title: [Epidemic nosocomial keratoconjunctivitis caused by adenovirus type 4].
abstract: 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.
authors.affiliation: Department of Ophthalmology, Sapporo Medical University, S-1, W-16, Chuo-ku, Sapporo 060-8543, Japan.
authors.forename: Osamutaro
authors.initials: O
authors.lastname: Fujiwara
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Mitamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tagawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ohba
authors.forename: Masato
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Konno
authors.forename: Akihiko
authors.initials: A
authors.lastname: Sato
authors.forename: Hiroko
authors.initials: H
authors.lastname: Sato
authors.forename: Masao
authors.initials: M
authors.lastname: Takaya
authors.forename: Asako
authors.initials: A
authors.lastname: Tashimo
authors.forename: Noriko
authors.initials: N
authors.lastname: Shizukawa
authors.forename: Nozomi
authors.initials: N
authors.lastname: Yakuwa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kawaguchi
authors.forename: Miho
authors.initials: M
authors.lastname: Shimizu
authors.forename: Shinji
authors.initials: S
authors.lastname: Nagai
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Inatomi
authors.forename: Kiyoe
authors.initials: K
authors.lastname: Miyanishi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ito
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Saito
authors.forename: Kimitoshi
authors.initials: K
authors.lastname: Nishizaka
authors.forename: Rie
authors.initials: R
authors.lastname: Hatakeyama
authors.forename: Taisuke
authors.initials: T
authors.lastname: Matuda
authors.forename: Kenji
authors.initials: K
authors.lastname: Ohtsuka
mesh_terms: 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