An Outbreak of Epidemic Keratoconjunctivitis by Adenovirus Type 8 in a Neonatal Intensive Care Unit.

Park,  Narimi; Youn,  Na Ji; Joung,  Kyoung Eun; Lee,  Jina; Kim,  Ee Kyung; Kim,  Han Suk; Kim,  Seong Joon; Song,  Jung Sook; Oh,  Hyang Soon; Lee,  Hoan Jong; Choi,  Jung Hwan

Original Article

Journal of the Korean Society of Neonatology 2008;15(1):44-53.
Published online May 1, 2008.

An Outbreak of Epidemic Keratoconjunctivitis by Adenovirus Type 8 in a Neonatal Intensive Care Unit.

Narimi Park, Na Ji Youn, Kyoung Eun Joung, Jina Lee, Ee Kyung Kim, Han Suk Kim, Seong Joon Kim, Jung Sook Song, Hyang Soon Oh, Hoan Jong Lee, Jung Hwan Choi

¹Department of Pediatrics, Seoul National University, College of Medicine, Seoul, Korea. kimhans@snu.ac.kr
²Department of Ophthalmology, Seoul National University, College of Medicine, Seoul, Korea.
³Infection Control Service, Seoul National University Hospital, Seoul, Korea.

신생아 중환자실에서의 아데노바이러스 8형에 의한 유행성 각결막염의 발생

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Abstract

PURPOSE
Epidemic keratoconjunctivitis (EKC) caused by adenovirus is a highly contagious disease, which has been reported as outbreaks involving adults in the community. However, there has been no report on EKC outbreak by adenovirus in a neonatal intensive care unit (NICU) in Korea. Aims of this study were to investigate the EKC outbreak by adenovirus type 8 in NICU and to confirm an effectiveness of polymerase chain reaction (PCR) for diagnosis.
METHODS
Conjunctival swab or nasopharyngeal aspirate specimens were taken from all patients and tested by viral culture and PCR. Adenovirus serotype was determined by sequencing of PCR product of selected region of hexon gene using the virus isolates or specimens.
RESULTS
An outbreak of EKC occurred which was involving 12 preterm infants in the NICU of the Seoul National University Children's Hospital between July 12th and August 1st, 2005. Three hospital staffs and one family member of the neonate were also affected. Adenovirus was detected in 12/12 (100%), 6/11 (54.5%) by PCR and virus culture, respectively. Eleven PCR-positive neonates were identified as serotype 8 by sequencing. The first affected 4 babies have had routine ROP (retinopathy of prematurity) examinations one week ago. While previous outbreaks were sustained for a few months, the event in our unit was controlled without complications in 3 weeks.
CONCLUSION
We analyzed the EKC outbreak by adenovirus type 8 in NICU. Adenovirus serotype was identified by PCR and sequencing with high sensitivity for the first time in Korea, so we suggest this method can be very useful for rapid diagnosis and infection control.

Key Words: Epidemic keratoconjunctivitis; Adenovirus; Neonatal intensive care units; Premature infant