Table 1 Comparison of nosocomial adenovirus keratoconjunctivitis (AKC) infection-control policies for patients with suspected AKC
| Policy for all AKC cases before the introduction of patient segregation (until May 2001) | Policy for non-epidemic status following the introduction of patient segregation in June 2001 |
| Patient examination measures | |
| Single use of multidose diagnostic solutions, eg, saline for fluorescein application | Single-dose eye-drops only; all unused units discarded weekly |
| Avoidance of both tonometry and the use of diagnostic lenses | No change |
| Disinfection of tonometer heads with hypochlorite 0.1% | Use of disposable tonometer heads and disinfection of non contact diagnostic lenses by washing under tap water before soaking in hypochlorite 0.1% for 5 min; contact diagnostic lenses are sterilised in gas plasma (ethylene oxide before 2005) |
| Handwashing with soap and water following clinical examination | Handwashing with soap and water, hibiscrub or betadine, before and after contact with every patient |
| Cleaning slit-lamp surfaces after clinical examination with 70% isopropyl alcohol | Cleaning slit-lamp surfaces before and after clinical examination with 70% isopropyl alcohol |
| Patient-segregation measures | |
| Patients with acute conjunctivitis identified at triage in A&E and their clinical notes marked to identify patients to staff | |
| Identified patients sent to a separate waiting area outside a designated examination cubicle (the Red Room) | |
| Patients examined in designated cubicle and sent home as soon as a clinician is free, to reduce exposure time of the patient to common waiting and examination areas | |
| Patient advice sheet | |
| None | Patient given advice sheet about AKC and methods of avoiding cross-infection |
| Policy for epidemic status* following the introduction of patient segregation in June 2001 | |
| Patients with acute conjunctivitis identified at the Hospital Entrance by a trained nurse and sent to a designated waiting area before examination in the Red Room | |
| Measures for infected doctors | |
| Suspended from patient contact until 2 weeks after the onset of symptoms in the second eye | Unchanged |
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*Defined as increasing numbers of cases of nosocomial infection uncontrolled by non-epidemic measures.
