On October 12, 2016, the Centers for Disease Control and Prevention (CDC) was informed by the US Virgin Islands Department of Health (DOH) of a cluster of cases of Epidemic Keratoconjunctivitis (EKC) reported from multiple ophthalmology practices in St Thomas, US Virgin Islands. The DOH received reports of 30-40 cases of EKC occurring in the last 3-4 weeks. The DOH sent samples to CDC to determine confirmation of EKC cases in the territory; five (5) conjunctival swab samples from five (5) cases were received by the CDC and all the samples tested positive for adenovirus.
The number of cases in the past month is reported as being significantly higher than usual. As a result, the DOH requested CDC’s assistance with this investigation. An Epidemiology Aid has been requested to 1) assist in case finding to describe the full scope of the EKC cluster, 2) assist in the systematic collection of data to characterize better understanding of potential risk factors for infection, 3) to assist in data collection, management and analysis and, 4) to assist local public health authorities with control of transmission.
EKC is a highly contagious acute infection of the eye (worse than pink eye) caused by several types of adenovirus. Symptoms can last up to two (2) weeks or more. The symptoms of EKC can occur in one or both eyes and include:
- A feeling that something is in the eye
- Redness, irritation and itchiness of the eyes
- Swelling of the eyelids
- Sensitivity to light
- Clear or yellow drainage that may make the eyelids stick together
- Blurred vision
- Eye pain
EKC is very contagious and children should stay home from school until symptoms are gone or until cleared by a doctor. It is OK to go to work-as adults are more responsible in taking care of themselves; however, healthcare workers should be clear of infection by a healthcare provider prior to returning to work.
EKC is transferred between individuals via physical contact-eye to hand, hand to door knob, etc. The virus can survive on surfaces (i.e. door knobs/towels) for months. There is no treatment for this virus; so, prevention is the cure; the DOH encourages the community to take every precaution in avoiding/reducing the contraction and spread of this virus in the territory by:
- Avoiding touching your eyes
- Washing your hands regularly
- Disinfecting surfaces as much as possible
Patients will remain contagious and can spread the virus to others for the duration of the infection. The dilemma with the EKC virus is that patients who have contracted the virus usually do not show signs until a week later and may unintentionally spread the virus. Hence the DOH warning of not touching your eyes, washing your hands regularly and disinfecting surfaces as much as possible.
If you have EKC:
- Avoid touching your eyes whenever possible. If you do touch your eyes, wash your hands thoroughly with soap and running water
- Avoid touching other people unless your hands are freshly washed
- Avoid hugging or kissing with close face to face contact during an EKC outbreak
- Dispose of or carefully was items (hot water and detergent) that touch your eyes
- Do not share eye makeup or other items used on the eyes (e.g., towels, tissues, eye drops, eye medications)
- Use a separate towel and face cloth for each member of the household
- Cover your mouth and nose when coughing or sneezing
- Use disposable tissues to blow your nose, sneeze or cough
If you visit a clinic for eye symptoms, tell them if your child’s school recently had an episode of EKC so they prevent spread of infection within the clinic
To report suspect cases please contact Dr. Esther Ellis, 340-718-1311 ext 3841.