Volume 15, Number 8—August 2009
CME ACTIVITY - Research
National Outbreak of Acanthamoeba Keratitis Associated with Use of a Contact Lens Solution, United States
, 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
Table 1
Demographic and clinical characteristics of 105 patients with Acanthamoeba keratitis, United States, 2005–2007
| Characteristic | No. (%) |
|---|---|
| Sex | |
| Female | 67 (64) |
| Age, y* | |
| 12–17 | 27 (26) |
| 18–24 | 17 (16) |
| 25–34 | 15 (14) |
| 35–49 | 24 (23) |
| >50 | 22 (21) |
| Contact lens wear | |
| Did not use contact lenses | 12 (11) |
| Used contact lenses | 93 (89) |
| Lens type | |
| Soft lenses | 82 (88) |
| Rigid lenses | 10 (11) |
| Hybrid lenses | 1 (1) |
| Contact lens solution use among contact users† | |
| Did not use cleaning or disinfecting contact lens solution | 6 (6) |
| Used any type of cleaning or disinfecting contact lens solution | 87 (94) |
| Type of solution used§ | |
| Multipurpose solution | 78 (90) |
| Hydrogen peroxide solution | 6 (7) |
| Daily cleaner | 11 (13) |
| Affected eye | |
| Right | 53 (50) |
| Left | 44 (42) |
| Both | 8 (8) |
| Symptoms when treatment soughtठ| |
| Pain | 78 (74) |
| Redness | 78 (74) |
| Sensitivity to light | 76 (72) |
| Sensation of foreign body | 71 (68) |
| Increased tearing | 59 (56) |
| Blurred vision | 57 (54) |
| Discharge from eye | 20 (19) |
| Clinical status¶ | |
| Resolved with pharmacologic therapy | 32 (38) |
| Currently receiving pharmacologic therapy | 29 (34) |
| Corneal transplant performed | 21 (25) |
| Corneal transplant planned | 3 (4) |
| Most recent visual acuity with best correction in affected eye# | |
| 20/20 | 17 (24) |
| 20/25–20/100 | 24 (34) |
| 20/>200 | 29 (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.
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)