Pattern of presentation and laboratory findings of patients with epidemic keratoconjunctivitis in the 2023 outbreak in North India: A hospital-based analysis

Abstract

Context: Epidemic keratoconjunctivitis (EKC) is a highly contagious acute conjunctival infection caused by adenovirus. In the 3rd week of July 2023, we observed a surge in the number of patients with EKC in North India. Identifying cases of EKC and controlling its spread are important for preventing larger outbreaks. Aims: The aim of this study was to know the pattern of presentation and laboratory investigation in cases of EKC during a recent outbreak. Materials and Methods: All patients with features of conjunctivitis were examined and investigated. Demographic data and clinical features were recorded. We also collected data on potential exposure through nonstructured interviews. Conjunctival swab and blood sample were collected from two patients for adenovirus qualitative polymerase chain reaction (PCR) and for other conjunctivitis virus panel PCR. Statistical Analysis Used: The characteristics of the EKC cases were described in terms of frequency (n) and percentage (%). The prevalence of EKC was calculated by dividing the number of EKC cases by the total number of patients visiting the clinic during the study period. Results: A total of 387 cases of EKC were reported out of the 2876 patients during the study period of 6 days (prevalence rate = 13.45%). The mean age of the patients was 30.69 ± 20.65 years. All patients complained of redness (n = 387, 100%) and a foreign body sensation (n = 334, 86.3%). The most common sign was conjunctival congestion in 100% of the cases. Four patients had superficial punctate keratitis, three had subepithelial haze, two had pseudomembrane, and one had atypical dacryoadenitis. Of the 387, 291 (75.2%) patients were definitively exposed to acute conjunctivitis within the family or workplace. Adenovirus was detected in both samples of conjunctival swab in real-time PCR; however, blood specimens tested were negative for adenovirus. Conclusions: The recent outbreak of EKC in India is highly contagious and due to adenovirus. The patient should be educated about the contagious nature of EKC and aware that it is easily transmitted by contact.

Keywords

• adenovirus ocular infection
• epidemic keratoconjunctivitis
• viral conjunctivitis