What is epidemic keratoconjunctivitis?
Epidemic keratoconjunctivitis (also sometimes referred to as viral keratoconjunctivitis) is a highly contagious viral infection of the eye. Symptoms can last up to two weeks or more. It is caused by adenoviruses and there is no specific treatment. Because they see lots of patients who may have infections, outbreaks are often associated with eye clinics. Bacteria, other viruses, allergies or chemical irritation can also cause types of conjunctivitis.
What are the symptoms?
The symptoms of epidemic keratoconjunctivitis can commence in one or both eyes and include:
- redness ("pink eye")
- swelling of the eyelids
- sensitivity to light (photophobia)
- clear, watery discharge
- blurred vision
- eye pain, or a feeling that something is in your eye.
Occasionally, people may also get:
- extreme tiredness
- swollen lymph nodes.
How is it spread?
Epidemic keratoconjunctivitis is highly contagious and adenoviruses can live on surfaces for up to 30 days.
People get epidemic keratoconjunctivitis by coming into contact with tears or discharge from the eyes of an infected person and then touching their own eyes. This can happen by touching the hands of someone with the infection, or by touching contaminated surfaces or objects.
Usually the symptoms develop between 5 days and two weeks after exposure to an infected person or surface.
People are thought to be infectious from a day or two prior to the onset of symptoms until around 2 weeks after symptoms develop.
Who is at risk?
Anyone can get epidemic keratoconjunctivitis. It is easily spread between people.
How is it prevented?
Epidemic keratoconjunctivitis is a highly contagious disease and children should stay home from school until symptoms have resolved or until cleared by a doctor, whichever is earlier. It is usually OK to go to work, but follow the infection control measures outlined below. However, health care workers should be clear of infection prior to returning to work.
If you have epidemic keratoconjunctivitis:
- avoid touching your eyes whenever possible. If you do touch your eyes, wash your hands thoroughly with soap and running water for at least 15 seconds
- avoid touching other people
- throw away or carefully wash items (in 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 another doctor or clinic, make sure you tell them that you have or have recently had epidemic keratoconjunctivitis so they can implement measures to prevent spread of infection.
Eye clinics must ensure that all reusable instruments that touch patient eyes, e.g. tonometers, are wiped clean and disinfected with either 5000ppm chlorine or 70% ethyl alcohol after each patient . Single use instruments are preferred for patients with a suspected eye infection.
During outbreaks clinics must ensure all staff thoroughly wash hands before and after each patient, try to see patients with infection in a different room to other patients, use only single-use eye drops, and ensure all surfaces touched by patients (including door knobs and handrails) are cleaned frequently with either 5000ppm chlorine or 70% ethyl alcohol. Any staff that develop infection must not attend work.
How is it diagnosed?
Epidemic keratoconjunctivitis is diagnosed by the signs and symptoms outlined above. Your doctor may also take a swab of your eyes to identify the responsible virus. A swab takes several days to return a result.
How is it treated?
There is no treatment available for epidemic keratoconjunctivitis, and it will usually go away by itself in around two weeks (this can range from one to six weeks). Paracetamol, cold packs and cold showers have been found to be helpful for relieving symptoms. Specific treatment is available for the other forms of conjunctivitis (bacterial, allergic).
What is the public health response?
Epidemic keratoconjunctivitis is not a notifiable disease in NSW. However public health units can provide advice on the control of outbreaks.
For further information please call your local public health unit on 1300 066 055.
- Guideline for Disinfection and Sterilization in Healthcare Facilities, USCDC, February 2017.
- MMWR 66(30);811-12, USCDC August 2017.