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Acute haemorrhagic conjunctivitis outbreak in the city of Fortaleza, northeast Brazil

F E A Moura¹, D C S Ribeiro², N Gurgel¹, A C da Silva Mendes¹, F N Tavares³, C N G Timóteo² and E E da Silva³

¹ Laboratory of Virology, Departmento de Patologia e Medicina Legal, Universidade Federal do Ceará, Fortaleza, Brazil
² Department of Ophthalmology, Hospital Walter Cantídio, Universidade Federal do Ceará, Fortaleza, Brazil
³ Laboratory of Enterovirus, Instituto Oswaldo Cruz, Av Brazil, 4365, Manguinhos, Rio de Janeiro-RJ, Brazil

Correspondence to:
Correspondence to:
Fernanda Edna Araújo Moura
Departamento de Patologia e Medicina Legal, Universidade Federal do Ceará, Rua Monsenhor Furtado SN, Rodolfo Teófilo, 60 441-750, Fortaleza-Ceará, Brazil; fernandaedna{at}terra.com.br

Background/aim: Between February and May 2003 an epidemic of acute haemorrhagic conjunctivitis affected more than 200 000 people in all five geographic regions of Brazil (north, south, midwestern, southeast, and northeast). The aim was to identify the aetiological agent and to describe clinical aspects of this outbreak in a group of patients treated at the ophthalmology department of the Hospital Walter Cantídio (OD-HWC) at the Universidade Federal do Ceará, in the city of Fortaleza, capital of the state of Ceará, northeastern Brazil.

Methods: Conjunctival swabs were collected from patients who spontaneously went to the laboratory of virology. Specimens were inoculated in HEp-2 and RD cell lines. The viral isolation was confirmed by performing reverse transcriptase polymerase chain reaction and indirect immunofluorescence assay.

Results: Viral conjunctivitis was diagnosed in 56 patients but only 24 of them allowed the collection of samples. Of 24 conjunctival swabs tested, 11 were positive for a variant of coxsackie virus A24 (CA24v) and one of the isolates reacted with anti-adenovirus monoclonal antibodies.

Conclusion: CA24v was confirmed as the aetiological agent of this outbreak of acute haemorrhagic conjunctivitis in the city of Fortaleza.

Abbreviations: AVC, acute viral conjunctivitis; CA24v, coxsackie virus A24; CPE, cytopathic effect; EV70, enterovirus 70; IFA, immunofluorescence assay; RT-PCR, reverse transcriptase polymerase chain reaction

Keywords: haemorrhagic conjunctivitis; coxsackie virus; Brazil

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