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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

The (pink) eyes have it: Keratoconjunctivitis outbreaks hit outpatient clinics in 4 states

Six separate outbreaks of Adenovirus-associated epidemic keratoconjunctivitis (EKC) occurred in four different states during 2008–2010, the Centers for Disease Control and Prevention reports.

The outbreaks of human adenovirus (HadV) were mainly associated with outpatient eye care. All included apparent lapses in basic infection control and inadequate cleaning and disinfection. Typically, EKC outbreaks last weeks to months and are characterized by a combination of health-care–associated and community transmission.

Overall, 411 EKC cases were identified in Florida, Illinois, Minnesota, and New Jersey. In each outbreak, health care–associated transmission appeared to occur via ophthalmologic examination. The outbreaks resulted in significant morbidity and cost resulting from the number of persons affected, duration of the outbreaks, and the temporary closure of a neonatal intensive-care unit and several clinics, the CDC emphasizes.

Five of the outbreaks occurred in outpatient settings, and health care providers were the likely sources of transmission in four of the clusters. Outpatient clinics, hospitals, and other facilities that provide ophthalmologic care should have protocols in place to prevent transmission of EKC, the CDC recommends. Infection control measures include:

Strict adherence to hand hygiene among staff members.

Use of disposable gloves for any potential contact with eye secretions.

Disinfection of ophthalmic instruments after each use (or use of disposable equipment).

Cohorting of suspected conjunctivitis patients (separate waiting room, sign-in area, and examination room).

Furloughing of staff members who have signs and symptoms consistent with EKC.

In addition, dedicating eye drop vials to single patients and increasing the frequency of environmental surface disinfection are strategies that should be used in outbreak situations and considered for routine practice, the CDC recommends. Clusters of EKC infections should be reported to the appropriate state or local health department.