Five-year trends in adenoviral conjunctivitis in employees of one medical center

Irene C Kuo, Colleen Espinosa

Research output: Contribution to journalArticle

Abstract

Objective: To describe the 5-year findings after a policy to screen for, diagnose, and isolate medical center employees with adenoviral conjunctivitis was implemented. Design: Observational report with a retrospective evaluation of a current quality improvement initiative. Setting: Johns Hopkins Medicine, Baltimore, Maryland. Participants: Johns Hopkins Medicine employees. Methods: Data were retrieved from records maintained for this initiative, in which employees with suspected adenoviral conjunctivitis were evaluated in the Occupational Health Clinic and swabbed for polymerase chain reaction (PCR) testing for adenoviral conjunctivitis. Signs, symptoms, work area, diagnoses, and disposition of employees with eye complaints as well as PCR result and adenoviral type were recorded. Five-year data were reviewed. Results: From 2011 to 2016, of 10,000 full-time equivalent employees, 1,059 employees visited the Occupational Health Clinic with suspicion of adenoviral conjunctivitis. Of these, 104 (10%) were PCR positive for adenovirus. Of these PCR-positive employees, 26 (25%) had the worst clinical presentation, epidemic keratoconjunctivitis (EKC). The Outpatient Pharmacy had the highest number of adenoviral conjunctivitis cases (n=9). The proportion of red-eye employees having PCR-positive adenoviral conjunctivitis increased over 5 years (P<.005, Cochrane-Armitage test for trend) as did the proportion of employees with EKC (P<.05). The proportion of employees with EKC caused by type 37 also increased (P<.05). Conclusions: Adenoviral conjunctivitis represents 10% of employee cases clinically suspected of this infection. Employees in patient-care areas should be screened even if they have no direct patient contact. Despite increases in the proportions of adenoviral conjunctivitis and of EKC over 5 years, no outbreaks occurred. This policy helps identify incipient EKC outbreaks and guides infection control efforts.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalInfection Control and Hospital Epidemiology
DOIs
StateAccepted/In press - Jun 28 2018

Fingerprint

Conjunctivitis
Keratoconjunctivitis
Polymerase Chain Reaction
Occupational Health
Disease Outbreaks
Medicine
Baltimore
Infection Control
Quality Improvement
Adenoviridae
Signs and Symptoms
Patient Care
Outpatients
Infection

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Five-year trends in adenoviral conjunctivitis in employees of one medical center. / Kuo, Irene C; Espinosa, Colleen.

In: Infection Control and Hospital Epidemiology, 28.06.2018, p. 1-6.

Research output: Contribution to journalArticle

@article{28c44bef7fc94d6d82729fe9d39417d1,
title = "Five-year trends in adenoviral conjunctivitis in employees of one medical center",
abstract = "Objective: To describe the 5-year findings after a policy to screen for, diagnose, and isolate medical center employees with adenoviral conjunctivitis was implemented. Design: Observational report with a retrospective evaluation of a current quality improvement initiative. Setting: Johns Hopkins Medicine, Baltimore, Maryland. Participants: Johns Hopkins Medicine employees. Methods: Data were retrieved from records maintained for this initiative, in which employees with suspected adenoviral conjunctivitis were evaluated in the Occupational Health Clinic and swabbed for polymerase chain reaction (PCR) testing for adenoviral conjunctivitis. Signs, symptoms, work area, diagnoses, and disposition of employees with eye complaints as well as PCR result and adenoviral type were recorded. Five-year data were reviewed. Results: From 2011 to 2016, of 10,000 full-time equivalent employees, 1,059 employees visited the Occupational Health Clinic with suspicion of adenoviral conjunctivitis. Of these, 104 (10{\%}) were PCR positive for adenovirus. Of these PCR-positive employees, 26 (25{\%}) had the worst clinical presentation, epidemic keratoconjunctivitis (EKC). The Outpatient Pharmacy had the highest number of adenoviral conjunctivitis cases (n=9). The proportion of red-eye employees having PCR-positive adenoviral conjunctivitis increased over 5 years (P<.005, Cochrane-Armitage test for trend) as did the proportion of employees with EKC (P<.05). The proportion of employees with EKC caused by type 37 also increased (P<.05). Conclusions: Adenoviral conjunctivitis represents 10{\%} of employee cases clinically suspected of this infection. Employees in patient-care areas should be screened even if they have no direct patient contact. Despite increases in the proportions of adenoviral conjunctivitis and of EKC over 5 years, no outbreaks occurred. This policy helps identify incipient EKC outbreaks and guides infection control efforts.",
author = "Kuo, {Irene C} and Colleen Espinosa",
year = "2018",
month = "6",
day = "28",
doi = "10.1017/ice.2018.145",
language = "English (US)",
pages = "1--6",
journal = "Infection Control and Hospital Epidemiology",
issn = "0899-823X",
publisher = "University of Chicago Press",

