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Constanze Wendt - One of the best experts on this subject based on the ideXlab platform.
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an outbreak of epidemic keratoconjunctivitis in a pediatric unit due to Adenovirus Type 8
Infection Control and Hospital Epidemiology, 2003Co-Authors: Iris E Chaberny, Paul Schnitzler, Heinrich K Geiss, Constanze WendtAbstract:OBJECTIVES: To investigate and control an outbreak of epidemic keratoconjunctivitis (EKC) occurring in a neonatal intensive care unit (NICU) and to determine signs specific for EKC in newborns. DESIGN: Outbreak investigation and case-control study. SETTING: NICU of a 1,600-bed university hospital in Heidelberg, Germany. PATIENTS: Case-patients were defined as individuals who had adenoviral antigen detected by ELISA or by PCR from conjunctival swabs or who had clinical signs of conjunctivitis. Twelve newborns from the NICU who had EKC between October and November 1998 were compared with 11 who had bacterial conjunctivitis. INTERVENTION: Control measures included cohorting patients in contact isolation, using gloves and gowns for patient care, and using a hand rub and disinfectants with virucidal activity. RESULTS: Thirteen patients, 6 healthcare workers, and 11 relatives of the patients had EKC, according to our case definition. Case-patients were more likely than control-patients to develop lacrimal swelling (P <.001), eye redness (P =.004), and lacrimation (P=.037) involving both eyes (P =.002). Prior examination by an ophthalmologist was a significant risk factor for EKC (P =.004). For diagnosis or treatment of retinopathy, premature newborns were seen by an ophthalmologist from a nearby eye care center where an EKC outbreak was ongoing. No new cases were diagnosed more than 10 days after the implementation of control measures. CONCLUSION: In newborns, lacrimal swelling, eye redness, and lacrimation in both eyes should evoke suspicion of EKC. Ophthalmologists who have had contact with known EKC cases should use antiseptics and disinfectants with virucidal activity before contact with newborns or abstain from examining newborns.
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An outbreak of epidemic keratoconjunctivitis in a pediatric unit due to Adenovirus Type 8
Infection control and hospital epidemiology, 2003Co-Authors: Iris E Chaberny, Paul Schnitzler, Heinrich K Geiss, Constanze WendtAbstract:OBJECTIVES: To investigate and control an outbreak of epidemic keratoconjunctivitis (EKC) occurring in a neonatal intensive care unit (NICU) and to determine signs specific for EKC in newborns. DESIGN: Outbreak investigation and case-control study. SETTING: NICU of a 1,600-bed university hospital in Heidelberg, Germany. PATIENTS: Case-patients were defined as individuals who had adenoviral antigen detected by ELISA or by PCR from conjunctival swabs or who had clinical signs of conjunctivitis. Twelve newborns from the NICU who had EKC between October and November 1998 were compared with 11 who had bacterial conjunctivitis. INTERVENTION: Control measures included cohorting patients in contact isolation, using gloves and gowns for patient care, and using a hand rub and disinfectants with virucidal activity. RESULTS: Thirteen patients, 6 healthcare workers, and 11 relatives of the patients had EKC, according to our case definition. Case-patients were more likely than control-patients to develop lacrimal swelling (P
Iris E Chaberny - One of the best experts on this subject based on the ideXlab platform.
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an outbreak of epidemic keratoconjunctivitis in a pediatric unit due to Adenovirus Type 8
Infection Control and Hospital Epidemiology, 2003Co-Authors: Iris E Chaberny, Paul Schnitzler, Heinrich K Geiss, Constanze WendtAbstract:OBJECTIVES: To investigate and control an outbreak of epidemic keratoconjunctivitis (EKC) occurring in a neonatal intensive care unit (NICU) and to determine signs specific for EKC in newborns. DESIGN: Outbreak investigation and case-control study. SETTING: NICU of a 1,600-bed university hospital in Heidelberg, Germany. PATIENTS: Case-patients were defined as individuals who had adenoviral antigen detected by ELISA or by PCR from conjunctival swabs or who had clinical signs of conjunctivitis. Twelve newborns from the NICU who had EKC between October and November 1998 were compared with 11 who had bacterial conjunctivitis. INTERVENTION: Control measures included cohorting patients in contact isolation, using gloves and gowns for patient care, and using a hand rub and disinfectants with virucidal activity. RESULTS: Thirteen patients, 6 healthcare workers, and 11 relatives of the patients had EKC, according to our case definition. Case-patients were more likely than control-patients to develop lacrimal swelling (P <.001), eye redness (P =.004), and lacrimation (P=.037) involving both eyes (P =.002). Prior examination by an ophthalmologist was a significant risk factor for EKC (P =.004). For diagnosis or treatment of retinopathy, premature newborns were seen by an ophthalmologist from a nearby eye care center where an EKC outbreak was ongoing. No new cases were diagnosed more than 10 days after the implementation of control measures. CONCLUSION: In newborns, lacrimal swelling, eye redness, and lacrimation in both eyes should evoke suspicion of EKC. Ophthalmologists who have had contact with known EKC cases should use antiseptics and disinfectants with virucidal activity before contact with newborns or abstain from examining newborns.
