ABSTRACT
The Ministry of Health of Government of Southern Sudan [MOH/GOSS] reported an outbreak of acute hemorrhagic conjunctivitis "red eye syndrome" in Juba town and the surrounding districts. A team composed of the Field Epidemiology and Laboratory training Program [FELTP] Residents and FELTP alumni investigated the outbreak to identify the etiological agent and the magnitude of spread in Juba town. The outbreak started on the 19th International epidemiological week. As of July 11, a total of 428 cases were listed from 6 health facilities. Three out of six conjunctival swabs sent to KEMRI/CDC laboratory in Kenya tested positive for coxsackie virus A24v. The MOH/GOSS and WHO/Juba with support from health NGOs initiated a massive health education targeting eye and personal hygiene, and case management
Subject(s)
Humans , Disease Outbreaks , Conjunctivitis, Acute Hemorrhagic/virology , Population SurveillanceABSTRACT
In this study, we have tested a reverse transcription (RT) nested polymerase chain reaction (nPCR) for detection of enterovirus (EV) RNA in cerebrospinal fluid (CSF), serum samples, and conjunctival swabs (CS) from patients with suspected enterovirus infections. A specific 113-bp fragment was amplified using primers designed based on 5' non coding region of the enterovirus genome. The enterovirus RT-nPCR was able to detect 0.001 plaque forming unit (pfu)/ml. Since no PCR product was detected in each of the CSF, CS and serum samples from patients with proven-non-enterovirus viral infections, this method was found to be specific. EV RNA was detected in all 30 culture-confirmed CSF samples and yielded positive results in 5 out of 7 additional cases of culture-negative CSF samples with other evidences of enterovirus infection. Overall, EV RNA was detected in 95 of the patients with clinical diagnosis of viral central nervous system (CNS) disease and confirmed enterovirus infection. Furthermore, we were able to detect EV RNA in 24 (47) out of 51 CSF samples from patients with clinical diagnosis of viral CNS disease and negative laboratory evidence of viral infection. The percentage of positive EV RNA detection in paired CSF and serum samples from 11 patients with an enterovirus isolate in CSF was 100 (11 of 11) and 73 (8 of 11), respectively. In addition, EV-specific IgM was detected in 64 (7 of 11) of the sera tested. The method was also tested against 136 samples of CS from patients with clinical diagnosis of acute hemorrhagic conjunctivitis. Ninety nine of them resulted positive (73), while only 27 (20) had been positive for viral culture. In summary, our study shows the importance of enterovirus RT-nPCR for the diagnosis of enterovirus associated disease in different kind of biological samples and different types of diseases.
Subject(s)
Humans , Animals , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Conjunctivitis, Acute Hemorrhagic/virology , Enterovirus , Meningitis, Aseptic/virology , Reverse Transcriptase Polymerase Chain Reaction , Acute Disease , Aged, 80 and over , Chlorocebus aethiops , Conjunctivitis, Acute Hemorrhagic/blood , Conjunctivitis, Acute Hemorrhagic/cerebrospinal fluid , Enterovirus , HeLa Cells , Meningitis, Aseptic/blood , Meningitis, Aseptic/cerebrospinal fluid , Prospective Studies , RNA, Viral , Sensitivity and Specificity , Tumor Cells, Cultured , Vero CellsABSTRACT
An epidemic of acute harmorrhagic conjunctivitis [AHC] started in Karachi in July, 1986 and quickly spread to other parts of the country. The epidemic died down by the end of September, 1986. The usual clinical picture of acute conjunctivitis was observed, however, haemorrhages were seen in. only 3.0% of the cases. The aetiological agent was identified as a variant of the Coxsackievirus type A 24, which seems to have appeared in this part of the world for the first time. The paper describes the laboratory investigations undertaken to study the aetiological agent and its virological characteristics