Abstract
This work describes and analyses an outbreak of epidemic keratoconjunctivitis which occurred in 2001 and 2002 in a nursing home for the elderly in Leganes (an area of Madrid). This is the first such published case in Spain with these characteristics and this serotype identification. Sociodemographic characteristics, epidemic curve and attack rates are described. Comparisons of the data were carried out using a chi2 test for qualitative variable and t-test for quantitative. Factors associated with the illness are explored by means of contingency tables and logistic regression models. One hundred and two cases were detected, with an attack rate of 36.4% for residents, and 12.9% for workers, not considering spatial or professional differences. The epidemic curve showed an interpersonal transmission pattern. Multivariate analysis identified the following risk factors in the residents: able to wander freely through the building, urinary incontinence and use of shared bathroom. In 34.6% of the conjunctival samples, adenovirus serotype 8 was detected with identical genomic sequence. Establishment of hygienic sanitary guidance adapted for the cleaning of such establishments and contact with residents as well as early diagnosis and good coordination of human and material resources are key factors in the prevention and control of these outbreaks in closed communities.
Highlights
Adenoviruses are a well recognised cause of keratoconjunctivitis, producing a characteristic sub epithelial punctate keratitis and follicular conjunctivitis which can be seen by examination of eye using a slit lamp [3]
Medical devices and products contaminated by adenoviruses have been implicated in the transmission within healthcare environments [6,7,8,9,10]
Described adenoviral epidemic keratoconjunctivitis (EKC) outbreaks usually been in specific environments: hospitals, ophthalmology units, emergency services facilities, factories, schools, residences, and camps (5 6 7 8) Factors associated with community outbreaks are the use of pools file://D:\TMP\CPDCLU9J.htm
Summary
This work describes and analyses an outbreak of epidemic keratoconjunctivitis which occurred in 2001 and 2002 in a nursing home for the elderly in Leganes (an area of Madrid). This is the first such published case in Spain with these characteristics and this serotype identification. Described adenoviral EKC outbreaks usually been in specific environments: hospitals, ophthalmology units, emergency services facilities, factories, schools, residences, and camps (5 6 7 8) Factors associated with community outbreaks are the use of pools file://D:\TMP\CPDCLU9J.htm. Our report is the first in Spain to describe the specific serotype identification and the diffusion of an EKC outbreak in a nursing home for the elderly (from December 2001 to March 2002) in Leganes (south of Madrid). The identification of possible risk factors associated with its occurrence and the assessment of the measures adopted for its control are described
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