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Characteristics of an Acanthamoeba keratitis outbreak in British Columbia between 2003 and 2007

Mieke N Fraser1, Quantine Wong, Lena Shah

  • 1British Columbia Centre for Disease Control, Epidemiology Services, Vancouver, British Columbia, Canada. Mieke.Fraser@bccdc.ca

Ophthalmology
|February 28, 2012
PubMed

Insights

Acanthamoeba keratitis (AK) incidence significantly rose in British Columbia from 2003-2007, linked to a recalled contact lens solution. Rates returned to normal, emphasizing improved contact lens hygiene education.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Public Health

Background:

  • Acanthamoeba keratitis (AK) is a severe microbial keratitis.
  • Contact lens wear is a primary risk factor for AK.
  • Previous outbreaks have been linked to specific contact lens solutions.

Purpose of the Study:

  • To quantify and describe Acanthamoeba keratitis (AK) cases in British Columbia (BC).
  • To identify risk factors associated with an AK outbreak.
  • To assess changes in AK incidence over time.

Main Methods:

  • A comparison of standardized annual incidence rates of laboratory-confirmed AK cases in BC from 1988-2007.
  • A case series involving interviews with 23 AK patients diagnosed between 2005-2007.
  • Descriptive analysis of demographics, risk factors, and contact lens habits.

Main Results:

  • Annual AK incidence significantly increased from 0.029 to 0.200 per 100,000 population between 1988-2002 and 2003-2007 (P=0.022).
  • Incidence returned to near historic levels (0.056/100,000) after 2007.
  • Key risk factors included a recalled contact lens solution (60.9%), daily soft contact lens wear (95.7%), showering with lenses (65.2%), and poor hygiene.

Conclusions:

  • A significant AK outbreak occurred in BC between 2003-2007.
  • A recalled contact lens solution was associated with many cases, but poor hygiene and unawareness of recalls were also critical factors.
  • Improved patient education on contact lens hygiene and AK risks is crucial.
Abstract

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