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An outbreak of epidemic keratoconjunctivitis in a pediatric unit due to Adenovirus Type 8
Infection control and hospital epidemiology, 2003Co-Authors: Iris E Chaberny, Paul Schnitzler, Heinrich K Geiss, Constanze WendtAbstract:OBJECTIVES: To investigate and control an outbreak of epidemic keratoconjunctivitis (EKC) occurring in a neonatal intensive care unit (NICU) and to determine signs specific for EKC in newborns. DESIGN: Outbreak investigation and case-control study. SETTING: NICU of a 1,600-bed university hospital in Heidelberg, Germany. PATIENTS: Case-patients were defined as individuals who had adenoviral antigen detected by ELISA or by PCR from conjunctival swabs or who had clinical signs of conjunctivitis. Twelve newborns from the NICU who had EKC between October and November 1998 were compared with 11 who had bacterial conjunctivitis. INTERVENTION: Control measures included cohorting patients in contact isolation, using gloves and gowns for patient care, and using a hand rub and disinfectants with virucidal activity. RESULTS: Thirteen patients, 6 healthcare workers, and 11 relatives of the patients had EKC, according to our case definition. Case-patients were more likely than control-patients to develop lacrimal swelling (P
Chen-wu Chen - One of the best experts on this subject based on the ideXlab platform.
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The change of etiological agents and clinical signs of epidemic viral conjunctivitis over an 18-year period in southern Taiwan
Graefe's Archive for Clinical and Experimental Ophthalmology, 2003Co-Authors: Cheng-hsien Chang, Minmuh Sheu, Kuei-hsiang Lin, Wen-loong Huang, Huei-zu Wang, Chen-wu ChenAbstract:Background Epidemic viral conjunctivitis is a highly contagious eye disease that occurs worldwide and is caused mainly by Adenoviruses and enteroviruses. An 18-year analysis of the changes of pathogens and clinical signs in a subtropical and densely populated island presents certain special features. Methods We retrospectively analyzed the clinical information and laboratory records of the conjunctivitis patients with positive conjunctival swabs from 1980 to 1997. Results The positive rate of laboratory diagnosis of epidemic conjunctivitis was 50.0% (1,233/2,467). From 1980 to 1994, the predominant causative agent of adenoviral keratoconjunctivitis was Adenovirus Type 8 (Ad8), with six genoTypes being evolved. Three of the new Ad8 genoTypes each caused a new epidemic. After 1995 the predominant adenoviral pathogens shifted to Ad37 and Ad19, and no more Ad8 was isolated. Enterovirus Type 70 (EV70) was isolated from four outbreaks of acute hemorrhagic conjunctivitis (AHC) from 1980 to 1984, but rarely in later years. Coxsackievirus A Type 24 variant (CA24v), which first appeared in 1985, appeared later as the causes of four major epidemics of AHC from 1985 to 1994. The overall clinical symptoms of viral conjunctivitis were more severe in the 1990s than in the 1980s. Conclusion In southern Taiwan, outbreaks of adenoviral keratoconjunctivitis caused by new genomic variants could be associated with the long-term endemic co-circulation of Ad8, Ad19, and Ad37, while epidemics of CA24v AHC were caused mainly by introduction of new viral strains from neighboring countries. The aggravation of host symptoms in the 1990s needs further investigation and close follow-up.
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Epidemic keratoconjunctivitis caused by a new genoType of Adenovirus Type 8 (Ad8)-a chronological review of Ad8 in Southern Taiwan.
