Acute Hemorrhagic Conjunctivitis Outbreak in Thailand, 1992

The 260 cases of acute hemorrhagic conjunctivitis seen at Siriraj Hospital during October to December, 1992 were studied. Evidence of coxsackie virus A24 variant (CA24v) infections was demonstrated in 76.8% of 95 cases. The isolation rates from conjunctival swabs and throat swabs were 68.2% and 32.8%, respectively. A four-fold rising titer of neutralizing antibody was shown in 59.5% of 42 cases. The disease was characterized by a short incubation period, sudden onset, a mild and self-limited course within 5 days without ocular sequelae. Lacrimation, swelling lida, itching, foreign body sensation and periorbital pain were common features with bilateral involvement in the majority of cases. Approximately 48% of eyes had a mucopurulent discharge. Preauricular lymphadenopathy, keratitis and subconjunctival hemorrhage were observed in 16.2%, 12.6%, and 10.1% of affected eyes, respectively. Respiratory disturbances accompanied the eye signs in some cases. Only one case developed neurological complications: facial palsy was observed for three months without recovery.