1. Epidemic keratoconjunctivitis (EKC), also known as adenoviral keratoconjunctivitis, is a highly contagious eye infection caused by adenoviruses, most commonly serotypes 8, 19, and 37. 2. It spreads through hand-to-eye contact or respiratory droplets and tends to occur in clusters in places like schools and workplaces. 3. The virus can survive outside the body for up to 30 days and enters host cells, causing inflammation and viral shedding for 10-14 days after symptoms appear. Diagnosis involves eye exams and viral testing of conjunctival swabs. While there is no vaccine or approved treatment, prevention focuses

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