Japanese journal of ophthalmology, 2001Co-Authors: Cheng-hsien Chang, Minmuh Sheu, Kuei-hsiang Lin, Wen-loong Huang, Chi-liang Chern, Chen-wu ChenAbstract:Abstract Purpose: To understand the pathogenic evolution of viral keratoconjunctivitis in Kaohsiung, Taiwan, a retrospective molecular and clinical analysis was conducted. Methods: From January 1990 to December 1994, conjunctival swab samples from patients suspected of having viral conjunctivitis were collected for viral culture isolation, neutralization test (NT), and endonuclease cleavage analysis. Six restriction endonucleases, comprising HindIII, BamHI, SalI, SstI, SmaI, and PstI, were used for cleavage. Clinical examinations of patients were performed by two senior ophthalmologists. Results: Twenty-one cases of a new genoType of Adenovirus (Ad) Type 8, designated as Ad8H, were discovered in the 27 detected Adenovirus cases. The Ad8H has a distinct cleavage pattern, especially by HindIII and SalI. The Ad8H keratoconjunctivitis induced more subconjunctival hemorrhage (33.3%), keratitis (33.3%), and lymphadenopathy (85.7%) than other genoTypes of Ad8 previously isolated in Kaohsiung, Taiwan. Conclusion: We have discovered a new genoType, Ad8H, which was prevalent as the main pathogen of the adenoviral keratoconjunctivitis in Kaohsiung, Taiwan from 1990 to 1994. Adenovirus Type 8 is evolving into more genoTypes with a trend towards more severe symptoms, including subconjunctival hemorrhage, keratitis, and lymphadenopathy.
Helena M. Tabery - One of the best experts on this subject based on the ideXlab platform.
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Adenovirus Type 8 Epithelial Keratitis: The Development, Accompanying Signs, and Sequelae
Adenovirus Epithelial Keratitis and Thygeson's Superficial Punctate Keratitis, 2011Co-Authors: Helena M. TaberyAbstract:This chapter shows the development of Ad8 keratitis in patients of whom all but one (Case 8) were exposed to the virus during a nosocomial outbreak of EKC. The infection was transmitted either directly in the Clinic or by infected contacts. Since in clinical practice infections with various Adenovirus seroTypes cannot be distinguished from each other, Ad8 can serve as a model of a sequence events common to all of them. In the absence of causative treatment, the cases presented in this chapter show the natural course of the disease. Cortisone eye drops were not used except for a couple of days during the acute stage in one patient (Case 8) because of an initial diagnostic error.
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The Development of Subepithelial Infiltrates: A Sequence of Events
Adenovirus Epithelial Keratitis and Thygeson's Superficial Punctate Keratitis, 2011Co-Authors: Helena M. TaberyAbstract:The preceding chapters show the appearance of subepithelial infiltrates following infections with various Adenovirus seroTypes captured in different patients at various points of time. This chapter features a sequence of events occurring in the same corneal area in a patient infected with Adenovirus Type 8 (Ad8) during a nosocomial outbreak. The series starts 3 weeks after symptom onset and ends 3 years later. A visualization in detail of a sequence of events occurring in the same corneal area is not an easy undertaking. To perform this task to perfection in a living, moving human eye is difficult, mainly because there are no reference points except the changes themselves; they are not an ideal substitute because changing between occasions, but that is all there is. In the present series, the cornea was heavily affected but there was an area that could be recognized for as long as 15 months. After its pattern had dissipated, the exact orientation was lost. Hence, the series ends with changes captured either in the same location or very close to it.
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Two outbreaks of Adenovirus Type 8 keratoconjunctivitis with different outcome
Acta ophthalmologica Scandinavica, 2009Co-Authors: Helena M. TaberyAbstract:In 1993, a case of Adenovirus Type 8 keratoconjunctivitis acquired in Central Europe was the starting point of an outbreak in Malmo, Sweden. Of the 33 diagnoses cases, 23 were infected nosocomially. In 29 the diagnosis was verified by virus culture. The outbreak was recognised 15 days after the appearance of the first secondary case. Nosocomial transmission was stopped by protective measures which didn't include separation of the infected patients from others. Epidemiologic investigation disclosed unrecognised infections as the main source of virus transmission; contaminated hands and a dropper bottle appeared to be major vectors. A new case of Adenovirus Type 8 infection, again introduced from Central Europe, turned up in September 1994. There was only one secondary case.
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Corneal surface changes in Thygeson's superficial punctate keratitis: a clinical and non-contact photomicrographic in vivo study in the human cornea.
