Communicable Diseases Factsheet Epidemic keratoconjunctivitis is a
highly contagious infection of the front
surfaces of the eye. There is no specific
Epidemic treatment, and symptoms usually
resolve in about two weeks. Hygienic
Keratoconjunctivitis practices are important to stop the
infection spreading to others.
Last updated: 3 September 2018
What is epidemic keratoconjunctivitis?
Epidemic keratoconjunctivitis (also sometimes referred to as viral keratoconjunctivitis) is a highly contagious
viral infection of the eye. Symptoms can last up to two weeks or more. It is caused by adenoviruses and there
is no specific treatment. Because they see lots of patients who may have infections, outbreaks are often
associated with eye clinics. Bacteria, other viruses, allergies or chemical irritation can also cause types of
conjunctivitis.
What are the symptoms?
The symptoms of epidemic keratoconjunctivitis can commence in one or both eyes and include:
Redness("pink eye")
Swelling of the eyelids
Sensitivity to light (photophobia)
Clear watery discharge
Blurred vision
Eye pain, or a feeling that something is in your eye
Occasionally, people may also get:
Fever
Headache
Extreme tiredness
Swollen lymph nodes
How is it spread?
Epidemic keratoconjunctivitis is highly contagious and adenoviruses can live on surfaces for up to 30
days.
People get epidemic keratoconjunctivitis by coming into contact with tears or discharge from the eyes of
an infected person and then touching their own eyes. This can happen by touching the hands of
someone with the infection, or by touching contaminated surfaces or objects.
Usually the symptoms develop between 5 days and two weeks after exposure to an infected person or
surface.
People are thought to be infectious from a day or two prior to the onset of symptoms until around 2
weeks after symptoms develop.
Who is at risk?
Anyone can get epidemic keratoconjunctivitis. It is easily spread between people.
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How is it prevented?
Epidemic keratoconjunctivitis is a highly contagious disease and children should stay home from school until
symptoms have resolved or until cleared by a doctor, whichever is earlier. It is usually OK to go to work, but
follow the infection control measures outlined below. However, health care workers should be clear of infection
prior to returning to work.
If you have epidemic keratoconjunctivitis:
Avoid touching your eyes whenever possible. If you do touch your eyes, wash your hands thoroughly
with soap and running water for at least 15 seconds
Avoid touching other people
Throw away or carefully wash items (in hot water and detergent) that touch your eyes
Do not share eye makeup or other items used on the eyes (e.g. towels, tissues, eye drops, eye
medications)
Use a separate towel and face cloth for each member of the household
Cover your mouth and nose when coughing or sneezing
Use disposable tissues to blow your nose, sneeze or cough
If you visit another doctor or clinic, make sure you tell them that you have or have recently had
epidemic keratoconjunctivitis so they can implement measures to prevent spread of infection.
Eye clinics must ensure that all reusable instruments that touch patient eyes, e.g. tonometers, are wiped clean
and disinfected with either 5000ppm chlorine or 70% ethyl alcohol after each patient1. Single use instruments
are preferred for patients with a suspected eye infection.
During outbreaks clinics must ensure all staff thoroughly wash hands before and after each patient, try to see
patients with infection in a different room to other patients, use only single-use eye drops, and ensure all
surfaces touched by patients (including door knobs and handrails) are cleaned frequently with either 5000ppm
chlorine or 70% ethyl alcohol. Any staff that develop infection must not attend work2.
How is it diagnosed?
Epidemic keratoconjunctivitis is diagnosed by the signs and symptoms outlined above. Your doctor may also
take a swab of your eyes to identify the responsible virus. A swab takes several days to return a result.
How is it treated?
There is no treatment available for epidemic keratoconjunctivitis, and it will usually go away by itself in around
two weeks (this can range from one to six weeks). Paracetamol, cold packs and cold showers have been found
to be helpful for relieving symptoms. Specific treatment is available for the other forms of conjunctivitis
(bacterial, allergic).
What is the public health response?
Epidemic keratoconjunctivitis is not a notifiable disease in NSW. However public health units can provide advice
on the control of outbreaks.
For further information please call your local Public Health Unit on 1300 066 055 or visit the New South Wales
Health website www.health.nsw.gov.au
1
Guideline for Disinfection and Sterilization in Healthcare Facilities, USCDC, February 2017.
2
MMWR 66(30); 811-12, USCDC August 2017.
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