Clinical and epidemiological features of adenovirus keratoconjunctivitis in London

Abstract

Ninety-eight patients were studied. Ninety were consecutive patients who were isolation-positive for adenovirus, and 8, who were associated with a hospital outbreak of adenovirus serotype 8 infection, developed characteristic features of infection but were isolation-negative. The ratio of males to females was 2 to 1, and most patients were aged 20 to 39. Adenovirus serotypes 3, 7, and 8 were isolated from 86% of patients, and serotypes 2, 4, 5, 11, 15, and 15/29 from the remaining 14%. Adenovirus serotype 7 was more commonly isolated from patients under the age of 19 and was not isolated during winter. Sources of infection could be identified in 36% of patients and included contact with upper respiratory tract or ocular infections, a hospital outbreak, and a recent visit to a swimming pool. Associated systemic disease was detected in 47% of patients, most of whom had upper respiratory tract infection. The most severe and prolonged conjunctivitis was caused by serotypes 5 and 8. Most patients developed epithelial punctate keratitis. Subepithelial punctate keratitis, which was once considered to be a characteristic feature of adenovirus serotype 8, developed in cases of serotype 3, 4 5, 7, and 8 infection.