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>  News Releases >   2003 >   March

New England Journal of Medicine takes notice of unusual outbreak of pinkeye in 2002

Dartmouth College Office of Public Affairs • Press Release
Posted 03/20/03 • Contact Sue Knapp

It's not often that "pinkeye" makes national news. But last winter, an unusual number of Dartmouth students came down with conjunctivitis, or pinkeye, and federal health officials and media both took notice.

While the occurrence of pinkeye on college campuses is not unusual, what was striking was the number of people afflicted and the cause, a strain of bacteria in the Streptococcus pneumoniae family. The appearance of bacterial pinkeye, rather than viral, piqued the attention of campus health professionals, who alerted state officials, who recommended contacting the Centers for Disease Control and Prevention (CDC).

"...a wonderful example of private doctors, the state health officials and a federal agency working together so productively."

-Jack Turco

This conjunctivitis event is recounted in this week's issue of the New England Journal of Medicine. According to Jack Turco, the Director of Dartmouth's Health Service and one of the co-authors of the study, there are several elements that make this outbreak noteworthy.

"First of all, in the past, big conjunctivitis outbreaks were assumed mostly likely viral," says Turco, "this was bacterial. Second, the CDC determined that the bacterial strain we had was identical to one that caused outbreaks in 1980 and 1981, more than 20 years ago. Third, it's a wonderful example of private doctors, the state health officials and a federal agency working together so productively."

Turco also notes that Dartmouth's e-mail system, called Blitzmail, was an extremely effective communications tool.

"The fact that Dartmouth is such a 'wired' campus helped us connect with all of the students," he says. "We are all intimately connected to our Blitzmail, and people at the CDC were impressed that we could get things done quickly because of this. We were able to contact a high percentage of the campus. Through this incident, we became a well-organized collection of basic scientists and public health officials working with our campus doctors and computer people to answer as many questions that we could."

Adds John Pryor, Director of Undergraduate Evaluation and Research and one of the co-authors on the study, "Our ability to create, launch and analyze a web survey to identify the possible transmission routes and then schedule a clinic with a web-based scheduling system definitely made an impression with our colleagues at the CDC."

Many questions remain, and many theories still exist regarding this outbreak of conjunctivitis. The CDC determined that this bacteria was mostly likely in the Streptococcus pneumoniae family, except it lacked the protective capsule normally found around the bacteria. The lack of this capsule may contribute to the fact that it was highly transmittable on the membrane of the eye, but it didn't cause serious internal infection, such as pneumonia. Another nagging question concerns that fact that this bacteria had reemerged after disappearing for a couple of decades. These investigations are ongoing.

Turco asserts that the lessons learned are valuable, nonetheless.

"I think it was reassuring to learn we can spread the word immediately on our campus; we can easily and quickly involve our state and federal experts when needed; we can pull people together to collect the data; we can put together and implement surveys and studies; and implement measures to prevent further infection," he says. "The other thing our study showed was that basic hygiene was the best way to stop the spread of pinkeye. A vaccine is not yet available, so we encouraged frequent hand washing and told students to reduce contact that might foster transmission."

Spring break on the Dartmouth campus effectively broke the infectious cycle of pinkeye last winter. All involved last year are breathing easier now that Dartmouth's winter term has again ended without a recurrence on campus of the rogue strain of Streptococcus pneumoniae.

- Susan Knapp

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