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2002 Ocular Microbiology and Immunology Group, Abstract 13

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An Outbreak of Pneumococcal Conjunctivitis on a College Campus
P. Sanchez,1 A Bashir,1 J Turco,1 J Pryor,1 J Schwartzman,1 M Martin,2 C Whitney,2 M Zegans1 1Dartmouth Medical School, 2CDC

Purpose: To describe the microbiology and clinical features of an outbreak of pneumococcal conjunctivitis on a college campus involving over 500 students.

Methods: Data from a consecutive series of conjunctival cultures, a prospective clinical evaluation and a retrospective survey will be presented.

Results: Streptococcus pneumoniae was isolated from more than 40% of all conjunctival specimens submitted for culture by the college health center during the outbreak. Prospective clinical evaluation of 65 students using a simplified screening protocol revealed that observation of a red eye at 2 feet, purulent discharge, complete obscuration of the tarsal blood vessels of the lower eyelid and chemosis were associated with isolation of S.pneumoniae from eye specimens (p<0.05). Of 232 students who responded to a survey after the outbreak, 70% experienced bilateral disease, discomfort was graded as moderate, and more than 90% received topical antibiotics and noted improvement in symptoms within 5 days of beginning treatment. Duration of symptoms ranged from 1 to 60 days; 87% reported that symptoms had resolved at the time of the survey. More than 90% students received an alcohol based portable hand sanitizer, however, most used none or less than 25% of the bottle. No permanent ocular sequelae were observed as a result of this infection. No members of the college health care center staff developed conjunctivitis.

Conclusions: A non-encapsulated strain of S. pneumoniae caused a large and disruptive outbreak of bilateral, purulent conjunctivitis among college students. A simplified clinical screening protocol was effective at identifying cases that were culture positive. Most patients experience resolution of symptoms within 5 days of treatment and no significant ocular sequelae were noted. Normal infection control practices were effective at preventing transmission of this organism to health care staff.

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