RESUMO
We describe a large outbreak of severe pustular conjunctivitis due to Neiserria gonorrhoeae. Over 9,000 cases occurred during 8 months in 1987-1988 in one district in North Omo, Ethiopia. Both sexes and all age groups were affected, particularly children under 5 years of age; only a small minority were neonates. Despite a highly successful cure rate for individual cases, the outbreak continued for a number of months. Several epidemiologic approaches were used to monitor the outbreak and identify the mechanism of transmission. The epidemic curve suggested person-to-person transmission. Routine surveillance data showed that there was no concurrent genital gonorrhea outbreak and genital transmission could not explain a community-wide outbreak. In the setting of intense crowding and relative lack of water, peak transmission of illness coincided with two periods following the rains, suggesting that flies were important in transmission. A case-control study identified lack of face-washing as a household risk factor. Eighty seven of one-hundred and forty six (59%) control houses with children were judged to contain children with clean faces, while only 102 of 216 (47%) case households contained children with clean faces (p less than .05). Our recommendations include measures to improve personal hygiene.
