弘前大学医学部附属病院眼科病棟における流行性角結膜炎流行の事例

Outbreak of epidemic keratoconjunctivitis in the ophthalmic ward of Hirosaki University Hospital

要約　目的：弘前大学医学部附属病院眼科（当科）病棟で発生した流行性角結膜炎（EKC）の院内流行についての報告。

事例：2018年11月下旬に医師1名が，その30日後の12月中旬に看護師1名がEKCにそれぞれ罹患し2週間の就労制限となった。その10日後，12月下旬に病棟入院患者2名のEKC感染が判明し，翌日退院となった。この際，診察医より他の医師に事例報告および注意喚起がなされた。2019年1月上旬に新たに入院患者1名がEKCを発症し，同日退院となった。その翌日に病棟退院患者2名が外来受診し，EKCを発症していることが判明した。当院感染制御センターとの協議のもと，感染対策の徹底と1月最初の事例発生から2週間の入院制限が決定した。さらにその翌日に病棟入院患者1名が新たにEKCに罹患していることが判明し，入院制限が当初の予定からさらに4日間延長された。その後，当科視能訓練士1名の臨床的EKCの発症と，退院患者2名の紹介先の病院でのEKC発症が判明したが，病棟内の新規EKC罹患者は発生しなかった。1月に入って最初のEKC院内患者発生から18日後に病棟業務再開となった。

結論：医療従事者3名，入院患者8名，計11名の眼科病棟におけるEKC outbreakを経験した。院内感染発症の危険性に留意した日常診療上の予防措置の重要性を確認した。

Abstract　Purpose：To report a case of EKC outbreak in the Department of Ophthalmology, Hirosaki University Hospital.

Case：A staff doctor and a nurse in the Department of Ophthalmology were diagnosed as EKC in the end of November and the middle of December, 2018, respectively. They were under restriction on work for two weeks. In the end of December, two patients in the same hospital room were involved in EKC. They were discharged from the hospital next day. The staff doctor on duty informed other staffs to pay attention to EKC infections among inpatients. Five days later, in the beginning of January 2019, another inpatient was diagnosed as EKC and discharged from the hospital the same day. Next day, two outpatients who had been discharged from the hospital in the end of December 2018 were diagnosed as EKC. Comprehensive infection control and limitation of admission for fourteen days were decided according to the discussion among ophthalmic doctors and members of infection control team. Next day, because another inpatient was diagnosed as EKC, duration of the limitation of admission was extended to seventeen days. Except two other outpatients who were discharged from the hospital were diagnosed as EKC in referred hospitals, there was no additional infection in the ophthalmologic ward since then. The limitation of admission was dissolved in the end of January 2019.

Conclusion：An EKC outbreak involving three medical staffs and eight patients occurred in the ophthalmologic ward of Hirosaki University Hospital from November 2018 to January 2019. Prevention of such an outbreak should be kept in mind among ophthalmic staffs.