WordNet

of critical importance and consequence; "an acute (or critical) lack of research funds"
having or demonstrating ability to recognize or draw fine distinctions; "an acute observer of politics and politicians"; "incisive comments"; "icy knifelike reasoning"; "as sharp and incisive as the stroke of a fang"; "penetrating insight"; "frequent penetrative observations" (同)discriminating, incisive, keen, knifelike, penetrating, penetrative, piercing, sharp
extremely sharp or intense; "acute pain"; "felt acute annoyance"; "intense itching and burning" (同)intense
having or experiencing a rapid onset and short but severe course; "acute appendicitis"; "the acute phase of the illness"; "acute patients"
of an angle; less than 90 degrees
of or relating to a hemorrhage (同)haemorrhagic
inflammation of the conjunctiva of the eye (同)pinkeye

PrepTutorEJDIC

(先の)『鋭い』,とがった / (痛み・感情などが)『激しい』,強い / (知力・感覚などが)『鋭い』,鋭敏な / (事態が)重大な / (病気が)急性の / (音が)高い,鋭い / 鋭角の

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/03/05 20:16:13」(JST)

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Acute hemorrhagic conjunctivitis with the eyelid pulled down for a more complete view

Acute hemorrhagic conjunctivitis (AHC) (also spelled acute haemorrhagic conjunctivitis) is a derivative of the highly contagious conjunctivitis virus, otherwise known as pink eye. Symptoms include excessively red, swollen eyes as well as subconjuntival hemorrhaging. Currently, there is no known treatment and patients are required to merely endure the symptoms while the virus runs its five to seven day course. While it was first identified in Ghana, the virus has now been seen in China, India, Egypt, Cuba, Singapore, Taiwan, Japan, Pakistan, Thailand, and the United States.

Signs and symptoms[edit]

The conjunctiva provides lining for the inside of the eyelid as well as a coating for the sclera, the white portion of the eyeball. It typically serves to provide lubrication for the eye through the production of mucus and tears. When infected with AHC, patients will experience painful, red eyes, swelling of the conjunctival tissue, and frequent mucus discharge from the eyes accompanied by excessive tearing and subconjuntival hemorrhaging. This hemorrhaging is caused by the rupture of blood vessels beneath the conjunctiva giving the eyes a bright red appearance. Some patients also experience blurry vision and fever in addition to the common symptoms and one in every ten thousand cases exhibitsparalysis similar to that of polio.

Cause[edit]

There are three main viruses that have been studied and confirmed as the agents responsible for AHC, including enterovirus 70, coxsakievirus A24 variant (CA24v) and adenovirus 11.

AHC can only exist in a human host and is transmitted through human contact with an infected individual or object, such as a towel used by an infected person. It is also easily communicable through fecal-oral pathways, thus allowing for its abundance in areas of the world with low levels of hygiene. Within one to two days of infection, symptoms will begin to become apparent.

Enterovirus 70[edit]

Enterovirus 70 is a member of the genus of viruses called Enterovirus and family of the viruses Picornaviridae. Usually very small (about 30 nm in diameter), it is non-enveloped (meaning it only has a nucleic acid core and protein capsid) and has a single-stranded positive-sense RNA genome; the protein capsid the virus itself is surrounded by is icosahedral. It is known as one of the more new enteroviruses within this category. It spreads easily from one person’s eyes to another’s through contact with infected objects, like fingers, or through the eye secretion itself. Enterovirus 70 infrequently causes polio-like permanent paralysis.

Coxsakievirus A24 variant[edit]

The Coxsakievirus is another member of the genus of viruses called Enterovirus and family of the viruses Picornaviridae. Its isolation host is human. It is an antigenic variant of the Coxsakievirus A24. It was studied independently for the first time in Singapore in 1970.

Adenovirus 11[edit]

Adenoviruses are a medium-sized variant that are nonenveloped, like Enterovirus 70. They have a double-stranded linear DNA genome. There are 57 variants of this virus, that each cause 5-10% of upper respiratory infections in humans. These viruses are some of the largest nonenveloped viruses in existence, and because of this, they can pass through the endosome without any necessary envelope fusion.

Treatment[edit]

There is no treatment currently available. The virus generally resolves itself within a five to seven day period. The use of steroids can actually cause a corneal microbial superinfection which then requires antimicrobial therapy to eliminate.

