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J Clin Virol. 2019 Jan 11;112:1-9. doi: 10.1016/j.jcv.2019.01.004. [Epub ahead of print]

Challenges in management of epidemic keratoconjunctivitis with emerging recombinant human adenoviruses.

Author information

1
Division of Bioinformatics, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan.
2
Department of Medicine, Ophthalmology, Fukuoka Dental College, Fukuoka, Japan; Singapore Eye Research Institute, Singapore; Department of Ophthalmology, Kyushu University, Japan; Duke-NUS Medical School, Singapore.
3
Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; Department of Ophthalmology, Health Sciences University of Hokkaido, Sapporo, Japan.
4
Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; Department of Ophthalmology, Health Sciences University of Hokkaido, Sapporo, Japan. Electronic address: nobukita@hoku-iryo-u.ac.jp.

Abstract

Adenoviral epidemic keratoconjunctivitis (EKC) presents as severe conjunctival inflammations involving the cornea that can lead to the development of corneal opacities and blurred vision, which can persist for months. EKC is highly contagious and responsible for outbreaks worldwide, therefore accurate diagnosis and rapid containment are imperative. EKC is caused by a number of types within Human adenovirus species D (HAdV-D): 8, 37 and 64 (formerly known as 19a) and these types were considered the major causes of EKC for over fifty years. Nonetheless, recent improved molecular typing methodologies have identified recombinant HAdV-D types 53, 54 and 56, as newly emerging etiologic agents of EKC infections worldwide. EKC cases due to these recombinant types have potentially been underdiagnosed and underestimated as a source of new EKC outbreaks. Recombination events among circulating HAdV-D types represent a source of new infectious disease threats. Also, the growing number of adenoviral types enabled genomic and phenotypic comparisons to determine pathological properties related to EKC. This review covers the clinical features of EKC, current challenges in clinical practice and recent progress in EKC-related HAdV research, which focuses on the development of novel diagnostic and therapeutic approaches.

KEYWORDS:

Epidemic keratoconjunctivitis; Human adenovirus; Recombination; Therapy

PMID:
30654207
DOI:
10.1016/j.jcv.2019.01.004
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