Acute hemorrhagic conjunctivitis (ahc; epidemic hemorrhagic keratoconjunctivitis)

General: First reported in 1969, first epidemic in United States in 1981; enterovirus; explosive 222c21c onset; usually bilateral; coxsackievirus A24 and enterovirus 70 have been implicated in the most recent outbreaks.

Ocular: Chemosis; follicular conjunctivitis; petechial bulbar hemorrhages; seromucous discharge; keratitis; lacrimation; lid edema; photophobia; preauricular lymphadenopathy.

Clinical: Systemic symptoms are rare, although several cases of lumbosacral radiculomyelitis have occurred late in the course of the disease; polio-like paralysis (associated with enterovirus 70).

Bern C, et al. Acute hemorrhagic conjunctivitis due to enterovirus 70 in American Samoa: serum-neutralizing antibodies and sex-specific protection. Am J Epidemiol 1992; 136: 1502-1506.

Fraunfelder FT, Roy FH. Current Ocular Therapy, 5th ed. Philadelphia: WB Saunders, 2000.

Minami K, et al. Seroepidemiologic studies of acute hemorrhagic conjunctivitis virus (enterovirus type 70) in West Africa. I. Studies with human sera from Ghana collected eight years after the first outbreak. Am J Epidemiol 1981; 114:267-273.

Whitcher JP, et al. Acute hemorrhagic conjunctivitis in Tunisia. Report of viral isolations. Arch Ophthalmol 1976; 94: 51-55.

Wright PW, et al. Acute hemorrhagic conjunctivitis. Am Fam Physician 1992; 45: 173-l78.

Yin-Murphy M, et al. A recent epidemic of acute hemorrhagic conjunctivitis. Am J Ophthalmol 1993; 116:212-