Conjunctivitis Outbreak in Northern Vietnam

Since September 2014, ‘pink eye’, or conjunctivitis, has rapidly spread throughout Northern Vietnam. Particularly so in the city of Hanoi, where more than 6,000 cases have been reported. The National Opthalmology Insitute (Hanoi) estimates that 40% of all daily cases – roughly 1,400-1,700 patients, need to be examined and treated for pink eye. Though this year’s pink eye outbreak has occurred slightly later in the season — compared to 2013, its rate of spread is said to be higher than in previous years. This may be due to the high level of humidity and dampness found at the beginning of the rainy season in Vietnam, as well as increased exposure to infected individuals. The reported number of individuals infected with pink eye is probably underestimated, since a large portion of patients choose to treat themselves at home or within private clinics [1].

Vietnamese public health authorities are concerned about the highly contagious characteristics of the disease, particularly in family, school and office environments.

Pink eye is a common illness that can occur at all ages. The disease is characterized by the inflammation – a result of the infection itself – of the conjunctiva (the inside of the eyelids). Some of the symptoms include: redness in the white of the eye, swelling of the eyelids, itching or burning eyes, swollen and tender areas in front of the ears, tearing, clear or slightly thick whitish drainage [2], burning or gritty feeling around the eyes area, thick and sticky discharge, and crusting on the eyelashes [3]. There are three primary causes of pink eye: viral infection, bacterial infection, and allergies [4].

Viral pink eye is caused by an adenovirus or herpes virus. Even though viral conjunctivitis is very contagious, it will resolve on its own within five to seven days without medical treatment. Individuals with pink eye caused by herpes virus are usually treated with antiviral medicine [5]. Bacterial pink eye is cause by bacteria, such as staphylococci, streptococci, and heamophillus [6]. Bacterial pink eye, which is just as contagious as viral conjunctivitis, can be treated with antibiotic therapy [7]. Allergic conjunctivitis is generally observed in individuals who have other allergic responses, including: hay fever, asthma, and eczema [8], which causes intense itching of the eyes. This type of pink eye can be treated with topical antihistamine or sodium cromoglicate eye drops [9]. Poor hand hygiene has also been identified as one of the main causes of the spread of pink eye. Individuals can also become infected by sharing personal items, such as washcloths, towels or tissues.

The spread of conjunctivitis is also associated with normal environmental fluctuations, such as increased humidity in Vietnam during the month of September. Along with the public's lack of basic medical knowledge about conjunctivitis and personal hygiene, these factors could create conditions ideal for pink eye outbreaks. A good number of patients, who acknowledge that pinkeye is a mild infection and eschew waiting at overcrowded hospitals and clinics, treat themselves at home with medicine and eyewash available at pharmacies. In most cases, pink eye sufferers purchase eye drops containing steroids. The use of these products, which can reduce immunity and worsen the condition if not used in the right phase [10], can lead to complications. Furthermore, doctors advise patients to restrain from administering betel leaves, or any therapy that are not scientifically supported, as self-medication since improper treatments can cause severe infection, vision lost, inflamed cornea, etc [10].

As of September 28, The Ministry of Health of Vietnam has urged local authorities to monitor incidence of conjunctivitis, enhance containment efforts, and educate the public on the disease and the risks associated with medicines that are not yet approved by doctors.










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