References[edit]

Unknown, . N.p.. Web. 15 May 2013. <http://emedicine.medscape.com/article/1203216-overview>.
Chowell, George et al. " Characterization of an Outbreak of Acute Hemorrhagic Conjunctivitis in Mexico, 2003." Digital Journal of Ophthalmology. 11. (2005): n. page. Web. 15 May. 2013. <http://www.djo.harvard.edu/site.php?url=/physicians/oa/712>.
Lurie, Emma. "Enterovirus 70." Adopt a Microbe. Unknown, 14 04 2009. Web. 15 May. 2013. <http://adoptamicrobe.blogspot.com/2009/04/enterovirus-70.html>.
Unknown, . Canada. Pathogen Regulation Directorate, Public Health Agency of Canada. ENTEROVIRUS 70. 2010. Web. <http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/enterovirus-70-eng.php>.
Unknown, . "Coxsackie Virus A24." European Virus Archive. European Virus Archive. Web. 15 May 2013. <http://www.european-virus-archive.com/Portal/produit.php?ref=579&id_rubrique=1>.
Chen, et al. "Molecular epidemiology of a variant of coxsackievirus A24 in Taiwan: two epidemics caused by phylogenetically distinct viruses from 1985 to 1989.." Journal of Clinical Microbiology. 31.5 (1993): n. page. Web. 15 May. 2013. <http://jcm.asm.org/content/31/5/1160.full.pdf>.

UpToDate Contents

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1. エンテロウイルスおよびパレコウイルス感染症の疫学、病因、治療、および予防 epidemiology pathogenesis treatment and prevention of enterovirus and parechovirus infections
2. ポリオおよび前角細胞への感染性疾患 polio and infectious diseases of the anterior horn
3. エンテロウイルスおよびパレコウイルス感染の臨床症状および診断 clinical manifestations and diagnosis of enterovirus and parechovirus infections

English Journal

A sialic acid binding site in a human picornavirus.

Zocher G1, Mistry N2, Frank M3, Hähnlein-Schick I1, Ekström JO4, Arnberg N5, Stehle T6.
PLoS pathogens.PLoS Pathog.2014 Oct 16;10(10):e1004401. doi: 10.1371/journal.ppat.1004401. eCollection 2014.
The picornaviruses coxsackievirus A24 variant (CVA24v) and enterovirus 70 (EV70) cause continued outbreaks and pandemics of acute hemorrhagic conjunctivitis (AHC), a highly contagious eye disease against which neither vaccines nor antiviral drugs are currently available. Moreover, these viruses can
PMID 25329320

A case of corneal endothelial dysfunction due to coxsackievirus A24 corneal endotheliitis after cataract surgery.

Lim DH1, Kim J, Lee JH, Chung ES, Chung TY.
Cornea.Cornea.2014 May;33(5):533-5. doi: 10.1097/ICO.0000000000000096.
PURPOSE: Corneal endotheliitis causes endothelial decompensation and is associated with significant visual impairment. The goal of this article is to report a case of corneal endotheliitis associated with coxsackievirus A24 infection after cataract surgery in a patient who had no previous symptoms i
PMID 24608251

Molecular evolution of VP3, VP1, 3C(pro) and 3D(pol) coding regions in coxsackievirus group A type 24 variant isolates from acute hemorrhagic conjunctivitis in 2011 in Okinawa, Japan.

Nidaira M1, Kuba Y, Saitoh M, Taira K, Maeshiro N, Mahoe Y, Kyan H, Takara T, Okano S, Kudaka J, Yoshida H, Oishi K, Kimura H.
Microbiology and immunology.Microbiol Immunol.2014 Apr;58(4):227-38. doi: 10.1111/1348-0421.12141.
A large acute hemorrhagic conjunctivitis (AHC) outbreak occurred in 2011 in Okinawa Prefecture in Japan. Ten strains of coxsackievirus group A type 24 variant (CA24v) were isolated from patients with AHC and full sequence analysis of the VP3, VP1, 3C(pro) and 3D(pol) coding regions performed. To ass
PMID 24517637

Japanese Journal

Molecular evolution of VP3, VP1,3C[pro] and 3D[pol] coding regions in coxsackievirus group A type 24 variant isolates from acute hemorrhagic conjunctivitis in 2011 in Okinawa, Japan

Microbiology and immunology 58(4), 227-238, 2014-04
NAID 40020045327

2011年に沖縄県で発生したコクサッキーウイルスA24変異型による急性出血性結膜炎の流行

沖縄県衛生環境研究所報 (46), 59-62, 2012
NAID 40020082700

炎症性眼疾患の診療(22)急性出血性結膜炎

臨床眼科 64(1), 18-22, 2010-01
NAID 40016965157

Related Pictures

★リンクテーブル★

リンク元	「結膜炎」「急性出血性結膜炎」「AHC」
関連記事	「acute」「hemorrhagic」

「結膜炎」

　　[★]

