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2019 OMIG Abstract

Seven-Year Experience with “Red Eye Policy” for Employees of
One Medical Center

Irene C. Kuo, MD1, Colleen Espinosa2
1The Wilmer Eye Institute, Department of Ophthalmology, the Johns Hopkins University School of Medicine, 2Division of Occupational and Environmental Medicine, The Johns Hopkins Hospital, Baltimore, MD

Purpose: To describe the 7-year findings of a policy to screen for, diagnose, and isolate employees at Johns Hopkins Medicine (JHM) with adenoviral conjunctivitis in order to control spread of epidemic keratoconjunctivitis (EKC).

Methods: As part of a retrospective evaluation, data were retrieved from records maintained for this ongoing quality improvement initiative in which employees with suspected adenoviral conjunctivitis were evaluated and swabbed in Occupational Health for polymerase chain reaction (PCR) testing for adenoviral conjunctivitis. Signs, symptoms, work area, diagnosis, and disposition of employees with eye complaints as well as PCR result and adenoviral genotype were recorded. Seven-year data were reviewed.

Results: From 2011 to 2018, of 10,000 full-time equivalent employees, 1520 employees visited Occupational Health with clinical suspicion of adenoviral conjunctivitis; 130 (8.6%) were PCR-positive for adenovirus. Forty-one (32%) of these employees had EKC. Ophthalmology had the highest number of adenoviral conjunctivitis cases of which 7/11 (64%) had EKC--the highest proportion of EKC of any work area. Certain work areas consistently have more cases of adenoviral conjunctivitis. Employees who did not adhere to the policy and went to urgent care centers first had a longer time course from symptoms to resolution (p =0.03). Unlike the 5-year results, the proportion of red eye employees having adenoviral conjunctivitis, of employees with EKC, and the proportion of EKC caused by any genotype did not show any trends.

Conclusion: Adenoviral conjunctivitis represents 8.6% of employee cases clinically suspicious for adenoviral infection. Ophthalmology staff and doctors remain at high risk despite education. Employees in patient care areas should be screened even if they have no direct patient contact. No outbreaks occurred. This policy has reduced the number of work furloughs that would have been based on clinical suspicion alone. It may help identify incipient EKC outbreaks and help guide infection control efforts.

Disclosure: N


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