Viral Conjunctivitis: Health experts worried over rise in cases of 'Apollo' | The Big Stories
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NewsTranscript
00:00 Welcome back on the AM show and we continue with our big stories. Now the
00:04 second big one we're looking at has to do with your health and my health. Now
00:09 acute hemorrhagic conjunctivitis. It's a viral infection. It's under the pink eye
00:16 group and we all call it a polo. But we'll be getting some dynamics on what it is.
00:21 We're talking about it because in recent times the GOA, the Ghana Optometric
00:27 Association has told us that it's spreading and of course I've seen it.
00:31 I've seen someone recently who has had it. But what's going on? We get all the
00:37 answers as we host our guest Dr. Jifa Bella Ofuri Eje. She is president of
00:46 Ophthalmological Society of Ghana and a consultant pediatric ophthalmologist at
00:51 the Kuala Lumpur Teaching Hospital. Thank you ma'am for joining the conversation.
00:54 Thank you Ben. It's good to have you. Good to have you too. I love your shade of brown
00:58 this morning. I caught you off guard there. You did. You know the gay girls, they are the good ones in colours.
01:06 If you say brown, they will say Ben's brown. That's why I decided to go safe and say a shade of brown.
01:13 So I will be quiet about that. So your gay girls will... My gay friends will give me pressure.
01:20 Okay. For all the gay ex-students, former students watching, please tell us what colour specifically this is.
01:29 You can send it to the live stream. That's just on the lighter side. We all call it a pull-up.
01:35 Yes. What's it supposed to be called? Let's start from there.
01:38 Okay. So it's an epidemic keratoconjunctivitis. So when you look at the eye, there's a white part of the eye
01:48 and then the black part of the eye. There's this thin film that covers that white part and it sort of lines the inside of the lid.
01:56 That is called the conjunctiva. It looks like a cling film and it just lies there and gives protection over the sclera.
02:03 Occasionally it may get inflamed and when it gets inflamed, we call it conjunctivitis.
02:09 It can be caused by a virus or it can be caused by a bacteria.
02:12 The epidemic one, the one that spreads, is the one that is caused by the virus.
02:18 There are different types of viruses that will cause a viral conjunctivitis.
02:22 You have the adenovirus, you have the Coxsackie virus.
02:26 The term Apollo actually originated in 1968 when the Apollo mission landed first on the moon.
02:33 That is when the first outbreak was recorded in the world and it was recorded in Ghana.
02:38 It was tied to the name.
02:39 Yeah, so it was tied to the name. That is the acute hemorrhagic type that you rightly said.
02:44 And it's caused by the enterovirus and the Coxsackie virus.
02:48 But after that, we've had different types of epidemic conjunctivitis that have been caused by other viruses.
02:55 By Ghana, we use the term loosely Apollo to mean viral conjunctivitis.
03:00 So it's different from the acute hemorrhagic.
03:03 If my understanding is correct, for example, in the COVID-related, we have even the common cold is in that family.
03:10 Yes, influenza, then you have your SARS, and then you have your COVID-19.
03:15 And everything in between. So that's how it's called.
03:17 Yes, so it's like calling every flu COVID-19.
03:20 Exactly.
03:21 I hope you understand the way I've understood it because that's what came to mind.
03:25 So just to veer off quickly, so when you're using, I use Alatessimina.
03:29 I'm a fan of Shainbata and Alatessimina.
03:32 You know, it's one of the most dangerous things to have it get into your eye.
03:35 Does that also, when it affects, does it affect the conjunctiva?
03:38 It can give some kind of chemical conjunctivitis.
03:42 That's completely different from this.
03:43 This is a viral infection.
03:45 The reason why there is a lot of talk about it is the fact that it is highly contagious.
03:52 Right.
03:52 Okay, but the good thing is that it is self-limiting and usually benign.
03:56 So usually will not result in very serious consequences.
04:01 But because it's highly contagious, it's important that we are careful when there is an epidemic.
04:07 Okay, so typically people will present with a pink eye.
04:10 Okay, then they'll complain of tearing, they'll complain of sand, a feeling of sand or gritty sensation.
04:16 Sensitivity.
04:17 Yes, and sometimes light sensitivity.