European journal of ophthalmology, 2004Co-Authors: Helena M. TaberyAbstract:PURPOSE. To elucidate mechanisms behind the morphology of Thygeson's superficial punctate keratitis (TSPK). METHODS. Sixteen patients were examined with the slit lamp and photographed by non-contact photomicrography. The results were compared with morphology of epithelial keratitis in herpes simplex Type 1 (HSV1), varicella zoster (VZV), and Adenovirus Type 8 (Ad8) infections, all previously studied by the same method, and with published histologic findings in TSPK. RESULTS. In the photographs, the corneal epithelium showed various numbers of abnormal subsurface cells measuring about 10-15 mum in diameter, present individually, in small groups, or aggregated in larger lesions (coarse lesions with the slit lamp). The surface epithelium was well preserved, except in larger lesions, which showed surface debris. The morphology was unlike HSV1 and VZV epithelial keratitis, but strongly resembled epithelial changes occurring in Ad8 infections on day 5, and later, after the onset of symptoms. CONCLUSIONs. TSPK shows a more widespread epithelial involvement than suspected with the slit lamp. Its morphology seems to reflect an action of a noxious agent targeted at the deeper epithelial layers, with the appearance of abnormal cells as a result. These might represent invading inflammatory cells, damaged intraepithelial ones, or both. The coarse lesions visualize areas of major involvement showing discernible signs of cell destruction. The similarity to Ad8 keratitis suggests that the source of the noxious agent might be located outside the cornea. The morphology, in conjunction with clinical features, is compatible with an immunologically mediated injury. The etiology remains unknown. (Eur J Ophthalmol 2004; 14: 85-93) (Less)
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Corneal epithelial changes due to Adenovirus Type 8 infection. A non-contact photomicrographic in vivo study in the human cornea.
Acta ophthalmologica Scandinavica, 2000Co-Authors: Helena M. TaberyAbstract:PURPOSE To investigate corneal epithelial changes in human Adenovirus Type 8 (Ad8) infection, and compare them with herpes simplex virus Type 1 (HSV1) changes. MATERIAL AND METHOD 12 patients with Ad8 infection: in 10 verified by tissue culture, in 2 clinically. The corneae were photographed by non-contact photomicrography. RESULTS Within the first days the epithelium showed multiple elevations measuring about 20-30 microm in diameter, and from about day 5 large numbers of scattered subsurficial abnormal cells. At the end of the first week larger (about 150-200 microm in diameter) epithelial foci started to appear. No focal ulcerative changes were observed. CONCLUSIONS The subsequent stages of Ad8 cytopathic effect are difficult to discern. The primary virus target seems to be the deeper epithelial layers. The damaged cells are probably successively transported toward the surface and desquamated. The etiology of larger focal changes is unclear. The presence (HSV1) or absence (Ad8) of ulcerative changes differentiates these two infections.
Shigeaki Ohno - One of the best experts on this subject based on the ideXlab platform.
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Molecular epidemiology of adenoviral keratoconjunctivitis in
2016Co-Authors: Shigeaki OhnoAbstract:Purpose: Adenoviral keratoconjunctivitis is a major cause of ocular morbidity and may lead to visual loss. Adenovirus Types 8, 19, and 37 may cause epidemic keratoconjunctivitis. The main objective of this study was to determine the Types of Adenoviruses causing keratoconjunctivitis in Saudi Arabia. Methods: We conducted a non-interventional observational clinical study. Seventy three eyes from 65 patients who presented to The Eye Center in Riyadh, Saudi Arabia with clinical features of acute adenoviral keratoconjunctivitis were included. Each patient underwent complete clinical examination and features such as membranous reaction, conjunctival hemorrhage, subepithelial corneal infiltrates, and preauricular lymph node enlargement were recorded. Conjunctival swabs were obtained from patients with presumed acute viral conjunctivitis. Immunochromatography (IC) and restriction fragment length polymorphism polymerase chain reaction (PCR-RFLP) were performed on the conjunctival swabs obtained from each eye. SeroType identification was performed using direct sequencing technique. Results: Forty-nine (67.1%) were Adenovirus Type 8, 8 (11.0%) were Adenovirus Type 3, 6 (8.2%) Type 37, 5 (6.8%) were Adenovirus Type 4, and 2 (2.3%) Type 19. The remaining 5 were Types 14, 19, and 22. The prevalence of membranous conjunctivitis was highest (83%) among eyes with Adenovirus Type 37 while subepithelial corneal opacities were mos
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genome variability of human Adenovirus Type 8 causing epidemic keratoconjunctivitis during 1986 2003 in japan
Molecular Vision, 2011Co-Authors: Xuehai Jin, Koki Aoki, Nobuyoshi Kitaichi, Toshihide Ariga, Susumu Ishida, Shigeaki OhnoAbstract:Purpose: Epidemic keratoconjunctivitis (EKC) is a contagious acute conjunctivitis associated with community-acquired infection. Human Adenovirus Type 8 (HAdV-8) is one of the major seroTypes isolated from patients with EKC. DNA restriction enzyme analyses were performed to investigate the genetic characteristics of the isolates and their chronological pattern. Methods: Viral samples were taken from 11 strains isolated from sporadic cases of EKC and identified as HAdV-8 by the neutralization method with Type-specific antiserum against HAdV-8 between 1986 and 2003 in Japan. DNA restriction enzyme analysis included six restriction enzymes: BamHI, HindIII, PstI, SacI, SalI, and SmaI. Results: The restriction patterns revealed that the genome Types were HAdV-8A and HAdV-8B in 1986, HAdV-8K in 1991, and HAdV-8E in 1996. HAdV-8K was a new genome Type revealed with the enzyme SacI. Two strains isolated in 2003 exhibited identical restriction patterns as HAdV-54, which was described in 2008 and collected from Japanese patients in 2000. Conclusions: Genetic changes might occur chronologically in HAdV-8. HAdV-8 displays considerable variability. The investigations of these variants might be helpful for defining the evolutionary tendency and to predict future outbreaks of HAdV infection.