英: conjunctivitis
関: 結膜

see. マイナーエマージェンシー第1版 p.65 SOP.174

概念

結膜に起こる炎症疾患の総称。

病原体と特徴

ウイルス性結膜炎

病原体：アデノウイルス、エンテロウイルス、単純ヘルペスウイルス、インフルエンザウイルス、水痘・帯状疱疹ウイルス、風疹ウイルス、麻疹ウイルス、EBウイルス。
治療法：対症療法。単純ヘルペスに対してはアシクロビル眼軟膏。
症状：透明な滲出液、耳介前リンパ節腫脹、結膜濾胞

細菌性結膜炎

症状：黄白色の眼脂、軽度疼痛

結膜炎をきたす疾患

SOP.175

	疾患名			病原体	潜伏期	病型	症状、経過
感染性結膜炎	流行性角結膜炎	epidemic keratoconjunctivitis	はやりめ	アデノウイルス8,19,37型(ときに4型)	7-14日	急性濾胞性結膜炎	眼脂、流涙、羞明。眼瞼腫瘤、結膜充血、浮腫、結膜の小出血斑。耳前リンパ節の腫脹と圧痛。2-4週間で消退。発症後10日後に角膜に点状上皮化混濁。
	咽頭結膜熱	pharyngoconjunctival fever	プール熱	アデノウイルス3型(ときに4,7型)	5-6日	急性結膜炎	急性結膜炎、咽頭炎、発熱。点状上皮化混濁は少ない。
	急性出血性結膜炎	acute hemorrhagic conjunctivitis		エンテロウイルス70型	1日	球結膜下出血。眼球は浮腫状、結膜充血、濾胞形成は軽度。耳前リンパ節腫脹軽度。発症より3-4日にびまん性の多発性びらん。眼痛、異物感、羞明。約1週間で治癒。罹患後2,3週間後に四肢の弛緩性の運動麻痺や脳神経麻痺があり得る。
	トラコーマ	trachoma
	封入体結膜炎	inclusion conjunctivitis
	新生児封入体結膜炎	neonatal inclusion conjunctivitis
	細菌性結膜炎	bacterial conjunctivitis
	淋菌性結膜炎	gonococcal conjunctivitis
	新生児膿漏眼	blennorrhea of the newborn
アレルギー性結膜疾患	アレルギー性結膜炎	allergic conjunctivitis
アレルギー性結膜疾患	春季カタル	vernal conjunctivitis
その他の結膜炎	フリクテン性結膜炎	phlyctenular conjunctivitis	束状結膜炎
	慢性濾胞性結膜炎	chronic follicular conjunctivitis
	Stevens-Johnson症候群	Stevens-Johnson syndrome
	眼類天疱瘡	ocular pemphigoid
	結膜弛緩症	conjunctivochalasis

「急性出血性結膜炎」

　　[★]

英: acute hemorrhagic conjunctivitis AHC
同: アポロ11病 Apollo 11 disease、アポロ病 Aporo disease
関: エンテロウイルス

法令

感染症法：五類感染症(眼科定点)　　→　　五類感染症眼科定点なのは急性出血性結膜炎と流行性角結膜炎
学校保健安全法施行規則：第三種。出席停止は学校医その他の医師において感染のおそれがないと認めるまで

病原体

エンテロウイルス70

潜伏期

1-2日

症状

結膜下出血を伴う急性濾胞性結膜炎

流行性角結膜炎、咽頭結膜熱、急性出血性結膜炎の比較

		俗称	病原体	好発年齢	季節性	潜伏期	症状	感染症法	学校保健安全法	出席停止
流行性角結膜炎	EKC	はやり目	アデノウイルス8型	なし	春～夏	1-2週間	漿液性の目脂、流涙、羞明。乳幼児では発熱、感冒様症状、下痢、眼瞼結膜に偽膜形成。眼瞼：腫脹。結膜：充血、浮腫、結膜の小出血斑。角膜：(発症約10日後)点状上皮下混濁。リンパ節：耳前リンパ節腫脹	五類感染症(眼科定点)	第三類	医師が感染のおそれがないと認めるまで
咽頭結膜熱	PCF	プール熱	アデノウイルス3,4,7型	小児	夏(基本的に通年)	1週間	発熱、咽頭炎、結膜炎	五類感染症(小児科定点)	第二種	出席停止は主要症状が消退した後二日を経過するまで
急性出血性結膜炎	AHC		コクサッキーウイルスA群24型、エンテロウイルス70型	成人	なし	1-2日	結膜下出血を伴う急性濾胞性結膜炎	五類感染症(眼科定点)	第三類	医師が感染のおそれがないと認めるまで