Epidemic keratoconjunctivitis in a chronic care facility: risk factors and measures for control.
J Am Geriatr Soc
; 41(11): 1177-81, 1993 Nov.
Article
em En
| MEDLINE
| ID: mdl-8227890
ABSTRACT
OBJECTIVE:
To study patterns of transmission of epidemic keratoconjunctivitis (EKC) in a chronic care facility and to assess control measures and prevent future outbreaks in this setting.DESIGN:
A retrospective cohort study.SETTING:
A 120-bed, four-unit, skilled nursing facility. PATIENTS Residents and employees of the above facility.INTERVENTIONS:
Increased frequency of cleaning; use of bleach disinfectant; universal precautions in handling eye secretions from residents with conjunctivitis; cohorting residents by unit; suspension of new admissions; closure of common gathering areas. MEASUREMENTS Resident demographics; possible risk factors for infection among residents (including mobility, underlying illness, medications, involvement in social activity, level of confusion) and among employees (including co-morbid illnesses and eye conditions, exposures to persons with conjunctivitis, visits to eye care specialists, use of contact lenses or glasses); testing of conjunctival specimens from symptomatic persons for viral and bacterial agents.RESULTS:
Of 95 residents on three chronic care units, 47 (attack rate 49%) had onset of eye symptoms consistent with EKC between September 14 and December 7, 1990. Thirty-eight (81%) of these had onset following the onset of symptoms in a resident with dementia who, despite habitual eye-rubbing and wandering into other residents' rooms, was not isolated or restricted in any way. Attack rates were higher (though not statistically significant) among more mobile residents (60% for ambulatory residents) and among those considered by staff to be confused (56%). Rapid antigen detection and culture confirmed adenovirus type 37 as the etiologic agent.CONCLUSIONS:
Transmission of infection with adenovirus type 37 was successfully interrupted following strict infection control, suspension of new admissions, cohorting of residents by unit, and change to a disinfectant that inactivates adenovirus. Recognition of conjunctivitis as an appropriate reason for restricting movement of an infected resident may have prevented extensive viral transmission in this outbreak.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções por Adenovirus Humanos
/
Adenovírus Humanos
/
Infecção Hospitalar
/
Surtos de Doenças
/
Controle de Infecções
/
Ceratoconjuntivite
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Am Geriatr Soc
Ano de publicação:
1993
Tipo de documento:
Article