Adenovirus type 8 keratoconjunctivitis – an outbreak and its treatment with topical human fibroblast interferon

Reilly, Sheena; Dhillon, Bal; Nkanza, Kamona M.; D'Souza, Annette M.; Taylor, Nancy S.; Hobbs, Sandra J.; Freke, A; Roome, A. P. C. H.

doi:10.1017/s0022172400066365

Cited by 27 publications

(21 citation statements)

References 12 publications

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“…The duration of the disease observed in this outbreak was basically consistent with that of a previous study [36]. Regarding the risk factors for transmission, previous studies have focused on risk factors for transmission in hospitals [25,27,[31][32][33][34][35][36][37]. Our research reveals the risk factors for school transmission in remote areas in developing countries.…”

Section: Discussionsupporting

confidence: 88%

“…Since the 1980s, EKC outbreaks caused by HAdV-8 have been reported in different countries and regions of the world. Most of the outbreaks were caused by iatrogenic ophthalmic transmission in hospitals [25,27,[31][32][33][34][35][36][37]. Two outbreaks of EKC in two schools in the Tibet autonomous region were reported for the first time in mainland China.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, EKC [18][19][20] is caused by enterovirus type 70, human coxsackievirus A24 variant (CVA24v), and HAdV-11. Outbreaks caused by adenovirus types 8, 56, 54 and enteroviruses CVA24v and EV70 have been reported in China and other countries or regions around the world [6,15,[21][22][23][24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

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An Outbreak of Epidemic Keratoconjunctivitis Caused by Human Adenovirus Type 8 in Primary School, Southwest China

Zhou

et al. 2019

Preprint

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Background: Two outbreaks of epidemic keratoconjunctivitis (EKC) occurred successively with an interval of five days in two primary boarding schools in Weixi Lisu Autonomous County, Diqing, and Tibetan Autonomous Prefecture, Yunnan. The aims of this study were to determine the intensity and characteristics of the outbreaks, as well as the clinical manifestations in the patients, the risk factors for infection and the pathogen responsible for the two outbreaks. Methods: An outbreak investigation was conducted in two primary schools, and a case-control study including patients from the Weixi County Ethnic Primary School was performed. Relevant specimens were collected according to the case definition, and next-generation sequencing was employed to identify the pathogen. An epidemiological investigation method was used to analyse the related epidemiological characteristics, such as risk factors. The phylogenetic tree was constructed by MEGA 7.0. Results: A total of 331 acute conjunctivitis cases, including probable cases of EKC, were reported in the two schools, and the attack rates were 30.59% (171/559, 95%CI: 26.76-34.42) and 20.41% (160/784, 95%CI: 17.58-23.24), respectively. Cases occurred in all grades and classes in both schools, and only one staff member in each school presented illness. The epidemics lasted for 54 days and 45 days, respectively. The patients had typical manifestations of EKC, such as acute onset, follicular hyperplasia, pseudomembrane formation, preauricular lymphadenopathy, corneal involvement and blurred vision, and a relatively long disease course (average 9.40 days, longest 23 days and shortest 7 days). The risk factor for infection was close contact with a patient or personal items contaminated by a patient. The pathogen responsible for the outbreaks was HAdV-8. The virus was highly similar to the 2016 HAdV-8 strain from Tibet, China. Conclusions: This study strongly suggests that HAdV-8 could lead to serious consequences. This is the second report of a HAdV-8-associated EKC outbreak in mainland China. Tibetan HAdV-8 might be circulating in southwest China; therefore, it is necessary to monitor the pathogens causing acute conjunctivitis in this area.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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An Outbreak of Epidemic Keratoconjunctivitis Caused by Human Adenovirus Type 8 in Primary School, Southwest China

Zhou

et al. 2019

Preprint

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“…More recently, purine and pyrimidine base analogs, such as ganciclovir, have been studied as both topical and internal medications and may show some promise (9,11,23,24,41,78,94,116,128,131,138). Otherwise, the best strategies are those of prevention, which have been successfully applied to curtail adenovirus outbreaks in ophthalmologic clinics, hospitals, and nurseries (15,96,129).…”

Section: Adenoviruses In Primary Immunodeficienciesmentioning

confidence: 99%

Adenoviruses in the immunocompromised host

1992

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Adenoviruses are among the many pathogens and opportunistic agents that cause serious infection in the congenitally immunocompromised, in patients undergoing immunosuppressive treatment for organ and tissue transplants and for cancers, and in human immunodeficiency virus-infected patients. Adenovirus infections in these patients tend to become disseminated and severe, and the serotypes involved are clustered according to the age of the patient and the nature of the immunosuppression. Over 300 adenovirus infections in immunocompromised patients, with an overall case fatality rate of 48%, are reviewed in this paper. Children with severe combined immunodeficiency syndrome and other primary immunodeficiencies are exposed to the serotypes of subgroups B and C that commonly infect young children, and thus their infections are due to types 1 to 7 and 31 of subgenus A. Children with bone marrow and liver transplants often have lung and liver adenovirus infections that are due to an expanded set of subgenus A, B, C, and E serotypes. Adults with kidney transplants have viruses of subgenus B, mostly types 11, 34, and 35, which cause cystitis. This review indicates that 11% of transplant recipients become infected with adenoviruses, with case fatality rates from 60% for bone marrow transplant patients to 18% for renal transplant patients. Patients with AIDS become infected with a diversity of serotypes of all subgenera because their adult age and life-style expose them to many adenoviruses, possibly resulting in antigenically intermediate strains that are not found elsewhere. Interestingly, isolates from the urine of AIDS patients are generally of subgenus B and comprise types 11, 21, 34, 35, and intermediate strains of these types, whereas isolates from stool are of subgenus D and comprise many rare, new, and intermediate strains that are untypeable for practical purposes. It has been estimated that adenoviruses cause active infection in 12% of AIDS patients and that 45% of these infections terminate in death within 2 months. In all immunocompromised patients, generalized illness involving the central nervous system, respiratory system, hepatitis, and gastroenteritis usually have a fulminant course and result in death. Treatments for adenovirus infections are of little proven value, although certain purine and pyrimidine analogs have shown beneficial effects in vitro and may be promising drugs.

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“…reported that topical IFN‐β was effective against an AdV8‐induced nosocomial outbreak of keratoconjunctivitis 19 . However, although a placebo‐controlled trial was carried out in that study, no statistically significant difference was observed in the recovery rate of patients receiving IFN‐β or placebo, possibly because of the small scale of the study 19 . In contrast, six times daily application of 2–5 × 10 5 IU IFN‐β eye drops reduced the duration of disease and prevented corneal subepithelial opacity in 45% of cases 15 .…”

Section: Discussionmentioning

confidence: 99%

Anti‐adenoviral effect of interferon‐β and interferon‐γ in serotypes that cause acute keratoconjunctivitis

Uchio

Inoue

Fuchigami

et al. 2011

Clinical Exper Ophthalmology

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Adenovirus type 8 keratoconjunctivitis – an outbreak and its treatment with topical human fibroblast interferon

Cited by 27 publications

References 12 publications

An Outbreak of Epidemic Keratoconjunctivitis Caused by Human Adenovirus Type 8 in Primary School, Southwest China

An Outbreak of Epidemic Keratoconjunctivitis Caused by Human Adenovirus Type 8 in Primary School, Southwest China

Adenoviruses in the immunocompromised host

Anti‐adenoviral effect of interferon‐β and interferon‐γ in serotypes that cause acute keratoconjunctivitis

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