04:19 And that sensation makes you want to put your fingers into your eye.
04:24 That is how you spread it.
04:25 So as long as you come into contact with the fluid, any surface you touch,
04:30 if someone touches it, then they get it.
04:32 So imagine there's an outbreak in a nursery school.
04:35 Yeah.
04:35 Touch their eye, touch every boy.
04:38 And then everybody, every child in the school gets it, takes it home.
04:42 For some reason, children deal with it nicely.
04:44 So usually the disease should take anything between 14 days to 21 days.
04:50 It's self-limited, meaning that if you don't do anything about it,
04:53 it will get better in about 80% of the cases.
04:56 For a few people, it may become severe, but for most people, it will just resolve by itself.
05:03 But the symptoms that it gives, because of the way it spreads,
05:06 we give you symptomatic treatment like we did during COVID.
05:10 Steam inhalation, you know, drink something warm.
05:14 Yes, so it's the same thing to make you comfortable
05:17 so you don't put your fingers into your eye to limit the spread.
05:21 So these children will have it and sometimes after about four or five days, they are good.
05:25 When their parents have it for three weeks, they are home.
05:28 I mean, children are a whole different...
05:29 Exactly, exactly.
05:31 So that is what we have to be careful about.
05:34 So make sure that you are not touching your eyes,
05:37 you're washing your eyes with soap and water.
05:40 And most of the times, cold compresses, that's magic.
05:44 So Ellen's free cloth or face towel, what we call,
05:48 just put it in cold water and put it on the eye.
05:51 It's so soothing, most people would not even need any eye drops at all.
05:55 So usually the eye drops that we give will be something just to make the eye comfortable.
06:00 So you are not having that sandy feeling because that's gritty sensation
06:03 is what makes you want to put your fingers in your eye.
06:06 Now, if your hands were contaminated and you put it into your eye,
06:10 then you can secondarily infect it with bacteria.
06:13 And that is when you have that whitish discharge.
06:16 And then there is a bacteria infection
06:18 that actually may have a lot more consequences
06:21 than just the plain viral conjunctivitis.
06:24 Okay, so I'll come to... I know that in treating it,
06:27 for some people, it may get to the point where...
06:29 I remember the last time I had it, which is so long ago,
06:33 it's...
06:35 But you would see that sometimes you would wake up in the room,
06:38 your eyelids are clasped shut, apart from the greasiness and everything.
06:43 And it's very uncomfortable.
06:47 So sometimes you may have to dispense some eye drop or something.
06:52 We call it artificial tears.
06:54 So just take note, this is not antibiotics.
06:56 This is not chloramphenicol.
06:57 Because antibiotics will not have any effect on the viruses.
07:02 So you're not using antibiotics.
07:04 Because antibiotics are for antibacterial infections.
07:08 And this is a virus.
07:10 So you don't need antibiotics.
07:12 So just to make the eye comfortable,
07:14 usually you have these artificial tears that may be sold over the counter.
07:19 Just put it in your eye, just to make your eyes comfortable.
07:22 Most important thing, fingers should not go into the eye.
07:26 - Yeah, Sebul. - Fingers should not go into the eye.
07:27 It's like having chickenpox and they tell you not to use it.
07:29 But you are itching all over. Oh my word.
07:32 Fingers must not go into the eye.
07:33 Once the fingers don't go into the eye,
07:36 you do not transmit it.
07:37 And then you yourself don't get secondarily infected.
07:40 And then over time, it gets better.
07:43 The first 10 days, or when the eye is really red,
07:46 is the most contagious time.
07:48 So that is when you can quickly pass it on to other people.
07:52 They say that maybe the first 4 to 7 days is the most severe time.
07:55 So you become worse, when it starts, you become worse
07:59 before you begin to get better.
08:01 And typically we'll start with one eye
08:03 and then move on to the other eye.
08:05 Most important thing is, do not use sea water.
08:09 Do not use your hairball preparation,
08:12 your breast milk.
08:13 One of the guys was asking me when I was coming.
08:15 Breast milk? People have advanced.
08:17 Yeah.
08:19 Advanced technology.
08:20 Yeah, so people would use breast milk for it.
08:22 People use sea water, salt water.
08:25 Sea water, how can you even... that will irritate...
