Epidemic keratoconjunctivitis

Epidemic keratoconjunctivitis (EKC) is a viral inflammatory disorder of the eye characterized by concurrent involvement of the cornea and conjunctiva. It is classified under viral keratoconjunctivitis and is most commonly caused by specific serotypes of adenovirus, particularly types 8, 19, and 37. The disease is distinguished from isolated conjunctivitis or keratitis by the co-involvement of both ocular structures. While the term 'keratoconjunctivitis' broadly encompasses multiple etiologies—including herpes simplex virus—the context of 'epidemic' implies a transmissible, often outbreak-associated form primarily linked to adenoviral strains.

The clinical presentation of EKC typically begins abruptly with intense bilateral eye redness, pain, foreign-body sensation, excessive tearing, and photophobia. A hallmark feature is the presence of diffuse conjunctival injection and preauricular lymphadenopathy, often accompanied by mucopurulent discharge. Corneal involvement may manifest as punctate epithelial keratopathy, subepithelial infiltrates, or, less commonly, stromal keratitis, which can lead to transient visual blurring. In rare cases, especially with certain adenovirus serotypes, corneal opacities may develop and persist beyond resolution of the acute phase, though permanent vision loss is uncommon in otherwise healthy individuals.

EKC occurs globally and is recognized as a cause of recurrent outbreaks in closed or semi-closed environments, including schools, military barracks, and healthcare facilities. Outbreaks are often associated with contaminated water sources, such as swimming pools or hot tubs, and have been documented following ophthalmic procedures or in hospital settings where cross-contamination occurs. The disease exhibits seasonal variation in some regions, with higher incidence during warmer months, although no consistent annual pattern has been established across all geographic areas. Surveillance data indicate that EKC contributes to significant morbidity in outpatient eye clinics, particularly among children and young adults, though source-backed details on age-specific burden or regional prevalence are not available in the provided snippets.

Transmission of EKC occurs primarily through direct contact with infected ocular secretions or via fomites—contaminated surfaces, towels, or medical equipment—that harbor viable adenovirus. The virus is highly stable in aqueous environments and can remain infectious on dry surfaces for days to weeks. Person-to-person spread is facilitated in settings with close interpersonal contact or shared items. There is no evidence in the provided sources of airborne or vector-borne transmission; the primary routes are ocular inoculation and hand-mediated transfer to the eyes.

Children and young adults are disproportionately affected, likely due to higher rates of close-contact exposure in school and recreational settings. Individuals in high-density occupational or institutional environments—including healthcare workers, teachers, and swimmers—face elevated risk of exposure. Immunocompromised individuals may experience more severe or prolonged disease, though this is not explicitly supported by the provided snippets. No specific demographic or comorbid risk factors are described in the source material beyond general susceptibility to viral ocular infections.

Preventive measures center on strict hygiene practices, including frequent handwashing with soap and water, avoidance of sharing personal items (e.g., towels, cosmetics, contact lenses), and disinfection of frequently touched surfaces. In healthcare settings, enhanced infection control protocols—including use of disposable gloves and protective eyewear during patient care—are recommended when managing suspected or confirmed cases. No vaccine is currently available for adenovirus-associated EKC, and antiviral therapy is not routinely indicated due to the self-limited nature of the disease. Source-backed detail on specific disinfectants or environmental decontamination protocols is not available.

In surveillance contexts, EKC should be flagged when clusters of acute bilateral conjunctivitis with corneal involvement and associated preauricular lymphadenopathy occur in institutional or community settings. Case definitions should include symptom onset within 1–2 weeks of exposure to a known case or shared environment, along with laboratory confirmation if feasible (e.g., PCR for adenovirus). Reporting should distinguish EKC from other forms of viral conjunctivitis (e.g., enteroviral, picornaviral) and bacterial causes. Given the lack of detailed epidemiologic data in the source material, surveillance interpretation should rely on temporal and spatial clustering rather than absolute incidence estimates.

1. 1 Wikidata. adenoviral keratoconjunctivitis.
2. 2 Wikipedia. Keratoconjunctivitis - Wikipedia.

ICD-10

ICD-11

Total cases

272K

Peak month

2018-06

Coverage

1 reporting countries · 2012-09-15 → 2026-05-02