Early-appearing antiviral activity in human tears during a case of picornavirus epidemic conjunctivitis.

The clinical, virological, and immunological courses of a laboratory-acquired hemorrhagic conjunctivitis were followed. Coxsackievirus type A24 (CA24) was isolated from tears for only two days but from sputum and fecal samples for 20 days. Maximal levels of virus were detected in the right eye (10(5.1) 50% tissue culture infective doses/ml) 5-7 hr before conjunctivitis in the right eye, and in feces (10(2.8) 50% tissue culture infective doses/g) and sputum (10(2.5) 50% tissue culture infective doses/ml) five and eight days after onset of conjunctivitis, respectively. Specific neutralizing activity against CA24 was detected in tear samples 48-56 hr after exposure, and elimination of virus was associated with the rise in the neutralizing activity in tears. This activity was detected earlier than previously reported antibody responses of the eye. The absence of interferon and the association of this early neutralizing activity in tears with early elimination of virus from the eye suggest that neutralizing activity may play a major role in the clinical and pathological manifestations of this infection.