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Volume 15, Number 8—August 2009

CME ACTIVITY

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

Jennifer R. VeraniComments to Author , Suchita A. Lorick, Jonathan S. Yoder, Michael J. Beach, Christopher R. Braden, Jacquelin M. Roberts, Craig S. Conover, Sue Chen, Kateesha A. McConnell, Douglas C. Chang, Benjamin J. Park, Dan B. Jones, Govinda S. Visvesvara, Sharon L. Roy, and for the Acanthamoeba Keratitis Investigation Team1
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (J.R. Verani, S.A. Lorick, J.S. Yoder, M.J. Beach, C.R. Braden, J.M. Roberts, D.C. Chang, B.J. Park, G.S. Visvesvara, S.L. Roy); Illinois Department of Public Health, Chicago, Illinois, USA (C.S. Conover); California Department of Public Health, Sacramento, California, USA (S. Chen); Florida Department of Health, Tallahassee, Florida, USA (K.A. McConnell); and Baylor College of Medicine, Houston, Texas, USA (D.B. Jones)

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Table 1

Demographic and clinical characteristics of 105 patients with Acanthamoeba keratitis, United States, 2005–2007

CharacteristicNo. (%)
Sex
Female
67 (64)
Age, y*
12–1727 (26)
18–2417 (16)
25–3415 (14)
35–4924 (23)
>50
22 (21)
Contact lens wear
Did not use contact lenses12 (11)
Used contact lenses93 (89)
Lens type
Soft lenses82 (88)
Rigid lenses10 (11)
Hybrid lenses
1 (1)
Contact lens solution use among contact users†
Did not use cleaning or disinfecting contact lens 
 solution6 (6)
Used any type of cleaning or disinfecting contact 
 lens solution87 (94)
Type of solution used§
Multipurpose solution78 (90)
Hydrogen peroxide solution6 (7)
Daily cleaner
11 (13)
Affected eye
Right53 (50)
Left44 (42)
Both
8 (8)
Symptoms when treatment sought‡§
Pain78 (74)
Redness78 (74)
Sensitivity to light76 (72)
Sensation of foreign body71 (68)
Increased tearing59 (56)
Blurred vision57 (54)
Discharge from eye
20 (19)
Clinical status¶
Resolved with pharmacologic therapy32 (38)
Currently receiving pharmacologic therapy29 (34)
Corneal transplant performed21 (25)
Corneal transplant planned
3 (4)
Most recent visual acuity with best correction in affected eye#
20/2017 (24)
20/25–20/10024 (34)
20/>20029 (41)

*Median 29 y, range 12–76 y.
†During 1 month before illness onset; n = 93.
‡Not mutually exclusive.
§Median time from symptom onset to anti-Acanthamoeba therapy (n = 80) was 49 d (range 4–197 d).
¶At the time of treating ophthalmologist interview; n = 85.
#At the time of treating ophthalmologist interview; n = 70.

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1Other members of the Acanthamoeba Keratitis Investigation Team: Stephanie P. Johnston, Alexandre DaSilva, Yvonne Qvarnstrom, Rama R. Sriram, E. Danielle Rentz, Leslie B. Hausman, Shannon K. Cosgrove, Brandy L. Peterson, Nicholas P. DiMeo, Rebecca C. Greco-Kone, Angela J. Deokar, Susan Brim, Aaron S. Kusano, David E. Cheek, Sharlene Persaud, Felicia Chow (Centers for Disease Control and Prevention [CDC]); Ingrid Trevino, (CDC and Illinois Department of Public Health, Springfield, IL, USA); Gita G. Mirchandani (CDC and Maryland Department of Health and Mental Hygiene, Baltimore, MD, USA); Emily J. Luckman (Maryland Department of Health and Mental Hygiene); Stacy M. Holzbauer (CDC and Minnesota Department of Health, St. Paul, MN, USA); Zack Moore (CDC and North Carolina Department of Health and Human Services, Raleigh, NC, USA); Adam J. Langer, Mary T. Glenshaw (CDC and New Jersey Department of Health and Human Services, Trenton, NJ, USA); Michael Cooper (CDC and Ohio Department of Health, Columbus, OH, USA); Tai-Ho Chen (CDC and Pennsylvania Department of Health, Harrisburg, PA, USA); Kira A. Christian (CDC and South Carolina Department of Health and Environmental Control, Columbia, SC, USA); L. Rand Carpenter (CDC and Tennessee Department of Health, Nashville, TN, USA); Marion A. Kainer (Tennessee Department of Health); John R. Su (CDC and Texas Department of Health, Austin, TX, USA); Ami S. Patel (CDC and Virginia Department of Health, Richmond, VA, USA); Aron J. Hall (CDC and West Virginia Department of Health and Human Resources, Charleston, WV, USA); Charlotte E. Joslin (University of Illinois at Chicago); Kirk R. Wilhelmus (Baylor College of Medicine)

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