The prevalence of adenoviral conjunctivitis at the Clinical Hospital of the State University of Campinas, Brazil

OBJECTIVES: Viral conjunctivitis is a common, highly contagious disease that is often caused by an adenovirus. The aim of this study was to evaluate the prevalence of adenoviral conjunctivitis by analyzing data from a prospective clinical study of 122 consecutively enrolled patients who were treated at the Clinical Hospital of the State University of Campinas (UNICAMP) after a clinical diagnosis of infectious conjunctivitis between November 2011 and June 2012. METHODS: Polymerase chain reaction was used to evaluate all cases of clinically diagnosed infectious conjunctivitis and based on the laboratory findings, the prevalence of adenoviral infections was determined. The incidence of subepithelial corneal infiltrates was also investigated. RESULTS: Of the 122 patients with acute infectious conjunctivitis included, 72 had positive polymerase chain reaction results for adenoviruses and 17 patients developed subepithelial corneal infiltrates (13.93%). CONCLUSIONS: The polymerase chain reaction revealed that the prevalence of adenoviral conjunctivitis was 59% in all patients who presented with a clinical diagnosis of infectious conjunctivitis from November 2011 to June 2012. The prevalence of adenoviral conjunctivitis in the study population was similar to its prevalence in other regions of the world.

Comparação do tratamento homeopático e convencional numa epidemia de conjuntivite / Comparación del tratamiento homeopático y convencional en una epidemia de conjuntivitis / Comparison between homeopathic and conventional treatment in a conjunctivitis epidemic

Objetivo: Comparar os resultados dos tratamentos homeopático e convencional na epidemia de conjuntivite viral em 1997 em Ranchuelo, VC, Cuba. Materiais e métodos: Estudo retrospectivo de 67 pacientes diagnosticados e hospitalizados durante uma epidemia de conjuntivite viral que aconteceu entre julho e setembro de 1997 na área de saúde de Ranchuelo, divididos em dois grupos; um grupo de 47 pacientes foi submetido a tratamento convencional, e em segundo grupo de 20 pacientes a tratamento homeopático. Resultados: Comprovou-se que o tratamento homeopático induziu a cura em menor tempo, o tratamento convencional requereu quase o dobro do tempo. Além do mais, o tratamento homeopático teve custo menor que o convencional, que foi mais do dobro. Conclusões: Foi demostrada a ação benéfica do tratamento homeopático no controle da epidemia, enquanto que a cura aconteceu num tempo mais breve e com menos custo que o tratamento convencional.

Aim: To compare results of homeopathic and conventional treatment in a conjunctivitis epidemic in 1997 in Ranchuelo, VC, Cuba. Materials and methods: Retrospective study comprising 67 patients diagnosed and hospitalized during a viral conjunctivitis epidemic between July and September 1997 in Ranchuelo health district divided in two groups; one group comprising 47 patients was given conventional treatment, and a second group comprising 20 patients was given homeopathic treatment. Results: Homeopathic treatment elicited faster healing, since conventional treatment required almost twice as long. Moreover, cost of homeopathic treatment was lowed compared to conventional treatment, the latter was more than twice as expensive. Conclusions: Homeopathic treatment proved beneficial to control this epidemic since healing was faster and less expensive than conventional treatment.

Objetivo: Comparar los resultados de los tratamientos homeopático y convencional sobre la epidemia de conjuntivitis viral del año 1997 en Ranchuelo, VC, Cuba. Material y métodos: Se trata de un estudio retrospectivo de un total de 67 pacientes que se diagnosticaron y se ingresaron durante la epidemia de conjuntivitis viral que se produjo en los meses de julio a septiembre de 1997 en el área de salud de Ranchuelo, conformados en dos grupos, un primer grupo de 47 pacientes tratados con medicamentos convencionales y un segundo grupo de 20 pacientes tratados con medicamentos homeopáticos, Resultados: Se comprobó que el tratamiento homeopático produjo la curación en menor tiempo, necesitando el otro tratamiento casi el doble del tiempo y además, que el tratamiento homeopático demostró ser más barato que el convencional, siendo el costo de éste último más del doble. Conclusiones: Quedó demostrada la buena acción del medicamento homeopático sobre la epidemia, con la curación que se produjo en mucho menos tiempo y con menos costo que con los otros medicamentos.

Molecular epidemiology of adenovirus conjunctivitis in Rio de Janeiro, Brazil, between 2004 and 2007 / Epidemiologia molecular de adenovírus associados à conjuntivite no Rio de Janeiro, Brasil, no periodo de 2004 a 2007

Viral conjunctivitis is a common, highly contagious disease often caused by adenovirus. We investigate the frequency of adenoviral conjunctivitis in the population of Rio de Janeiro, Brazil, between March 2004 and May 2007 and identified the predominant serotype circulating among this population. Seventy-five ocular swabs were collected from 66 patients with clinical presentation of conjunctivitis. The specimens were analyzed for detection of adenovirus (AdV) by polymerase chain reaction (PCR). The PCR products were further analyzed for virus typing by sequence analysis and/or heteroduplex mobility assay (HMA). Forty-five samples (60%) were positive for AdV of which 21 samples were typed as AdV19 (46.7%), 7 AdV8 (15.5%), 3 AdV31 (6.7%), and one each AdV1, AdV2, AdV3, AdV4 and AdV6. For nine samples the serotype was not determined. AdV19 was the predominant serotype circulating in Rio de Janeiro during the studied period.

