June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Efficacy of compartmentalization in adenovirus type 54 epidemic keratoconjunctivitis outbreak in an isolated island
Author Affiliations & Notes
  • Yutaka Oomatsu
    ophtalmology, Tottori university, Yonago, Tottori, Japan
  • Dai Miyazaki
    ophtalmology, Tottori university, Yonago, Tottori, Japan
  • Kazuki Matsuura
    ophtalmology, Tottori university, Yonago, Tottori, Japan
  • Yoshitsugu Inoue
    ophtalmology, Tottori university, Yonago, Tottori, Japan
  • Eiichi Uchio
    Ophthalmology, Fukuoka university, Fukuoka, Fukuoka, Japan
  • Yumiko Shimizu
    ophtalmology, Tottori university, Yonago, Tottori, Japan
  • Footnotes
    Commercial Relationships   Yutaka Oomatsu, None; Dai Miyazaki, None; Kazuki Matsuura, None; Yoshitsugu Inoue, None; Eiichi Uchio, None; Yumiko Shimizu, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4899. doi:
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      Yutaka Oomatsu, Dai Miyazaki, Kazuki Matsuura, Yoshitsugu Inoue, Eiichi Uchio, Yumiko Shimizu; Efficacy of compartmentalization in adenovirus type 54 epidemic keratoconjunctivitis outbreak in an isolated island. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4899.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To analyze epidemiological characteristics of human adenovirus type 54 (HAdV-54) epidemic keratoconjunctivitis (EKC) outbreak and assess efficacy of compartmentalization for development of infection control measure.

Methods : HAdV-54 outbreak in an isolated island, Oki, were epidemiologically analyzed. In 2017 outbreak, 136 EKC patients belonging to 3 nursery schools, were infected. Adenovirus was typed as HAdV-54 by PCR / direct sequencing. The effect of compartmentalization for infection control was assessed using the cumulative infection rate during the outbreak. Effect of clinical characteristics on disease duration was assessed using Kaplan-Meier survival curve and Cox proportional hazard model.

Results : HAdV-54 infection was confined to three nursery schools in the isolated island, and children and their parents were infected. Age distribution of patients was bimodal (0-5 and 30-35 years). Incubation period and disease duration was 9.3 ± 3.5 and 13.0 ± 5.4 days. Basic reproductive number (number of cases directly infected by an infectious patient during his disease course) was 1.43.
School class without index case was first compartmentalized. Others were compartmentalized into 3 cohorts on school basis. Incidence in the first compartment and the other 3 cohorts were 0%, 13.2%, 20.4%, and 17.2%, respectively. Compartmentalization for asymptomatic subjects without history of contact with patients effectively reduced infection rate.
Their incidences were well predicted by Susceptible-Exposed-Infectious-Recovered model. Calculated incidence confirmed effective reduction of incidence by compartmentalization. Presence of multiple subepithelial infiltrate (hazard ratio (HR) 0.19, P = 0.000) and pseudo-membrane (HR: 0.31, P = 0.005) were significant factors to prolong disease duration.

Conclusions : Compartmentalization may merit development of effective infection control for HAdV-54 outbreak.

This is a 2020 ARVO Annual Meeting abstract.

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