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Parasites on the Rise: A New Epidemic of Acanthamoeba Keratitis

      Historically, the overwhelming majority of contact lens associated with infectious corneal ulcers in the United States have been attributable to bacteria.
      • Rattanatam T.
      • Heng W.J.
      • Rapuano C.J.
      • Laibson P.R.
      • Cohen E.J.
      Trends in contact lens-related corneal ulcers.
      • Mah-Sadorra J.H.
      • Yavuz S.G.
      • Najjar D.M.
      • Laibson P.R.
      • Rapuano C.J.
      • Cohen E.J.
      Trends in contact lens-related corneal ulcers.
      However, over the past two years, two distinct epidemics of contact lens-associated non-bacterial infectious keratitis have been recognized. Last year the Center for Disease Control (CDC) alerted health care providers and consumers of an epidemic of Fusarium keratitis, and just last month they warned of an alarming increase in the number of reported cases of Acanthamoeba keratitis.
      Update: Fusarium keratitis:United States, 2005 to 2006.
      Acanthamoeba keratitis multiple states, 2005 to 2007.
      The two outbreaks are disturbingly similar. Both involve patients with recalcitrant keratitis poorly responsive to topical antibiotics and both involve highly publicized voluntary recalls of contact lens solutions. Particularly disturbing is that this is not the first epidemic of Acanthamoeba keratitis linked to the use of contact lens solutions. An outbreak of Acanthamoeba keratitis in the mid-1980s was linked to the use of homemade saline solution.
      Acanthamoeba keratitis associated with contact lenses: United States.
      With the recent Fusarium and Acanthamoeba outbreaks, multi-purpose contact lens solutions appear to be part of the problem.
      Update: Fusarium keratitis:United States, 2005 to 2006.
      Acanthamoeba keratitis multiple states, 2005 to 2007.
      • Chang D.C.
      • Grant G.B.
      • O’Donnell K.
      • et al.
      Multi-state outbreak of Fusarium keratitis associated with use of a contact lens solution.
      The recent increase in non-bacterial corneal ulcers has raised a number of questions about the etiology, diagnosis, and management of these cases.
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      References

        • Rattanatam T.
        • Heng W.J.
        • Rapuano C.J.
        • Laibson P.R.
        • Cohen E.J.
        Trends in contact lens-related corneal ulcers.
        Cornea. 2001; 20: 290-294
        • Mah-Sadorra J.H.
        • Yavuz S.G.
        • Najjar D.M.
        • Laibson P.R.
        • Rapuano C.J.
        • Cohen E.J.
        Trends in contact lens-related corneal ulcers.
        Cornea. 2005; 24: 51-58
      1. Update: Fusarium keratitis:United States, 2005 to 2006.
        MMWR Morb Mortal Wkly Rep. 2006; 55: 563-564
      2. Acanthamoeba keratitis multiple states, 2005 to 2007.
        MMWR Morb Mortal Wkly Rep. 2007; 56: 532-534
      3. Acanthamoeba keratitis associated with contact lenses: United States.
        MMWR Morb Mortal Wkly Rep. 1986; 35: 405-408
        • Chang D.C.
        • Grant G.B.
        • O’Donnell K.
        • et al.
        Multi-state outbreak of Fusarium keratitis associated with use of a contact lens solution.
        JAMA. 2006; 296: 953-963
        • Christie C.L.
        • Meyler J.G.
        Contemporary contact lens care products.
        Cont Lens Anterior Eye. 1997; 20 (S11–S7)
        • Snyder C.
        Lens care complications: where’s the rub?.
        Cont Lens Anterior Eye. 2006; 29: 161-162
        • Saw S.M.
        • Ooi P.L.
        • Tan D.T.
        • et al.
        Risk factors for contact lens-related Fusarium keratitis: a Case-Control Study in Singapore.
        Arch Ophthalmol. 2007; 125: 611-617
        • Joslin C.E.
        • Tu E.Y.
        • Shoff M.E.
        • et al.
        The association of contact lens solution use and Acanthamoeba keratitis.
        Am J Ophthalmol. 2007; 144: 169-180
        • Levy B.
        • Heiler D.
        • Norton S.
        Report on testing from an investigation of Fusarium keratitis in contact lens wearers.
        Eye Contact Lens. 2006; 32: 256-261
        • Rosenthal R.A.
        • Dassanayake N.L.
        • Schlitzer R.L.
        • et al.
        Biocide uptake in contact lenses and loss of fungicidal activity during storage of contact lenses.
        Eye Contact Lens. 2006; 32: 262-266
        • Joslin C.E.
        • Tu E.Y.
        • McMahon T.T.
        • Passaro D.J.
        • Stayner L.T.
        • Sugar J.
        Epidemiological characteristics of a Chicago-area Acanthamoeba keratitis outbreak.
        Am J Ophthalmol. 2006; 142: 212-217
      4. Lawson A.B. Kleinman K. Spatial and syndromic surveillance for public health. John Wiley and Sons, West Sussex, United Kingdom2005

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