RED EYE diagnosis causative agent and control measures
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1. Epidemic keratoconjunctivitis (EKC), also known as adenoviral keratoconjunctivitis, is a highly contagious eye infection caused by adenoviruses, most commonly serotypes 8, 19, and 37. 2. It spreads through hand-to-eye contact or respiratory droplets and tends to occur in clusters in places like schools and workplaces. 3. The virus can survive outside the body for up to 30 days and enters host cells, causing inflammation and viral shedding for 10-14 days after symptoms appear. Diagnosis involves eye exams and viral testing of conjunctival swabs. While there is no vaccine or approved treatment, prevention focuses
RED EYE diagnosis causative agent and control measures
- 1. Epidemic keratoconjunctivitis(pinkeye’s) DEPARTMENT OF MICROBIOLOGY AND IMMUNOLOGY Prepared by: Daniel Mwandu Angel Charles Date: 24/01/2024
- 2. Presentation Outline • Introduction • Etiology • Shedding and incubation period • Pathogenesis • Diagnosis • Treatment, Prevention, and Control January 24, 2024 2 1:28:18 AM
- 3. INTRODUCTION • Epidemic keratoconjunctivitis (EKC), also known as adenoviral keratoconjunctivitis, • It is a highly contagious eye infection that affects both the cornea and the conjunctiva • It can spread through hand-to-eye contact by hands or objects that are contaminated with the infectious virus. • It can also spread by respiratory droplets. • EKC infections tend to occur in clusters such as military camps, schools, hospitals, nursing homes, and workplaces.
- 4. ETIOLOGY Acute Conjunctivitis VIRUSES Adenoviruses >75% Others: Rubella, measles, . Herpesviruses, Picornaviruses(coxs ackievirus and enterovirus) BACTERIA C.trachomatis Staphylococcus spp S. pneumoniae ALLERGIC pollen, grass and other airborne 80%
- 5. cont.
- 6. Cont. • About 19 serotypes known to cause epidemic keratoconjunctivitis (EKC). • The most commonly associated serotypes include adenovirus 8, 19, and 37. • Adenovirus, serotype 8 is the major agent of epidemic keratoconjunctivitis (EKC) • less frequently, serotypes 2-5, 7, 9, 10, 11, 14, 16, 21, and 29.
- 7. VIRAL SHEDDING AND INCUBATION PERIOD • The incubation period is 2-14 days, • Most people will have symptoms in 5-6 days after exposure. • Infected person may remain infectious for 10-14 days after symptoms develop • Viral shedding also may occur before symptoms
- 8. PATHOGENESIS Adenoviruses are able to survive outside of the body for a prolonged period of time (up to 30 days). Adenovirus (AdV) is a lytic, naked ds DNA virus The presence, internalization and replication of the virus of AdV on the ocular surface causes secretion of IL-8. IL-8 inflammatory cells and promotes the internalization of AdV into the host cell. Also actives complement-mediated lysis of AdV- infected cells, and ADCC via NK cells
- 9. DIAGNOSIS • PE: Eye examination. • Specimens from Conjunctival swab for dipstick test and or PCR should be collected in the early illness, • Viral shedding for keratoconjunctivitis is 2 weeks • Serum is required after two week( useful for epidemiology purpose)
- 11. Laboratory Diagnosis A. Viral Culture: CPE in 2 to 7 days (cell rounding, grapelike clusters) B. Direct examination of clinical specimens Polymerase chain reaction (PCR) assays C. Immunoassay tests Neutralization and hemagglutination inhibition tests. Adenovirus Swab Test(RP Adeno Detector and Adeno Plus), ELISA
- 12. Adenovirus Swab Test • The RPS Adeno Detector is based on the principle of lateral flow immunochromatography. • The test involves running a soft swab between the lower eyelid and conjunctiva to obtain a sample of fluid, • sensitivity of 98% and a specificity of 85%. • Adenovirus swab tests should be done within the 7 days of the appearance of symptoms to ensure the most accurate results.
- 13. Treatment, Prevention and Control • No approved antiviral drugs and Vaccines for adenoviral infections • Treatment is based on the symptoms, antibiotic used to prevent 2o bacterial infections. • Face washing, Environmental and total body hygiene to prevent transmission of disease from one person to another • Chlorination of swimming pool to prevent outbreaks of adenovirus conjunctivitis.
- 14. Reference 1. Arun Kumar Adhikary: Genetic characterization of adenovirus Type 8 (Ad8) isolated in South-East Kyushu for the period of 1998-1999, Nov, 2000. 2. Andria M. Pihos :Epidemic keratoconjunctivitis: A review of current concepts in management, 25 July 2012. 3. Jeremy Hoffman: Adenovirus: ocular manifestations, 2020. 4. Cristina Martin et al: Epidemic keratoconjunctivitis: efficacy of outbreak management, Aug ,2021.
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Editor's Notes
- #5: Viruses represent about 80% of all causes of acute conjunctivitis, Adenoviral conjunctivitis is known to be the most common cause of red eye in the world, About 62% to 75% of cases of infectious conjunctivitis are caused by adenovirus.
- #6: Species also known as serogroup
- #9: Adenoviruses are unusually stable to chemical or physical agents and adverse pH conditions, allowing for prolonged survival outside of the body and water.
- #12: Throat swab, eye swab, urine and stool etc. Cytopathic changes may take several days to develop and consist of cell rounding and aggregation into grape like clusters.
- #13: The RPS Adeno Detector detects common epitopes on the hexon protein of the adenovirus within a conserved region among all known serotypes. One antibody is immobilized in the detection zone of the device. The second antibody is labeled with colloidal