Viruses Associated with Acute Conjunctivitis in Vanuatu

Abstract

The first manifestation of a viral infection may be conjunctivitis. There are limited data on the etiology of viral conjunctivitis in Vanuatu, a country in the South Pacific Ocean. Patients presenting to one of two Vanuatu health centers with presumed infectious conjunctivitis were eligible if symptom onset was within 14 days of screening. Conjunctival and anterior nasal swabs were obtained and subjected to unbiased RNA deep sequencing (RNA-seq) to identify DNA and RNA viruses. For samples collected from May to November 2021, RNA-seq identified a viral etiology in 12/48 patients. Human adenovirus species were the most common viruses (58%) detected, followed by human herpes viruses (cytomegalovirus, varicella zoster virus, and human herpes 7 virus). Rhinovirus C, Epstein-Barr virus, and bocavirus were also detected. In summary, the etiology for viral conjunctivitis in Vanuatu appears broad. Unbiased testing may be useful for disease surveillance.

Figure 1.

Stacked bar graph of DNA and RNA viruses detected with RNA-seq. CMV = cytomegalovirus; EBV = Epstein-Barr virus; HAdV = human adenovirus; HHV-7 = human herpes virus 7; VZV = varicella zoster virus.

Figure 2.

Representative external photos of affected patients. Top panel: 2-year-old boy with left eye involvement, purulent discharge, and eyelid crustiness associated with human adenovirus B. Second panel: 3-year-old girl with bilateral eye involvement associated with bocavirus. The left eye was more injected than the right eye with associated tearing and discharge. Third panel: 3-year-old boy with associated rhinovirus C infection. Bottom panel: 68-year-old man with left eye involvement associated with varicella zoster virus. Scabbing of vesicles (red arrows) can be seen in the V1 distribution.