08:28 Because they feel that it's sterile.
08:31 So if there is any problem with the surface of the cornea
08:34 and you instill any of these things, it may result in blindness.
08:38 So you are better...
08:39 Wait, wait, wait, hold for me.
08:41 I want you to go slowly there.
08:44 You are saying that, if you have any such eye infection
08:48 and you choose to go and use, for example, sea water,
08:50 does it include the breast milk?
08:52 Breast milk, hairball preparation, urine,
08:55 all these things that we use.
08:57 All people do that.
08:57 People even drink urine to cure certain diseases.
09:00 So people use all kinds of things too.
09:03 It is self-limiting.
09:04 It will get better.
09:05 And you say that all those can cause blindness.
09:08 If there is a problem on the surface,
09:10 imagine if it is just a viral congenital virus.
09:13 You may get away with it.
09:14 But if there is a little scratch on the clear part of the eye,
09:17 what we call the cornea, it may result in a cornea ulcer.
09:20 If that cornea ulcer, if not treated well,
09:24 will result in cornea opacity and then will result in blindness.
09:29 Wow.
09:30 So it's important that you allow it to run its course.
09:34 Okay. Cold compresses would help.
09:37 Artificial lubricants, whatever you do, do not let your fingers go into it.
09:42 The cold compresses you're speaking of, so what? A damp or...?
09:45 So cold, a face towel, just dip it in tap water, cold water.
09:49 Close your eyes, squeeze the water as close to you as you can.
09:51 Just put it on it.
09:53 Okay.
09:53 Close your lids and just put it on it.
09:55 And it's so soothing.
09:57 I had a few colleagues who had had it.
09:59 And like you have had it several years ago,
10:01 I have also had it several years ago.
10:03 And I fear it so much
10:05 because I have seen adults behave like children when they have got it.
10:09 It's painful.
10:10 So I see, sometimes I see close to eight to nine kids with it.
10:14 I wash my hands every single time.
10:17 I don't even use a hand sanitizer.
10:19 I wash my hands with soap and water.
10:21 By the time I'm done, my skin is so dry,
10:24 it looks like the skin of a crocodile or something.
10:26 But I prefer that to get in it.
10:28 So constant washing of that.
10:30 Imagine this is something I do every day
10:32 and I see all these kids and I haven't had it.
10:35 It just tells you that if you take precautionary measures,
10:38 you're not likely to get it.
10:39 Speaking of those precautionary measures,
10:41 apart from hand washing and all of that,
10:43 is there any way of preventing it?
10:44 Like with COVID, we're told that, I mean,
10:46 your immune system, take care of your immune system
10:48 because that can also help in combating it.
10:51 Like it would do the common cold.
10:53 Does the immune system or anything else play a role?
10:55 Yes, so you will not have a full-blown one
10:58 with the tearing, with the red eyes, with the...
11:02 Some people have it and it passes quickly.
11:05 They notice their eyes are pink, tearing here
11:08 and they're a bit uncomfortable and then it passes quickly.
11:11 So sometimes some people are able to rid of the virus,
11:14 just like in COVID, people's viral load of the COVID
11:18 came down drastically after a few days.
11:21 So some of us had to stay till about 14 to 21 days
11:24 to clear the virus.
11:25 So yes, yeah, when you're healthy, it helps.
11:28 But most importantly, do not put anything in your eye
11:32 that would worsen it.
11:33 Because if left alone, you should be fine.
11:36 You know, there are two things that are probably
11:40 the nightmare of a broadcaster on TV like I am,
11:44 or even on radio, but especially on TV.
11:47 The common cold or COVID in that family and that one.
11:52 It's, I run away from it like the plague.
11:57 So we have that in common.
11:59 And maybe I wash my hands a lot.
12:02 Exactly.
12:02 Not even before COVID I was doing that.
12:04 Now it's been accelerated.
12:06 But what is causing this current outbreak?
12:10 And how bad is it?
12:11 Because I've actually seen about two people who have it.
12:15 I think it's actually subsided.
12:18 The difficulties that we're not able to sample
12:21 what exact virus is causing it,
12:23 because it is a clinical diagnosis.
12:26 You see the person, you look at them under the slit lamp.
12:29 There's something we see on the conjunctiva called follicles.
