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Muscat, Oman: Conjunctivitis outbreak, influenza or adenovirus suspected

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  • Muscat, Oman: Conjunctivitis outbreak, influenza or adenovirus suspected

    Adenovirus isn't influenza. Certain strains of flu could cause conjunctivitis as well.

    Published Date: 2014-03-13 11:40:23
    Subject: PRO/EDR> Conjunctivitis - Oman: (Muscat) expatriates
    Archive Number: 20140313.2329930

    CONJUNCTIVITIS - OMAN: (MUSCAT) EXPATRIATES
    *******************************************
    A ProMED-mail post
    http://www.promedmail.org
    ProMED-mail is a program of the
    International Society for Infectious Diseases
    http://www.isid.org

    Date: Wed 12 Mar 2014
    Source: Times of Oman [edited]
    http://www.timesofoman.com/News/Article-30980.aspx


    A virulent strain of conjunctivitis that is contagious in nature and is associated with the flu season has hit Muscat's expatriate population.

    Ophthalmologists at private hospitals in the capital blame a new serotype of the virus for the disease affecting for longer than usual this season, in some cases for up to 8 weeks.

    Since mid-February [2014], people suffering from conjunctivitis with itchy bloodshot eyes have accounted for about 30 per cent of the patients at eye hospitals and clinics across town.

    "The instance of affliction is very high this season and many of our patients have been found to have pharyngitis and fever along with conjunctivitis," said ophthalmologist Jyotsna Parihar of the Dharamsey Eye Centre.

    Doctors at the Dharamsey Eye Centre have been treating at least 5 to 6 families a day for conjunctivitis for the last few weeks. "Every third patient of mine is suffering from this disease," said Dr Amita Rajesh Kakkad.

    [A man who] has been under "house arrest" since last week [week of 3 Mar 2014] with bloodshot, watery eyes accompanied by irritation that she had thought would go away in 2 days complained, "Nothing can be more frustrating than being forced to stay home with work piling up in office,". A resident of Qurum has had fever and a sore throat with conjunctivitis for the past 7 days. "The last time I had a conjunctivitis infection was several years ago and it went away on its own in 3 days," he recalled. "With the ongoing school examination, parents are in a dilemma whether to allow a child to go to school. It is very important that children with conjunctivitis do not go to school till they are cured. So is the case with office-goers. The family members of an infected person should quarantine him/her till there are no traces of the infection. They should not share towels and handkerchiefs with the other members as this infection spreads when a patient, after touching the eye, touches another object which may then be touched by a healthy person," doctors said.

    Doctors said the trigger for the disease this year [2014] was the common adenovirus, which causes an allergic reaction in the eyes that leads to inflammation of the lids and bleeding of the blood vessels. "The virus produces a secretion called interferon that eventually self-destructs. The infection has been severe in most cases this year [2014]. The only consolation is the low incidence of corneal involvement or keratoconjunctivitis, which causes corneal ulcers and can even lead to blindness if not treated properly," a doctor said.

    Doctors said the trigger for a longer and stronger bout of conjunctivitis could be one of 2 things: "It could be a new serotype of adenovirus or an old strain that has returned after many years, in which case people would be less immune to it," one of them opined.

    But the good thing is that it is not AHC [acute hemorrhagic conjunctivitis] infection of enterovirus 70 and coxsackie A 24 strains. "These particular strains are highly dangerous and can cause loss of vision in extreme cases," a doctor said.

    The cornea being infected is a sign that the disease will linger. "After a week, the signs and symptoms change if the cornea is infected. Then the patient has severe pain in the eye and the vision is blurred, which is temporary, of course," another doctor said. Though the disease is self-limiting, at times it relapses if the patients do not take due precaution. "I warn against self-medication. If there is any sign of the infection, the patient should immediately consult an ophthalmologist. The patients are advised to wash both eyes with clean water at least 3 to 4 times a day," doctors said. S Arshad Ali Wasti, Senior Consultant, Ophthalmologist, Starcare Hospital, however, said conjunctivitis is a seasonal epidemic and is now receding with the change in weather. "The ideal way of prevention is to encourage hygienic measures like frequent hand washing and avoiding contact with the eyes," he said.

    [Byline: Rahul Das]

    --
    Communicated by:

    <promed@promedmail.org>

    [The following has been in part extracted from moderator ML's comments from ProMED-mail post Conjunctivitis - Japan: eyeball-licking 20130614.1773328:

    Conjunctivitis is commonly referred to as "red" or "pink" eye, a sign of inflammation that is usually accompanied by a discharge of varying viscosity. Conjunctivitis may be due to viruses, bacteria, fungi, allergens, or toxins (such as chlorine in swimming pool water). A watery discharge is most consistent with viral or allergic conjunctivitis. A mucopurulent or purulent discharge, often associated with morning crusting and difficulty opening the eyelids, strongly suggests a bacterial infection. Pain, photophobia, or blurred vision suggests a more serious disease process such as keratitis, which is inflammation of the cornea.

    Conjunctivitis due to adenoviruses may be accompanied by upper respiratory tract infection, common cold, or sore throat and is spread through hand-to-eye contact or by contact with objects, such as ophthalmologic equipment, that are contaminated with infectious tears, eye discharge, or respiratory discharges. A person can be contagious a few days before developing symptoms to approximately 14 days after symptom onset (http://www.cdc.gov/mmwr/pdf/wk/mm6232.pdf). Treatment of adenoviral conjunctivitis is supportive.

    Acute hemorrhagic conjunctivitis (AHC) is a highly contagious viral infection characterized by conjunctival erythema and edema and subconjunctival hemorrhages and caused by either coxsackie group A24 and enterovirus E70. AHC may be accompanied by polio-like neurologic involvement (http://jid.oxfordjournals.org/conten...4/660.abstract). Epidemics of AHC have occurred worldwide, spread by the fecal-oral route especially where sanitation is poor (http://emedicine.medscape.com/article/1203216-overview). AHC usually resolves without sequelae.

    Oman, with a population of about 3.8 million people, is a sultanate on the southeast coast of the Arabian Peninsula at the mouth of the Persian Gulf. It is bordered by the United Arab Emirates to the northwest, Saudi Arabia to the west, and Yemen to the southwest. Muscat is its capital and largest city, with a population of about 734 697 (http://en.wikipedia.org/wiki/Muscat,_Oman). 600 000 foreigners live in Oman, most of whom are guest workers from India, Pakistan, Bangladesh, Egypt, and the Philippines (http://en.wikipedia.org/wiki/Oman#Demographics). - Mod.ML
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