}

TY - JOUR

T1 - Five-year trends in adenoviral conjunctivitis in employees of one medical center

AU - Kuo, Irene C

AU - Espinosa, Colleen

PY - 2018/6/28

Y1 - 2018/6/28

N2 - Objective: To describe the 5-year findings after a policy to screen for, diagnose, and isolate medical center employees with adenoviral conjunctivitis was implemented. Design: Observational report with a retrospective evaluation of a current quality improvement initiative. Setting: Johns Hopkins Medicine, Baltimore, Maryland. Participants: Johns Hopkins Medicine employees. Methods: Data were retrieved from records maintained for this initiative, in which employees with suspected adenoviral conjunctivitis were evaluated in the Occupational Health Clinic and swabbed for polymerase chain reaction (PCR) testing for adenoviral conjunctivitis. Signs, symptoms, work area, diagnoses, and disposition of employees with eye complaints as well as PCR result and adenoviral type were recorded. Five-year data were reviewed. Results: From 2011 to 2016, of 10,000 full-time equivalent employees, 1,059 employees visited the Occupational Health Clinic with suspicion of adenoviral conjunctivitis. Of these, 104 (10%) were PCR positive for adenovirus. Of these PCR-positive employees, 26 (25%) had the worst clinical presentation, epidemic keratoconjunctivitis (EKC). The Outpatient Pharmacy had the highest number of adenoviral conjunctivitis cases (n=9). The proportion of red-eye employees having PCR-positive adenoviral conjunctivitis increased over 5 years (P<.005, Cochrane-Armitage test for trend) as did the proportion of employees with EKC (P<.05). The proportion of employees with EKC caused by type 37 also increased (P<.05). Conclusions: Adenoviral conjunctivitis represents 10% of employee cases clinically suspected of this infection. Employees in patient-care areas should be screened even if they have no direct patient contact. Despite increases in the proportions of adenoviral conjunctivitis and of EKC over 5 years, no outbreaks occurred. This policy helps identify incipient EKC outbreaks and guides infection control efforts.

AB - Objective: To describe the 5-year findings after a policy to screen for, diagnose, and isolate medical center employees with adenoviral conjunctivitis was implemented. Design: Observational report with a retrospective evaluation of a current quality improvement initiative. Setting: Johns Hopkins Medicine, Baltimore, Maryland. Participants: Johns Hopkins Medicine employees. Methods: Data were retrieved from records maintained for this initiative, in which employees with suspected adenoviral conjunctivitis were evaluated in the Occupational Health Clinic and swabbed for polymerase chain reaction (PCR) testing for adenoviral conjunctivitis. Signs, symptoms, work area, diagnoses, and disposition of employees with eye complaints as well as PCR result and adenoviral type were recorded. Five-year data were reviewed. Results: From 2011 to 2016, of 10,000 full-time equivalent employees, 1,059 employees visited the Occupational Health Clinic with suspicion of adenoviral conjunctivitis. Of these, 104 (10%) were PCR positive for adenovirus. Of these PCR-positive employees, 26 (25%) had the worst clinical presentation, epidemic keratoconjunctivitis (EKC). The Outpatient Pharmacy had the highest number of adenoviral conjunctivitis cases (n=9). The proportion of red-eye employees having PCR-positive adenoviral conjunctivitis increased over 5 years (P<.005, Cochrane-Armitage test for trend) as did the proportion of employees with EKC (P<.05). The proportion of employees with EKC caused by type 37 also increased (P<.05). Conclusions: Adenoviral conjunctivitis represents 10% of employee cases clinically suspected of this infection. Employees in patient-care areas should be screened even if they have no direct patient contact. Despite increases in the proportions of adenoviral conjunctivitis and of EKC over 5 years, no outbreaks occurred. This policy helps identify incipient EKC outbreaks and guides infection control efforts.

UR - http://www.scopus.com/inward/record.url?scp=85049315368&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85049315368&partnerID=8YFLogxK

U2 - 10.1017/ice.2018.145

DO - 10.1017/ice.2018.145

M3 - Article

C2 - 29950191

AN - SCOPUS:85049315368

SP - 1

EP - 6

JO - Infection Control and Hospital Epidemiology

JF - Infection Control and Hospital Epidemiology

SN - 0899-823X

ER -