12:33 And then a few things that make us know that,
12:35 ah, this is an epidemic, a viral keratoconjunctivitis.
12:40 And because it is self-limiting,
12:42 we typically will not take samples to the lab
12:45 to find out which exact virus is causing it.
12:49 But because this virus is highly contagious,
12:53 that is why it is spreading so quickly.
12:55 And I think it happened around the time
12:56 when the kids reopened school.
12:58 So then it actually increased contact
13:02 and then spread it quite across the entire country.
13:07 Yes, so typically it is because it is highly contagious.
13:11 And that is why when it comes...
13:12 So we've gotten a few of these epidemics in the past.
13:15 Even this year, we got a few of them.
13:17 But probably because that virus wasn't very, very contagious,
13:20 it just settled in that community or in that school
13:24 among those children, and then it got better.
13:26 This one seems to be a bit virulent and then going around.
13:30 But because it's, like I said, it's self-limiting,
13:32 it is not cost-effective going to spend so much money
13:36 sampling that virus, et cetera.
13:38 Unless maybe you're on set like I am,
13:40 or you're acting a movie,
13:41 and you need this to be gone in much faster.
13:43 Unfortunately, it can't be gone.
13:46 It can't be gone.
13:47 Once it starts, you know,
13:48 you just have to be patient for it to run its course.
13:51 So don't even get it in the first place.
13:53 Do whatever possible.
13:54 Build your immune system.
13:55 Wash your hands.
13:56 Avoid too much contact with someone who may have it.
13:59 And just put in place the right processes.
14:02 I know that the Ghana Health Service has also,
14:05 you know, is also involved in all of this.
14:07 When you read today's Ghanaian Times newspaper,
14:10 it says the Ghana Optometric Association,
14:14 I don't know whether it's not supposed to be optometrists,
14:17 which confirmed the nationwide outbreak,
14:19 said that seeking professional care was important
14:22 to prevent spread and possible complications
14:24 from the infection.
14:25 So when it happens like this,
14:26 you're saying it is, it will deal with itself.
14:30 But this is also suggesting that we must seek,
14:33 you know, help.
14:34 Which is which?
14:35 How do we go about it?
14:36 So usually the mild ones,
14:38 and there are lots of people who've had it
14:39 who haven't come to the hospital.
14:40 I have personally had family members.
14:42 Sometimes it's financial.
14:44 It's not because of options.
14:48 Yeah, but I have had family members,
14:51 friends who have had it,
14:52 and I haven't had to go into the hospital
14:54 because they know what it is.
14:55 But definitely, when you get it and it is painful,
14:59 you are uncomfortable,
15:00 you must seek proper medical care.
15:03 And that is why we spoke about the don'ts.
15:05 This is because in recent times,
15:08 unfortunately you can acquire any medicine at all
15:11 you want in Ghana over the counter.
15:13 Okay, some people will use medicines
15:14 that have been given to other people
15:16 for whatever condition, and it may worsen it.
15:19 So once you are not comfortable,
15:21 you need to seek medical care.
15:23 So you have the ophthalmologist available,
15:25 you have your ophthalmic nurses available,
15:28 you go to your polyclinic,
15:29 you just report to them,
15:32 and then we will take good care of you.
15:34 Okay, a few more things from this story
15:36 that I want you to clarify for us,
15:39 and some myths that I may want you to debunk.
15:41 You've already spoken about the seawater,
15:44 urine, breast milk,
15:46 hamam for you,
15:47 and other things that are used.
15:50 I mean, I can't even think of,
15:53 breast milk is filmy already,
15:54 I have some more.
15:56 But here, so infected persons are also urged
15:59 to discard of tissue used in cleaning the eyes,
16:03 and to avoid using handkerchiefs
16:06 to clean discharging eyes.
16:08 Tell us a bit more about that.
16:09 So this is basically,
16:11 you remember I said that it is transmitted
16:14 when you come into contact with a fluid, okay?
16:17 And then you touch anything,
16:19 any contact your hand has with that contaminated fluid
16:23 will transmit the disease.
16:24 So we suggest that you use something like tissue paper,
16:27 because once you use a tissue paper,
16:28 you dispose of it.
