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March 11, 1983, Vol 249, No. 10 >
ARTICLE | March 11, 1983

Acute Hemorrhagic Conjunctivitis: Title and subTitle BreakInvestigation of a Large-scale Community Outbreak in Dade County, Florida FREE

Peter A. Patriarca, MD; Ida M. Onorato, MD; Virgil E. F. Sklar, MD; Lawrence B. Schonberger, MD, MPH; Rose M. Kaminski, MS; Milford H. Hatch, ScD; David M. Morens, MD; Richard K. Forster, MD
[+] Author Affiliations

Reprint requests to the Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333 (Dr Patriarca).


JAMA. 1983;249(10):1283-1289. doi:10.1001/jama.1983.03330340025025
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References

An outbreak of acute hemorrhagic conjunctivitis (AHC) due to enterovirus type 70 occurred in Dade County, Florida, from September to December 1981. Younger age groups, members of larger households, and the poor were at significantly greater risk of acquiring AHC than others in the community. Schoolchildren were most likely to introduce AHC into the household. After exclusion of all affected children from school, there was a dramatic reduction in reported cases, with attack rates declining more rapidly for school-aged children than for other age groups. Although AHC spread readily among family members, a retrospective study of 124 affected households showed an association between lower attack rates and simple hygienic measures. Should outbreaks of AHC recur, measures to reduce transmission should include exclusion of affected schoolchildren and educating the public about hygienic precautions.

(JAMA 1983;249:1283-1289)

REFERENCES

1 +
Chatterjee S, Quarcoopome CO, Apenteng A:  An epidemic of acute hemorrhagic conjunctivitis in Ghana . Ghana Med J 1970;;9:9-11.
2 +
Manku MS:  Epidemic keratoconjunctivitis . East Afr Med J 1972;;49:763-767.
3 +
Kono R, Sasagawa A, Ishii K, et al:  Pandemic of a new type of conjunctivitis . Lancet 1972;;1:1191-1194.
4 +
Roy IS, Roy SN, Ahmed E:  Epidemic acute conjunctivitis . Br J Ophthalmol 1972;;56:501-503.
5 +
Lim KH, Yin-Murphy M:  Epidemic conjunctivitis in Singapore in 1970 and 1971 . Singapore Med J 1973;;14:86-89.
6 +
Dawson CR, Whitcher JP, Schmidt NJ:  Acute hemorrhagic conjunctivitis . JAMA 1974;; 230:727-728.
7 +
Kono R, Miyamura K, Tajiri E, et al:  Neurologic complications associated with acute hemorrhagic conjunctivitis virus infection and its serologic confirmation . J Infect Dis 1974;; 129:590-593.
8 +
Pramanik DD:  Joy Bangla—an epidemic of conjunctivitis in India . Practitioner 1971;; 207:805-806.
9 +
Thongcharoen P, Jatikavanij V, Wasi C, et al:  An outbreak of acute hemorrhagic conjunctivitis in Thailand: II. Epidemiologic investigation . J Med Assoc Thai 1974;;57:248-251.
10 +
Hierholzer JC, Hilliard KA, Esposito JJ:  Serosurvey for acute hemorrhagic conjunctivitis virus (enterovirus 70) antibodies in the southeastern United States, with review of the literature and some epidemiologic implications . Am J Epidemiol 1975;;102:533-544.
11 +
Lim KH:  Epidemic conjunctivitis: Discovery of a new aetiologic agent . Singapore Med J 1973;;14:82-85.
12 +
Jones BR:  Epidemic haemorrhagic conjunctivitis in London 1971: A conjunctival picornavirus infection . Trans Ophthalmol Soc UK 1973;;92:625-627.
13 +
Mirkovic RR, Kono R, Yin-Murphy M, et al:  Enterovirus type 70: The etiologic agent of pandemic acute hemorrhagic conjunctivitis . Bull WHO 1973;;49:341-346.
14 +
Maichuk IF, Shulpina NB, Andzhelov VO, et al:  An outbreak of a new type of epidemic conjunctivitis . Vestn Oftalmol 1973;;1:66-70.
15 +
Bernard KW, Hieholzer JC, Dugan JB, et al:  Acute hemorrhagic conjunctivitis in Southeast Asian refugees arriving in the United States—isolation of enterovirus 70 . Am J Trop Med Hyg 1982;;31:541-547.
16 +
 Acute hemorrhagic conjunctivitis—Latin America, Panama, and Belize . MMWR 1981;; 30:450-451, 497-500.
17 +
 Acute hemorrhagic conjunctivitis—Florida, North Carolina . MMWR 1981;;30:501-502.
18 +
Sklar VEF, Patriarca PA, Onorato IM, et al:  An outbreak of acute hemorrhagic conjunctivitis in south Florida: Clinical description and therapeutic trial . Am J Ophthalmol , in press.
19 +
Mantel N, Haenszel W:  Statistical aspects of the analysis of data from retrospective studies of disease . JNCI 1959;;22:719-748.
20 +
Hatch MH, Malison MD, Palmer EL:  Isolation of enterovirus 70 from patients with acute hemorrhagic conjunctivitis in Key West Florida . N Engl J Med 1981;;305:1648-1649.
21 +
Saxena RC, Bhatia M, Chaturvedi UC:  Recent epidemic conjunctivitis in Lucknow: A clinical study . Orient Arch Ophthalmol 1972;; 10:253-257.
22 +
Sugiura S, Ochi M, Kono M, et al:  Outbreak of acute haemorrhagic conjunctivitis in Hokaido . Acta Soc Ophthalmol Jpn 1972;;76:424-432.
23 +
Mitsui Y, Kajima M, Matsumura K, et al:  Haemorrhagic conjunctivitis: A new type of epidemic viral keratoconjunctivitis . Jpn J Ophthalmol 1972;;16:99-106.
24 +
Kono R, Sasagawa A, Miyamura K, et al:  Serologic characterization and sero-epidemiologic studies on acute hemorrhagic conjunctivitis virus . Am J Epidemiol 1975;;101:444-457.
25 +
 Acute hemorrhagic conjunctivitis—American Samoa . MMWR 1982;;31:21-22.

