National Outbreak ofAcanthamoebaKeratitis Associated with Use of a Contact Lens Solution, United States

Abstract

Premarket standardized testing for Acanthamoeba spp. is warranted.

Microsporidia and Acanthamoeba: the role of emerging corneal pathogens

“…3,37 The abrupt rise in cases, however, makes it unlikely that a radical change in hygiene habits was solely responsible and, further, the large number of cases not using AMO Complete MoisturePlus still constituted a sizable increase over the known background rate of infection making it also unlikely the sole cause. 37 Focus on other contemporaneously introduced risk factors including the labeling change for the use of multipurpose solutions allowing the omission of lens rubbing as well as the introduction and subsequent market dominance of silicone hydrogel lenses in the contact lens market have similarly not yielded an explanation.…”

“…37 Focus on other contemporaneously introduced risk factors including the labeling change for the use of multipurpose solutions allowing the omission of lens rubbing as well as the introduction and subsequent market dominance of silicone hydrogel lenses in the contact lens market have similarly not yielded an explanation. 3,11 The lack of a specific lens-related risk factor and the significant increase across all solution systems and lens types suggests an increase in exposure to Acanthamoebae characteristic of water contamination seen with almost all previous outbreaks. Our ongoing studies in Chicago continue to demonstrate a geographic-based pattern of disease consistent with the domestic water distribution system as well as a higher rate of Acanthamoeba isolation from domestic taps than previously described.…”

“…Further, the initial CDC surveys captured only culture-positive cases over the last decade indicating that the rise in these centers was real, applying this narrow diagnostic criterion within this time frame. 3,36 Taken together, a consistent case definition, confirmation of real cases, and various, but consistent contemporary and historical background rates, it appears that the recent rise in cases of Acanthamoeba keratitis in the United States meets the criteria of a true outbreak.…”

“…Several parasitic corneal pathogens have been well described, including Onchocerca, Leishmania, and Trypanosoma, 1,2 with recent attention focused on notable numbers of Microsporidia keratitis in South Asia and a more modest increase of Acanthamoeba keratitis in the United States as well as other developed countries. [3][4][5][6][7][8][9][10] Clinically, parasitic infections are usually characterized as chronic and intractable presenting with non-specific findings masquerading as other infectious and non-infectious disease. Despite the recent outbreaks, these infections remain comparatively rare, requiring a substantial clinical suspicion to warrant the specific media and/or special histological expertise for diagnosis.…”

Encephalitis Due to Free Living Amoebae: An Emerging Issue in Human Health

“…The number of affected individuals is increasing worldwide. Morever, recent outbreaks of Acanthamoeba keratitis have been recently reported in the United States and Australia (Verani et al, 2009;Tu and Joslin, 2010;Patel et al, 2010;Joslin et al, 2010). AK is an acute, painful infection that can occur in immunocompetent individuals.…”