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ARTICLE
Year : 1983  |  Volume : 31  |  Issue : 5  |  Page : 632-634

Recent epidemic of acute haemorrhagic conjunctivitis in Calcutta


Deptt, of Ophthalmology, Ramakrishna Mission Seva Pratishthan, Calcutta, India

Correspondence Address:
B K Baidya
Deptt, of Ophthalmology, Ramakrishna Mission Seva Pratishthan, Calcutta
India
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Source of Support: None, Conflict of Interest: None


PMID: 6671779

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How to cite this article:
Baidya B K, Basu R N, Chakraborty A K. Recent epidemic of acute haemorrhagic conjunctivitis in Calcutta. Indian J Ophthalmol 1983;31:632-4

How to cite this URL:
Baidya B K, Basu R N, Chakraborty A K. Recent epidemic of acute haemorrhagic conjunctivitis in Calcutta. Indian J Ophthalmol [serial online] 1983 [cited 2019 Dec 14];31:632-4. Available from: http://www.ijo.in/text.asp?1983/31/5/632/36612

Table 2

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Table 2

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Table 1

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Table 1

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An epidemic of acute haemorrhagic conjunctivitis broke out in greater Calcutta and its surroundings during the summer months of 1981. Popularly known as `Jai Bangla', epidemic conjunctivitis previously swept over this part of country extensively and again to a lesser extent in 1975.

Our paper is based on the observations on 300 cases of acute conjunctivitis from the Eye Out patient Department of Ramakrishna Mission Seva Pratishthan,. Calcutta.


  Material and Methods Top


During the 3 months period from 1st May to 31st July, 300 well documented cases of acute conjunctivitis were selected from our O.P.D. A detailed history about the onest of symptoms, previous attacks, occupation and socio-economic status of the patient was noted. All the patients were subjected to general physical exami­nation. Ocular examination was done under oblique illumination, corneal loupe and slit-lamp. In suspected cases, a fluorescein strip was used to demonstrate any corneal involvement. Before starting any treatment swabs were taken from the conjunctivitiva for bacterial and viral culture. A smear was prepared from conjunc­tival discharge and staining with gram-stain, examined under microscope.

For virus culture, conjunctival swab specimens were collected in Hanks B.S.S. with antibiotics. After proper incubation, centrifugation and deep freeze preservation, the specimens were inoculated in-

1) Embryonated eggs by chorio-allantoic, intra amniotic and intra-allantoic routes.

2) Infant swiss mice by intracerebral and intraperitoneal routes.

3) 'Vero' cell cultures.

The virological study was conducted in the virology department of School of Tropical Medicine, Calcutta.

In most cases, repeat clinical examination of the patients were done on 3rd, 5th, 8th and 15th day after the first visit,


  Observations Top


Epidemiological

The spread of conjunctivitis was rapid like fire and within a very short period hundreds of people belonging to all spheres and socio­economic status were affected. Starting in 1st week of May the epidemic reached its peak during first half of June and thereafter rapidly declined in July. The incubation period was very short and was estimated to be 12 to 24 hours. The transmission was by actual con­tamination either from hand to eye or from infected fomites.

The disease affected mostly the young adult population; more than 60% of the patients being in the age group of 20-40 years. Males were affected twice as frequently as females.

The peak incidence of age in case of males was around 30 years and in females, 23 years [Figure 1].

Suffering from conjunctivitis during previous epidemics did not offer any immunity as previously suffered people were affected as frequently and severely as the rest during this epidemic.

Clinical

The clinical picture was more or less uniform in all cases. [Table - 1] shows the different features of the disease and their relative frequencies. The disease started with foreign body sensation in the eye, lacrimation, pain, serous discharge, and photophobia; at first in one eye and invariably affecting the other within few hours. This followed by swelling of the eyelids, Conjunctival follicles and chemosis and and subconjunctival haemorrhages. Sub­conjunctival haemorrhage was the predominant feature and was noticed in all cases in variable extent. Initially the haemorrhages were small petechial in size, appearing in the lower bulbar conjunctiva and rapidly spreading to the other parts of conjunctiva. Nearly one third of the cases developed large blotch haemorrhage. The degree of subconjunctival haemorrhage did not corelate with the severity of other features of the disease.

Corneal involvement and, pre-auricular lymphadenopathy were observed only in a few cases. General symptoms of fever, headache, malaise, sore throat etc. were also uncommon.

Acuteness of the disease persisted for 3 to 5 days and complete recovery took place within 12 days with preservation of normal visual acuity. Large subcounjuntival haemorrhages took further 10-12 days for complete disappearance.

Treatment

The disease has essentially a self-limiting course, and no specific treatment is known. Frequent wash of the eyes with normal saline or plain water was found to be very affective in alleviating acute symptoms and lessening the severity of the disease. However, to prevent secondary infection, all patients were prescribed chloramphenical eye drop six time daily and Tetracycline eye ointment at bed time.


  Conclusion and Summary Top


In a recent epidemic of acute haemorrhagic conjunctivitis which outbroke in Calcutta and its surroundings from May to July, 1981, sub­conjunctival haemorrhage was the predominant

feature in all cases with minimal of corneal involvement, lymphadenopathy and general symptoms. The possibility of bacterial infection was ruled out. No virus strain could be isolated even after meticulus cultures and inoculations. From epidemiological and clinical points of view it was suggested that the consative organism was probably one of the entero viruses.



 
 
    Tables

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