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1 +
Chatterjee S, Quarcoopome CO, Apenteng A:  An epidemic of acute hemorrhagic conjunctivitis in Ghana . Ghana Med J 1970;;9:9-11.
2 +
Manku MS:  Epidemic keratoconjunctivitis . East Afr Med J 1972;;49:763-767.
3 +
Kono R, Sasagawa A, Ishii K, et al:  Pandemic of a new type of conjunctivitis . Lancet 1972;;1:1191-1194.
4 +
Roy IS, Roy SN, Ahmed E:  Epidemic acute conjunctivitis . Br J Ophthalmol 1972;;56:501-503.
5 +
Lim KH, Yin-Murphy M:  Epidemic conjunctivitis in Singapore in 1970 and 1971 . Singapore Med J 1973;;14:86-89.
6 +
Dawson CR, Whitcher JP, Schmidt NJ:  Acute hemorrhagic conjunctivitis . JAMA 1974;; 230:727-728.
7 +
Kono R, Miyamura K, Tajiri E, et al:  Neurologic complications associated with acute hemorrhagic conjunctivitis virus infection and its serologic confirmation . J Infect Dis 1974;; 129:590-593.
8 +
Pramanik DD:  Joy Bangla—an epidemic of conjunctivitis in India . Practitioner 1971;; 207:805-806.
9 +
Thongcharoen P, Jatikavanij V, Wasi C, et al:  An outbreak of acute hemorrhagic conjunctivitis in Thailand: II. Epidemiologic investigation . J Med Assoc Thai 1974;;57:248-251.
10 +
Hierholzer JC, Hilliard KA, Esposito JJ:  Serosurvey for acute hemorrhagic conjunctivitis virus (enterovirus 70) antibodies in the southeastern United States, with review of the literature and some epidemiologic implications . Am J Epidemiol 1975;;102:533-544.
11 +
Lim KH:  Epidemic conjunctivitis: Discovery of a new aetiologic agent . Singapore Med J 1973;;14:82-85.
12 +
Jones BR:  Epidemic haemorrhagic conjunctivitis in London 1971: A conjunctival picornavirus infection . Trans Ophthalmol Soc UK 1973;;92:625-627.
13 +
Mirkovic RR, Kono R, Yin-Murphy M, et al:  Enterovirus type 70: The etiologic agent of pandemic acute hemorrhagic conjunctivitis . Bull WHO 1973;;49:341-346.
14 +
Maichuk IF, Shulpina NB, Andzhelov VO, et al:  An outbreak of a new type of epidemic conjunctivitis . Vestn Oftalmol 1973;;1:66-70.
15 +
Bernard KW, Hieholzer JC, Dugan JB, et al:  Acute hemorrhagic conjunctivitis in Southeast Asian refugees arriving in the United States—isolation of enterovirus 70 . Am J Trop Med Hyg 1982;;31:541-547.
16 +
 Acute hemorrhagic conjunctivitis—Latin America, Panama, and Belize . MMWR 1981;; 30:450-451, 497-500.
17 +
 Acute hemorrhagic conjunctivitis—Florida, North Carolina . MMWR 1981;;30:501-502.
18 +
Sklar VEF, Patriarca PA, Onorato IM, et al:  An outbreak of acute hemorrhagic conjunctivitis in south Florida: Clinical description and therapeutic trial . Am J Ophthalmol , in press.
19 +
Mantel N, Haenszel W:  Statistical aspects of the analysis of data from retrospective studies of disease . JNCI 1959;;22:719-748.
20 +
Hatch MH, Malison MD, Palmer EL:  Isolation of enterovirus 70 from patients with acute hemorrhagic conjunctivitis in Key West Florida . N Engl J Med 1981;;305:1648-1649.
21 +
Saxena RC, Bhatia M, Chaturvedi UC:  Recent epidemic conjunctivitis in Lucknow: A clinical study . Orient Arch Ophthalmol 1972;; 10:253-257.
22 +
Sugiura S, Ochi M, Kono M, et al:  Outbreak of acute haemorrhagic conjunctivitis in Hokaido . Acta Soc Ophthalmol Jpn 1972;;76:424-432.
23 +
Mitsui Y, Kajima M, Matsumura K, et al:  Haemorrhagic conjunctivitis: A new type of epidemic viral keratoconjunctivitis . Jpn J Ophthalmol 1972;;16:99-106.
24 +
Kono R, Sasagawa A, Miyamura K, et al:  Serologic characterization and sero-epidemiologic studies on acute hemorrhagic conjunctivitis virus . Am J Epidemiol 1975;;101:444-457.
25 +
 Acute hemorrhagic conjunctivitis—American Samoa . MMWR 1982;;31:21-22.

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