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analysis of the complete genome sequence of epidemic keratoconjunctivitis related human Adenovirus Type 8 19 37 and a novel seroType
Journal of General Virology, 2009Co-Authors: Hisatoshi Kaneko, Shigeaki Ohno, Koki Aoki, Toshihide Ariga, Hiroaki Ishiko, Takeshi Ohguchi, Yoshitsugu Tagawa, Tomohiro Iida, Tatsuo SuzutaniAbstract:We determined the complete genome sequence of epidemic keratoconjunctivitis (EKC)-related human Adenoviruses (HAdVs). We analysed a total of 12 HAdV strains; three protoType strains and two HAdV-8, three HAdV-19 and three HAdV-37 clinical isolates from EKC patients in Japan, and one novel seroType of HAdV. Genome organization of these seroTypes was identical to those of the recently determined HAdV-19 and HAdV-37. The identities of the whole genome were over 99 % among strains from the same seroType, except for HAdV-19p, which is not associated with conjunctivitis, resulting in the formation of a distinct cluster in the phylogenetic analysis. The penton, loop 1 and loop 2 of hexon, early region 3 (E3) and fiber were hypervariable regions between seroTypes. Results suggest that the HAdV-19 clinical strain is a recombinant of HAdV-19p-like and HAdV-37-like strains, and that the acquisition of the penton, E3 or fiber may be related to ocular tropism.
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Nucleotide sequence variation in the hexon gene of human Adenovirus Type 8 and 37 strains from epidemic keratoconjunctivitis patients in Japan.
Journal of General Virology, 2009Co-Authors: Hisatoshi Kaneko, Koki Aoki, Hiroaki Ishiko, Takeshi Ohguchi, Yoshitsugu Tagawa, Tatsuo Suzutani, Shigeaki OhnoAbstract:Human Adenovirus Type 8 (HAdV-8) and 37 (HAdV-37) cause epidemic keratoconjunctivitis (EKC) associated with community-acquired and nosocomial infections. The nucleotide sequences of the entire hexon and fiber genes of eight HAdV-8 and 26 HAdV-37 strains were analysed and the transition mutations in each gene were compared among strains. Compared with protoType strains, the hexon gene of HAdV-8 and -37 strains showed between two and seven and one and twelve variations at nine and 21 different positions, respectively. All of these, except one position in HAdV-37, were located in the conserved region 4 (C4). There were only three polymorphisms in the fiber gene of both HAdV-8 and HAdV-37, fewer than those in C4. The nucleotide sequence of HAdV-8 and -37 C4 might be readily modified during EKC epidemics.
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bacterial infection in the conjunctiva of patients with adenoviral conjunctivitis
Japanese Journal of Ophthalmology, 2001Co-Authors: Y Watanabe, Koki Aoki, E Uchio, N Itoh, N Usui, H Nakagawa, K Inoue, R Hinokuma, Y Asato, Shigeaki OhnoAbstract:Abstract Purpose: We evaluate the microbiological features of mixed infection in Adenovirus-infected conjunctiva. Subjects: Isolation of bacteria was performed in 82 samples of adenoviral conjunctivitis at six eye clinics in Japan. Methods: For microbiological diagnosis, we performed immunochromatography (IC) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis for detection and serotyping of Adenovirus, and PCR for detection of herpes simplex virus (HSV) and Chlamydia trachomatis antigens out of 82 samples with adenoviral conjunctivitis. Results: Pathogenic bacteria were isolated in 6 samples out of 82. Out of these 6 cases, 5 samples were gram-negative rods and most of them were Flavobacterium meningosepticum (4 samples). Adenovirus Type 8 was isolated from all these mixed infection cases. However, HSV-1 and Chlamydia trachomatis were not found. Conclusions: From these results, it is suggested that gram-negative rods, especially F. meningosepticum, are the most common bacteria causing mixed bacterial infection in adenoviral conjunctivitis.