Preventing eye flu is in your hands

As monsoon spreads across India, viral keratoconjunctivitis, commonly known as ‘eye flu’, also begins its march all over the country, especially during the hot and humid months of July and August.

Just as the WHO declared the end of the Covid-19 public health emergency on March 5, 2023, another epidemic — eye flu — began spreading across India in July and August. This outbreak received little attention. The health authorities did not issue any advisories or coordinate preventive measures. However, some academic groups, such as Bodhya, and state governments in Manipur, Chhattisgarh (which reported nearly 20,000 cases in July), Nagaland and Himachal Pradesh took initiatives. They issued alerts and advised on hand hygiene. AIIMS-Delhi reported nearly 100 cases daily, with doctors emphasising the importance of basic hygienic measures.

Symptoms

Eye flu remains a seasonal and annual outbreak. Once infected, symptoms develop quickly, including redness in both eyes (usually one at a time), excessive watering, and a thick, sticky discharge. Patients may experience a gritty sensation, haemorrhages, and swelling of the eyelids. Severe cases affecting the cornea, which involve a large majority of those infected in India, can impair vision.

Eye flu outbreaks frequently begin in public places like eye clinics where contaminated surfaces can quickly transmit the virus and spread this viral infection. During an epidemic, all objects should be considered contaminated. Schools, hospitals, swimming pools, and other close-contact settings like offices, theatres and even families at home remain prone to outbreaks.

Adenovirus (AdV), the leading cause of viral keratoconjunctivitis or eye flu, is highly contagious, has a short incubation period and a great epidemic potential.

AdV is a double-stranded DNA virus that infects multiple cell types and replicates within the nucleus of the cell. Non-pathogenic forms of AdV are commonly used in gene therapy to deliver therapeutic genes in the treatment of genetic disorders. Currently, there is no vaccine available to prevent eye flu.

AdV is highly contagious and can persist on nearly all surfaces, including towels, pens, doorknobs, tables and furniture, for more than a month. These are objects that people are most likely to touch or use frequently. This information has been available in public domain for more than 20 years, and should be widely used to prevent eye flu.

Unlike airborne Covid-19, eye flu can be prevented entirely with good hygiene. The virus cannot fly into your eyes; it is your own contaminated hands that bring it to your eyes. If you avoid touching your eyes with unwashed hands and do not share towels or linens, and other items of personal use, you can effectively prevent the spread of eye flu and also avoid infecting yourself.

Preventive measures

To prevent its transmission, frequently touched surfaces, especially in eye hospitals or clinics, should be disinfected with bleach. Infected individuals, notably schoolchildren and office workers, should remain in isolation until the redness subsides. Even after symptoms disappear, the residual virus remaining in tears and on hands can still spread the infection.

Treatment

Over 100 different AdV types exist, but type D-8, one of the most severe, is common in India. There is no specific antiviral treatment for AdV conjunctivitis, as it is generally self-limiting. Although topical antibiotics are sometimes used to alleviate symptoms, they are not always necessary. Artificial tear eye drops can reduce discomfort, and povidone-iodine antiseptic eye washes in clinics may lower infectivity.

Corticosteroids can speed up the resolution of inflammation but must be used under the supervision of an ophthalmologist. Importantly, unsupervised use of steroids in herpes-related eye infections, which can produce similar symptoms, may cause serious complications, including blindness.

With awareness and simple hygiene practices, especially hand washing and avoiding eye-touching, eye flu is entirely preventable. The key to stopping its spread lies in your hands — just wash them frequently.

— The writer is Emeritus Professor, PGI, Chandigarh