety assessment. The responder rate was higher with ketotifen than with olopatadine on day 5 (72% vs 54% for patient assessment, 88% vs 55% for investigator assessment) and day 21 (91% vs 55%, 94% vs 42%). Global efficacy ratings were higher with ketotifen, and severity scores for hyperemia and itching were significantly lower. Both drugs elicited comparable comfort ratings. The most common adverse events were burning/stinging and headache.

Adult↗
PubMed2004

Eotaxin-1 (CCL11) up-regulation in tears during seasonal allergic conjunctivitis.

PURPOSE: To compare in-season eotaxin-1 levels in tears of patients suffering from seasonal allergic conjunctivitis (SAC) with (1) tears of normal subjects and (2) tears of SAC patients out of season. METHODS: Tears of 11 SAC patients and six control volunteers were collected during the pollen season. Tears of five SAC patients showing a strong sensitivity to grass pollen (skin-prick tests and specific serum IgE) were collected both in season and out of season. ELISA measured eotaxin-1 level. RESULTS: Eotaxin-1 concentration in tears of SAC patients [2,100+/-503 (SEM) pg/ml] and normal subjects (1,193+/-176 pg/ml) were significantly different (P=0.0049). Regarding allergic patients, the clinical score (sum of five allergic criteria) was significantly different in season and out of season (P=0.0043) as was also the case with eotaxin-1 concentration (P=0.024). CONCLUSIONS: The eotaxin-1 concentration in tears of patients showing hay fever could confirm a diagnosis of seasonal ocular allergy.

Adult↗