Acute hemorrhagic conjunctivitis outbreaks associated with Coxsackievirus A-24 in India, 2023

Objective: Acute hemorrhagic conjunctivitis (AHC), commonly called pink eye, saw an alarming increase in incidence from July to September 2023 in different parts of India. Pink eye occurrences had reportedly increased three to four times more than in prior years, raising concerns among the community and healthcare professionals. This study aimed to identify the aetiological agent associated with AHC in 2023, genetically characterize the agent and describe the clinical presentation.

Methods: From July to September 2023, 300 ocular and throat swab samples were collected from patients with AHC across various regions of India, including Maharashtra, Daman & Diu, Delhi, Lucknow, and Hyderabad. These samples represented a diverse geographic spread of the condition. The swabs were examined for qRT-PCR analyses, to detect adenovirus and enterovirus. Following this, conserved regions within the enteroviral 5'-UTR and VP2/3 C gene were further investigated for serotype identification.

Results: Enterovirus was found in 52.6 % (158 out of 300) of the patients. Among the enterovirus-positive samples, coxsackievirus-A24 was present in every positive sample.

Conclusion: The rise in AHC cases in India in 2023 was attributed to the Coxsackievirus-A24 strain GIV C5.