Ocular Illness in Association with Adenovirus Type 3 Infection: An Epidemic of Conjunctivitis and Keratoconjunctivitis in Stockholm 1969

Abstract

At the out-patient Eye Clinic of Karolinska Hospital, Stockholm, an accumulation of patients with acute follicular conjunctivitis was seen during the summer and autumn of 1969. 143 cases were subjected to a detailed clinical and virological examination. The patients had been separated into 3 clinical groups before the virological diagnosis became available. Adenovirus type 3 was isolated from the conjunctivae of 45 out of 71 patients presenting a clinical picture typical of adenovirus disease. In 49 patients with clinically probable adenovirus disease the virus was isolated in 4 cases. No evidence of virus infection was found in specimens from 23 patients in whom the development of clinical symptoms excluded an initially suspected adenovirus disease. 47% of patients with positive adenovirus type 3 isolation had corneal affection. In most cases the corneal changes were epithelial or combined epithelial-subepithelial. Strictly subepithelial opacities as in epidemic keratoconjunctivitis were seen in 6 of the adenovirus type 3 positive cases. The accumulation of cases with adenovirus type 3 infection had an epidemic character. The majority of the patients were adults and systemic symptoms were noted in only 37% of the cases. In contrast to epidemic keratoconjunctivitis no eye-to-eye spread was noted. A differential diagnosis of ocular disease caused by adenovirus type 3 and adenovirus type 8 on a clinical basis in the absence of epidemiological evidence was found to be difficult.