epidemic keratosis

1. Epidemic keratoconjunctivitis(pinkeye’s)
DEPARTMENT OF MICROBIOLOGY AND IMMUNOLOGY
Prepared by:
Daniel Mwandu
Angel Charles
Date: 24/01/2024

2. Presentation Outline
• Introduction
• Etiology
• Shedding and incubation period
• Pathogenesis
• Diagnosis
• Treatment, Prevention, and Control
January 24, 2024 2
1:28:18 AM

3. INTRODUCTION
• Epidemic keratoconjunctivitis (EKC), also known as
adenoviral keratoconjunctivitis,
• It is a highly contagious eye infection that affects both the
cornea and the conjunctiva
• It can spread through hand-to-eye contact by hands or
objects that are contaminated with the infectious virus.
• It can also spread by respiratory droplets.
• EKC infections tend to occur in clusters such as military
camps, schools, hospitals, nursing homes, and
workplaces.

4. ETIOLOGY
Acute Conjunctivitis
VIRUSES
Adenoviruses >75%
Others:
Rubella, measles, .
Herpesviruses,
Picornaviruses(coxs
ackievirus and
enterovirus)
BACTERIA
C.trachomatis
Staphylococcus
spp
S. pneumoniae
ALLERGIC
pollen, grass
and other
airborne
80%

5. cont.

6. Cont.
• About 19 serotypes known to cause epidemic
keratoconjunctivitis (EKC).
• The most commonly associated serotypes
include adenovirus 8, 19, and 37.
• Adenovirus, serotype 8 is the major agent of
epidemic keratoconjunctivitis (EKC)
• less frequently, serotypes 2-5, 7, 9, 10, 11, 14,
16, 21, and 29.

7. VIRAL SHEDDING AND INCUBATION PERIOD
• The incubation period is 2-14 days,
• Most people will have symptoms in 5-6 days
after exposure.
• Infected person may remain infectious for 10-14
days after symptoms develop
• Viral shedding also may occur before symptoms

8. PATHOGENESIS
 Adenoviruses are able to survive outside of the body
for a prolonged period of time (up to 30 days).
 Adenovirus (AdV) is a lytic, naked ds DNA virus
 The presence, internalization and replication of the
virus of AdV on the ocular surface causes secretion
of IL-8.
 IL-8 inflammatory cells and promotes the
internalization of AdV into the host cell.
 Also actives complement-mediated lysis of AdV-
infected cells, and ADCC via NK cells

9. DIAGNOSIS
• PE: Eye examination.
• Specimens from Conjunctival swab for dipstick test
and or PCR should be collected in the early illness,
• Viral shedding for keratoconjunctivitis is 2 weeks
• Serum is required after two week( useful for
epidemiology purpose)

10. Differential diagnosis

11. Laboratory Diagnosis
A. Viral Culture: CPE in 2 to 7 days (cell rounding, grapelike
clusters)
B. Direct examination of clinical specimens
 Polymerase chain reaction (PCR) assays
C. Immunoassay tests
 Neutralization and hemagglutination inhibition
tests.
 Adenovirus Swab Test(RP Adeno Detector and
Adeno Plus),
 ELISA

12. Adenovirus Swab Test
• The RPS Adeno Detector is based on
the principle of lateral flow
immunochromatography.
• The test involves running a soft swab
between the lower eyelid and
conjunctiva to obtain a sample of fluid,
• sensitivity of 98% and a specificity of
85%.
• Adenovirus swab tests should be
done within the 7 days of the
appearance of symptoms to ensure the
most accurate results.

13. Treatment, Prevention and Control
• No approved antiviral drugs and Vaccines for
adenoviral infections
• Treatment is based on the symptoms, antibiotic
used to prevent 2o bacterial infections.
• Face washing, Environmental and total body
hygiene to prevent transmission of disease from
one person to another
• Chlorination of swimming pool to prevent
outbreaks of adenovirus conjunctivitis.

14. Reference
1. Arun Kumar Adhikary: Genetic characterization of
adenovirus Type 8 (Ad8) isolated in South-East Kyushu
for the period of 1998-1999, Nov, 2000.
2. Andria M. Pihos :Epidemic keratoconjunctivitis: A review
of current concepts in management, 25 July 2012.
3. Jeremy Hoffman: Adenovirus: ocular manifestations,
2020.
4. Cristina Martin et al: Epidemic keratoconjunctivitis:
efficacy of outbreak management, Aug ,2021.

15. THANK YOU