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Epidemic keratoconjunctivitis in a chronic care facility: risk factors and measures for control.

Abstract：

OBJECTIVE:To study patterns of transmission of epidemic keratoconjunctivitis (EKC) in a chronic care facility and to assess control measures and prevent future outbreaks in this setting. DESIGN:A retrospective cohort study. SETTING:A 120-bed, four-unit, skilled nursing facility. PATIENTS:Residents and employees of the above facility. INTERVENTIONS:Increased frequency of cleaning; use of bleach disinfectant; universal precautions in handling eye secretions from residents with conjunctivitis; cohorting residents by unit; suspension of new admissions; closure of common gathering areas. MEASUREMENTS:Resident demographics; possible risk factors for infection among residents (including mobility, underlying illness, medications, involvement in social activity, level of confusion) and among employees (including co-morbid illnesses and eye conditions, exposures to persons with conjunctivitis, visits to eye care specialists, use of contact lenses or glasses); testing of conjunctival specimens from symptomatic persons for viral and bacterial agents. RESULTS:Of 95 residents on three chronic care units, 47 (attack rate 49%) had onset of eye symptoms consistent with EKC between September 14 and December 7, 1990. Thirty-eight (81%) of these had onset following the onset of symptoms in a resident with dementia who, despite habitual eye-rubbing and wandering into other residents' rooms, was not isolated or restricted in any way. Attack rates were higher (though not statistically significant) among more mobile residents (60% for ambulatory residents) and among those considered by staff to be confused (56%). Rapid antigen detection and culture confirmed adenovirus type 37 as the etiologic agent. CONCLUSIONS:Transmission of infection with adenovirus type 37 was successfully interrupted following strict infection control, suspension of new admissions, cohorting of residents by unit, and change to a disinfectant that inactivates adenovirus. Recognition of conjunctivitis as an appropriate reason for restricting movement of an infected resident may have prevented extensive viral transmission in this outbreak.

journal_name

J Am Geriatr Soc

journal_title

Journal of the American Geriatrics Society

authors

Buffington J,Chapman LE,Stobierski MG,Hierholzer JC,Gary HE Jr,Guskey LE,Breitenbach RA,Hall WN,Schonberger LB

doi

10.1111/j.1532-5415.1993.tb07299.x

subject

Has Abstract

pub_date

1993-11-01 00:00:00

pages

1177-81

issue

eissn

0002-8614

issn

1532-5415

journal_volume

pub_type

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Epidemic keratoconjunctivitis in a chronic care facility: risk factors and measures for control.