A conjuntivite viral é doença ocular comum, altamente contagiosa, frequentemente causada por adenovírus. Neste estudo, investigamos a frequência de conjuntivite por adenovírus na população do Rio de Janeiro, Brasil, entre março de 2004 e maio de 2007, e identificamos o sorotipo predominante circulando nesta população. Setenta e cinco swabs de secreção ocular foram coletados de 66 pacientes com conjuntivite. As amostras foram analisadas para detecção de adenovírus (AdV) por reação em cadeia da polimerase (PCR). Os produtos da PCR foram caracterizados por sequenciamento e/ou ensaio de mobilidade do heteroduplex (Heteroduplex Mobility Assay - HMA) para identificação do sorotipo viral. Quarenta e cinco (60%) amostras foram positivas para AdV das quais 21 foram identificadas como pertencentes ao sorotipo AdV19 (46,7%), sete AdV8 (15,5%), três AdV31 (6,7%), e uma de cada: AdV1, AdV2, AdV3, AdV4 e AdV6. Para nove amostras o sorotipo não pode ser identificado. O AdV 19 foi o sorotipo predominante circulando no Rio de Janeiro durante o período estudado.

Self-medication: initial treatments used by patients seen in an ophthalmologic emergency room

OBJECTIVE: This study seeks to identify practices of self-medication in the treatment of ocular emergencies. We examine patients' use of both homemade preparations and manufactured products before seeking specialized care. MATERIALS AND METHODS: We conducted a cross-sectional analytic survey of consecutive patients seen in the ophthalmology emergency room of a teaching hospital. RESULTS: The sample included 561 subjects, 51.3 percent males and 48.7 percent females, with a mean age of 39.8 years. Prior to seeking emergency care, 40.5 percent reported self-medicating; 29.4 percent used a homemade preparation (13.9 percent referred to an industrialized product like boric acid as a homemade preparation), and 11.1 percent used a manufactured product. The most frequently used products included a boric acid solution (53.3 percent), a normal saline solution (35.7 percent), herbal infusions (6.1 percent) and breast milk (4.8 percent). Viral conjunctivitis was the most frequent diagnosis (24.4 percent), followed by the presence of a corneal foreign body (7.4 percent). No significant differences were found in the self-treatment of ocular injuries according to gender (p = 0.95), level of education (p = 0.21) or age (p = 0.14). In addition, self-medication practices were not related to the medically judged severity of the condition. CONCLUSION: Patients often attempt to treat conditions that require ophthalmologic emergency care by self-medicating with homemade or manufactured products. The most widely used products include boric acid, normal saline, leaf infusions and breast milk. This behavior occurs independently of educational level, gender, age or the nature of the ocular condition. Self-medication is a culturally driven practice that is used even in cases of acute ocular injuries.

Epidemic adenoviral conjunctivitis report of an outbreak in a military Garrison and recommendations for its management and prevention

The study was conducted to document the cases of adenoviral conjunctivitis, evaluate its clinical patterns, prevent its transmission and reduce its severity and complications during an epidemic. A total of 2968 cases of adenoviral conjunctivitis were documented during the months of June, July and August 2003. By simple randomization, 200 Patients were selected and divided into two groups on the basis of treatment. Group 1 [Treatment group] 40% patients were given topical anti-histamine/decongestant eye drops whereas Group 2 [Control group] 60% patients were managed conservatively by washing eyes with cold water and applying ice packs on the eyes. Highest incidence of the disease was seen in the month of July 2003. In most of cases [90%] both eyes of the respondents were affected. Acute illness lasted from 4.91 days in Group 1 and 7.86 days in Group 2. Commonly observed symptoms included redness, watering, itching, burning, pain in the eyes and photophobia. Duration of the illness was less and severity was mild in Group 1 patients as compared with Group 2 patients this was found to be statistically significant using T test [P< 0.05]. None of the cases reported any complication after complete recovery from adenoviral conjunctivitis. Adenoviral conjunctivitis is a highly contagious disease and often spreads in epidemics, particularly in crowded communities with poor hygiene. Prevention of transmission is the most important therapeutic measure particularly in the ophthalmic clinics of the hospitals. Although the disease is benign and self-limiting, cold compresses and topical anti-histamine/decongestant eye drops reduce the discomfort and severity of the disease

Role of adenoviruses in viral conjunctivitis

To assess the incidence of adenoviruses in viral conjunctivitis, 40 cases diagnosed clinically as viral conjunctivitis were studied. Adenoviruses detection by conjunctival swabing and scraping was done using the indirect immunofluorescent technique. Results have shown that 75% of cases were positive for adenoviruses, and that both types of sampling methods were efficient in detecting the intranuclear viral antigens in the infected conjunctival cells. The peak of adenoviruses conjunctival infection was observed in November, December and January. It is recommended to use the conjunctival swab method for direct detection of adenoviruses in the infected conjunctival cells by indirect immunofluorescent method

An epidemic of acute haemorrhagic conjunctivitis caused by coxsackie A24 variant.

An epidemic of acute haemorrhagic conjunctivitis (AHC) caused by a variant of coxsackie A24 (cox A24) occurred in Delhi during August to September 1988. Cox A24 antigen was detected by indirect immunofluorescence (IFA) in conjunctival cell smears of 13 of the 38 (34.2%) patients studied. Virus was isolated from conjunctival swabs in 11 (28.9%) patients and all isolates were neutralized by cox A24 antiserum. Five virus strains sent to Virology Division of Centres for Disease Control, Atlanta, USA, were confirmed as cox A24 variant. Enterovirus type 70 (EV70) was not demonstrable either by IFA or neutralization tests. Conjunctival swabs from 10 healthy laboratory controls did not show any evidence of EV70 or cox A24 virus or their antigens.