title: Acute haemorrhagic conjunctivitis outbreak in the city of Fortaleza, northeast Brazil.
abstract: OBJECTIVE
  Between February and May 2003 an epidemic of acute haemorrhagic conjunctivitis affected more than 200 000 people in all five geographic regions of Brazil (north, south, midwestern, southeast, and northeast). The aim was to identify the aetiological agent and to describe clinical aspects of this outbreak in a group of patients treated at the ophthalmology department of the Hospital Walter Cantídio (OD-HWC) at the Universidade Federal do Ceará, in the city of Fortaleza, capital of the state of Ceará, northeastern Brazil.
  
  
  METHODS
  Conjunctival swabs were collected from patients who spontaneously went to the laboratory of virology. Specimens were inoculated in HEp-2 and RD cell lines. The viral isolation was confirmed by performing reverse transcriptase polymerase chain reaction and indirect immunofluorescence assay.
  
  
  RESULTS
  Viral conjunctivitis was diagnosed in 56 patients but only 24 of them allowed the collection of samples. Of 24 conjunctival swabs tested, 11 were positive for a variant of coxsackie virus A24 (CA24v) and one of the isolates reacted with anti-adenovirus monoclonal antibodies.
  
  
  CONCLUSIONS
  CA24v was confirmed as the aetiological agent of this outbreak of acute haemorrhagic conjunctivitis in the city of Fortaleza.
authors.affiliation: Laboratory of Virology, Departamento de Patologia e Medicina Legal, Universidade Federal do Ceará, Rua Monsenhor Furtado SN, Rodolfo Teófilo, 60 441-750, Fortaleza-Ceará, Brazil. fernandaedna@terra.com.br
authors.forename: F E A
authors.initials: FE
authors.lastname: Moura
authors.forename: D C S
authors.initials: DC
authors.lastname: Ribeiro
authors.forename: N
authors.initials: N
authors.lastname: Gurgel
authors.forename: A C
authors.initials: AC
authors.lastname: da Silva Mendes
authors.forename: F N
authors.initials: FN
authors.lastname: Tavares
authors.forename: C N G
authors.initials: CN
authors.lastname: Timóteo
authors.forename: E E
authors.initials: EE
authors.lastname: da Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003232:Conjunctivitis, Acute Hemorrhagic / Q000453:epidemiology* / Q000821:virology; D003236:Conjunctivitis, Viral / Q000453:epidemiology* / Q000821:virology; D003384:Coxsackievirus Infections / Q000175:diagnosis / Q000453:epidemiology; D004196:Disease Outbreaks; D030015:Enterovirus C, Human / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods