The Division of Public Health is forwarding this Health Advisory from the Centers for Disease Control and Prevention. To contact DPH about this Health Advisory, call 1-888-295-5156. This number is answered during normal business hours, and during non-business hours for emergencies.
Distributed via Health Alert Network
May 25, 2007, 21:35 EDT (9:35 PM EDT)
The Centers for Disease Control and Prevention (CDC), collaborating with the Food and Drug Administration, state and other partners, has identified an outbreak of a serious but rare eye infection called Acanthamoeba keratitis (AK). This infection is caused by a free-living ameba (Acanthamoeba) a microscopic organism found everywhere in nature. Infections can result in permanent visual impairment or blindness. AK primarily affects otherwise healthy people, most of whom wear contact lenses. In the United States, an estimated 85% of cases of this infection occur in contact lens users. The incidence of the disease in the U.S. is approximately one to two cases per million contact lens users.
CDC has received reports of 138 cases of culture-confirmed AK in 35 states and Puerto Rico, with complete patient data available for 46 case-patients. Thirty-nine of the 46 case-patients wore soft contact lenses. Preliminary information obtained by CDC from patient interviews indicates that, among soft contact lens users who reported the use of any type of solution, 21 (58%) reported having used Advanced Medical Optics (AMO) CompleteR MoisturePlusTM Multi-Purpose Solution in the month prior to symptom onset. Out of the 37 case-patients for whom clinical data was available, 9 (24%) failed medical therapy and required or are expected to undergo corneal transplantation.
Based on these findings people who wear soft contact lenses who use Advanced Medical Optics (AMO) CompleteR MoisturePlusTMMulti-Purpose Solution should:
All contact lens users should closely follow prevention measures to help prevent eye infections, which include
Clinicians evaluating contact lens users with symptoms of eye pain or redness, tearing, decreased visual acuity, discharge, sensitivity to light, or foreign body sensation should consider AK and refer the patient to an ophthalmologist, if appropriate. Diagnosis requires a high degree of suspicion, especially in a contact lens wearer with a recent diagnosis of another form of keratitis, such as herpes simplex virus keratitis, who is not responding to therapy. Diagnosis is made on the basis of clinical picture and isolation of organisms from corneal culture or detection of trophozoites and/or cysts on histopathology. However, a negative culture does not necessarily rule out Acanthamoeba infection. Confocal microscopy and polymerase chain reaction assays to detect Acanthamoeba may also assist with diagnosis. Early diagnosis can greatly improve treatment efficacy.
Clinicians from Delaware have not reported any confirmed or suspect cases to CDC. Clinicians should consider obtaining clinical specimens (e.g., corneal scrapings) for culture before initiating treatment. Clinicians or microbiology laboratories should report cases of AK to Delaware Division of Public Health, Bureau of Epidemiology at 888-295-5156. Acanthamoeba isolates should be submitted to the Delaware Public Health Laboratory (after consultation with Epidemiology) according to instructions provided by the Public Health Laboratory
For more information, see the CDC website: http://www.cdc.gov/ncidod/dpd/parasites/acanthamoeba/index.htm