An Epidemic of Presumed Acanthamoeba Keratitis That Followed Regional Flooding

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Abstract
MICROBIAL keratitis is an important cause of corneal scarring and blindness.1-3Acanthamoeba keratitis (AK), first recognized in 1973,4 is a rare protozoal infection with symptoms that mimic herpes simplex virus, thereby delaying diagnosis and treatment.5-10 The early reported cases of AK were attributed to corneal injury or to exposure to contaminated water, but results of later reports suggested a link between contact lens use and AK.10,11 In 1986, the Centers for Disease Control and Prevention issued a report of 24 cases of AK in which they noted that 20 cases (83%) were associated with contact lens use.12 Between 1973 and 1988, there were 208 cases of AK reported in the United States, and 85% were among contact lens wearers.13,14 In general, contact lens wearers are predisposed to ulcerative keratitis of varied causes, with an estimated 2.0 to 20.9 cases per 10000 wearers per year.3