16:30 If you're using handkerchief,
16:31 it goes back into your pocket,
16:33 it will mix with the money in your pocket,
16:35 mix with the debt in your pocket,
16:37 and if you use that same handkerchief back into the eye,
16:40 you are--
16:41 Reinfecting yourself.
16:42 No, you're using bacteria,
16:44 because then there are germs there,
16:45 and those germs can give you a secondary infection, okay?
16:48 And if that money is given to someone,
16:51 or those car keys are handed over to someone
16:53 with the virus on it,
16:55 they accidentally touch their eye,
16:57 then that spread continues.
16:59 So once you use a tissue,
17:01 you dispose of it,
17:02 you wash your hands.
17:03 If you don't touch your eyes,
17:04 those are the--
17:05 that's the best thing,
17:06 because then you are sure that you're not transmitting it.
17:08 But then again,
17:09 you have issues with people who use pillows together,
17:12 who sleep on the same bed,
17:14 so that's one too can be transmitted.
17:16 Quick question.
17:17 Can you reinfect yourself?
17:18 Here's what I mean.
17:19 I mean, how quickly can you get the virus back?
17:22 Because let's say you use even tissue,
17:26 or a handkerchief.
17:27 Let's say when it is resolving itself,
17:30 it's been two, three weeks,
17:30 and you've practically gone through the process.
17:33 Now somehow, a few days later,
17:34 you take the same handkerchief and use it.
17:36 Can you reinfect yourself?
17:37 No, that same handkerchief, no.
17:39 That same handkerchief, no.
17:40 Because it's that same virus, right?
17:42 So you'd have immunity, right?
17:43 Unless there's another epidemic of a different strain
17:47 that is what you may be able to pick up.
17:49 But with that same virus,
17:50 and remember the handkerchief,
17:52 we're not so worried about the viral,
17:55 reinfecting yourself with the virus,
17:57 like the secondary bacterial infection was.
18:01 Yeah, because that could be even more.
18:02 That could be the problem, yes.
18:05 There's also this assertion that,
18:07 and it's like when we started hearing about AIDS,
18:11 people said, "You shouldn't touch them,
18:13 you shouldn't do this and that."
18:14 Thankfully, we've gone past that phase.
18:16 But now we hear that some people even believe that,
18:19 "Oh, the person has it."
18:20 You look at them, "Oh, she knows some ways,
18:21 "she knows how to do it."
18:23 What is the truth of that?
18:24 I can imagine the ophthalmologists in Colombo,
18:26 everybody should have pink eye by now,
18:28 because we are looking at people who have it.
18:31 So it is just a myth.
18:32 It is just a myth.
18:34 It's just supposed to say that
18:35 that's how contagious it is,
18:37 even by looking at someone,
18:39 but you won't get it.
18:40 Because we even get to examine the people
18:42 behind the slit lamp,
18:44 we touch the eye and all that.
18:46 So wash your hands, it's important.
18:48 Wash your hands and then make sure
18:50 that your hands do not go into your eye
18:53 if you have a viral conjunctivitis.
18:56 Okay.
18:57 I believe we've addressed all of those
19:00 pertinent issues.
19:01 What other things are you going to leave us with
19:04 as we deal with the spread?
19:07 And, well, I don't think as of now,
19:10 like COVID, we'll talk of reporting or anything.
19:12 It's self-resolving.
19:15 And it's benign.
19:16 You know, COVID was, in some cases, was fatal.
19:20 So that is what we were worried about.
19:22 This one usually is benign.
19:24 It will not result in death.
19:25 Yes. So unless, of course,
19:27 a secondary infection,
19:29 then the white, the clear part of the eye
19:31 gets a scar, and that is what we worry about.
19:34 So once you get it,
19:35 you think it is too severe,
19:37 you cannot deal with the pain.
19:38 You have to seek medical attention
19:41 because you may have the severe form.
19:43 So if you have it, your tear and pink eye,
19:45 it's itchy here and there,
19:48 but you're fine, that's okay.
19:49 But the moment you think that this is too painful,
19:52 your lids are swollen shut.
19:54 You are having whitish discharge of the eye.
19:57 You need to seek medical attention.
19:59 And by medical attention, I mean medical professional.
20:01 Not going to buy medication.
20:03 Don't go to any...
