[Epidemic nosocomial keratoconjunctivitis caused by adenovirus type 4].
OBJECTIVE
To evaluate the clinical features of nosocomial epidemic keratoconjunctivitis(EKC) occurring in the ophthalmology ward of Sapporo Medical University Hospital and to devise preventive measures for it.


METHODS
We studied the symptoms and clinical course of 2 patients who had EKC and 16 patients who had EKC caused by nosocomial infections in our hospital. We attempted to detect adenovirus antigen and viral DNA from conjunctival swabs and also to isolate the virus.


RESULTS
The clinical symptoms of EKC were conjunctival hyperemia in 18 patients(100%), conjunctival follicles in 11 patients (61.1%), discharge in 8 patients(44.4%), superficial punctate keratopathy in 7 patients(38.9%), swelling of the eyelids in 3 patients(16.7%), and fever in 3 patients(16.7%). 72% were positive for Adeno-check. Adenovirus type 4 was isolated from the conjunctival swabs. We considered that the route of hospital infection was infection from the doctor's hands, from eye drops, and from contact lenses. We disclosed that nosocomical EKC had occurred in our hospital. The hospital infection was eliminated by closing the ophthalmology ward and sterilizing instruments and washing hands.


CONCLUSIONS
The delay of proper measures increased the risk of nosocomical infection. We recognized the importance of careful observation of patients and immediate preventive efforts in nosocomical infection.
Fujiwara
Osamutaro
O
Department of Ophthalmology, Sapporo Medical University, S-1, W-16, Chuo-ku, Sapporo 060-8543, Japan.
Mitamura
Yoshinori
Y
Tagawa
Hiroshi
H
Ohba
Masahiro
M
Hashimoto
Masato
M
Suzuki
Yasuo
Y
Konno
Shinsuke
S
Sato
Akihiko
A
Sato
Hiroko
H
Takaya
Masao
M
Tashimo
Asako
A
Shizukawa
Noriko
N
Yakuwa
Nozomi
N
Kawaguchi
Satoshi
S
Shimizu
Miho
M
Nagai
Shinji
S
Inatomi
Shuichiro
S
Miyanishi
Kiyoe
K
Ito
Hiroki
H
Saito
Yoshiyuki
Y
Nishizaka
Kimitoshi
K
Hatakeyama
Rie
R
Matuda
Taisuke
T
Ohtsuka
Kenji
K
D000258:Adenovirus Infections, Human / Q000517:prevention & control / Q000635:transmission*; D003428:Cross Infection / Q000517:prevention & control / Q000635:transmission*; D005260:Female; D006801:Humans; D007637:Keratoconjunctivitis / Q000209:etiology* / Q000517:prevention & control; D008297:Male