20:04 We're not demonizing herbs.
20:06 We know of their efficacy and everything.
20:08 When they come through the approved routes,
20:10 I have seen once in a regional hospital,
20:14 I was visiting someone,
20:16 I believe this was in Koforidia,
20:18 where someone, I mean,
20:20 you see how when you have parched land
20:23 that has become so dry,
20:24 there are so many cracks on it.
20:26 - Someone's skin was...
20:27 - This was literally the person's skin from head to toe.
20:30 And some pus, very bad odor was coming out.
20:35 The person eventually passed in that ward.
20:37 And guess what?
20:39 That person had had something common.
20:41 Was it typhoid or fever?
20:42 Some sort of gone to a herbalist.
20:46 And the herbalist had given this person something.
20:48 I don't know whether maybe it was just because
20:50 this person had maybe a natural allergy
20:52 or something reaction to it.
20:54 But that was what happened from hands, head, face, whole body.
21:00 It was agonizing.
21:01 I watched this young man.
21:02 He was about 19 or 21.
21:05 So let's be careful with some of these things.
21:08 You may do them and regret for life.
21:10 Some of them, what they will leave you with,
21:12 you can't remedy it for the rest of your life.
21:14 - Exactly.
21:14 - So you have to watch out.
21:16 - And for your eye, you cannot get a spare eye.
21:19 Who's going to give you the eye?
21:21 Even if someone was willing to give you their spare eye,
21:23 it could not be medically possible
21:25 unless you are transplanting some part of the eye.
21:28 So the eye is a precious organ.
21:30 God gave us two for good reasons.
21:32 So you've got to keep both of them.
21:35 - Just this final bit, it came to mind while you were speaking.
21:38 So for someone who maybe may not introduce something else,
21:42 but let's say the person already has an underlying issue on the eye,
21:47 whether glaucoma or whatever,
21:49 is there a difference when they get pink eye?
21:52 - Not necessarily.
21:54 Maybe if you're diabetic, okay?
21:56 Because you know diabetes, if you have an infection
22:01 and your sugars are not well controlled, it becomes very fluid.
22:04 And then if you are someone who wears contact lense,
22:07 so if you were a contact lense wearer, you have pink eye,
22:11 they said, "No, no, no, you've got to take off the contact lenses."
22:14 - Okay, for those who use contact lenses.
22:17 - Yes, so if you use contact lenses and you have pink eye,
22:20 you want to just let the eye rest a bit,
22:23 take the contact lenses out and use your glasses
22:26 for the period that you have the pink eye.
22:29 So basically, these are some of the things.
22:31 And someone who has low, an immunocompromised person,
22:35 someone with low immunity,
22:36 the disease may have a different cause in that person.
22:40 But in healthy individuals, if you have symptoms
22:43 and it is bothersome, you should just go to the nearest hospital and seek help.
22:49 - So the final bit there, when you get pink eye,
22:52 you have more life, what I say, no slaying with pink eye.
22:56 So if you have pink eye, please contact lenses,
22:58 no matter what, don't come and give us any wahala.
23:01 That's been our conversation this morning
23:03 with Dr. Jifa Bella Oforije.
23:07 That's a very Wegehe-ish name.
23:09 - Oh no, it's not. No, not Wegehe-ish at all.
23:12 My Gehe friends are sorry. - I'm looking for trouble this morning.
23:15 - For me. - No, for myself.
23:17 - My roommate is from Gehe, so I gather a lot from medical school, yeah.
23:23 - All right. She's president of the Ophthalmological Society of Ghana.
23:27 It's always a mouthful.
23:28 Consultant, pediatric ophthalmologist at the Collingwood Teaching Hospital.
23:33 Doc, it's been enjoyable.
23:34 I would have shaken your hand, but on second thought.
23:37 - You are scared. My hands are super cold.
23:38 - I'm not saying scared, but hopefully if I have anything,
23:41 I'll not transmit it to you.
23:42 And if you have anything, you'll not transmit it to me.
23:45 So let's start the example from right here.
23:47 - I agree. - Thank you so much for joining the conversation.
23:50 - My pleasure. Thank you to your listeners too.
23:52 - Right. So we continue right here on The AM Show.
23:55 We'll be right back.
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