BATON ROUGE, La. (WAFB) – The Louisiana Department of Health has identified 10 Acanthamoeba infections since 2024, including a fatal brain infection this year. The state epidemiologist said contact lens wearers should remove their lenses before showering, swimming or using a hot tub.
Theresa Sokol, state epidemiologist with the Louisiana Department of Health, said Acanthamoeba is found in many environments.
What is Acanthamoeba
“Acanthamoeba are what we call a free-living amoeba,” Sokol said. “They are single-celled organisms that live in the environment. They are in soil, in dust, and in fresh and salt water.”
Sokol said these organisms can also be found in swimming pools, drinking water systems and HVAC systems.
“Almost everyone will be exposed to Acanthamoeba in their lifetime,” Sokol said. “The good news is that most people exposed to Acanthamoeba will not get sick, but for a few people it can cause serious infections of the sinuses, brain, and sometimes also the skin and eyes.”
Cases reported in Louisiana
Sokol said eight of ten infections recorded since 2024 were eye infections. Seven of these eight people wore contact lenses and five cases resulted in permanent vision loss.
“This is a serious infection, although it does not usually spread to other parts of the body or lead to death,” Sokol said.
The other two patients were reported this year, Sokol said. One had a sinus infection and the other had a brain infection. The patient with a brain infection died. Sokol said both patients suffered from underlying medical conditions.
Sokol said the department is not releasing further details about patients, including where they live.
“We want to protect the privacy of infected patients,” Sokol said. “So we don’t share more detailed information than that.”
She said patients were spread across the state. Sokol said the amoeba can live in tap water in any drinking water system in Louisiana.
“The amoeba can live in tap water anywhere in Louisiana or the United States, because it really takes a very, very high level of chlorination to kill these amoebae,” Sokol said. “This is not a level that would be practical for use in drinking water systems.”
What contact lens wearers should do
Sokol said eye infections related to contact lens use often occur in healthy people. She said some of these people were not following the best contact lens hygiene or wearing their lenses while swimming or showering.
“Contact lenses can absorb and retain water,” Sokol said. “If the lenses come into contact with tap water, swimming pools or any other water where amoebae live, then these amoebae can cling or become trapped under the lens, which is directly against the cornea. This is where the infection occurs.”
Sokol said contact lens wearers should:
- Wash your hands with soap and water and dry them thoroughly before handling lenses.
- Remove lenses before showering, using a hot tub, or swimming.
- Clean and rinse the lenses with the appropriate solution each time they are removed.
- Store lenses properly.
“You have to dry them thoroughly,” Sokol said of the hands. “You don’t want to get your hands wet while you’re handling them.”
She said that leftover water on the hands can get into the lenses.
“That’s the water that can then get into your contact lens and be absorbed or cling to it and then stay there,” Sokol said. “That’s what we’re trying to avoid.”
Sokol said getting water in your eyes without wearing contact lenses has not been shown to pose an infection risk. She said someone who has had eye trauma or recent eye surgery could potentially have an opening. She said most infections are identified in people who wear contact lenses.
Symptoms, diagnosis and treatment
Sokol said the symptoms of Acanthamoeba eye infections can resemble those of other common eye infections. They include eye pain, redness, blurred vision, sensitivity to light, and excessive tearing.
“It’s really best, any time you have any of these symptoms, to check with your doctor,” Sokol said. “There are prescription treatments.”
“The earlier you seek care, the more likely you are to have a positive outcome,” she said.
Sokol said symptoms could appear “several days or up to several weeks after exposure.” She said it can be difficult to know when someone has been exposed.
Sokol said the amoeba can sometimes be seen under a microscope. She said reference laboratories can also perform tests to identify the amoeba’s genetic material. The specimen depends on the type of infection, she said. A brain infection may require a brain biopsy, and an eye infection may be tested for with fluid from the eye.
She said skin and sinus infections caused by Acanthamoeba are often treatable but can spread to other parts of the body, making them more difficult to treat.
“Brain infection caused by Acanthamoeba is often difficult to diagnose,” Sokol said. “If diagnosis occurs at a later stage, this sometimes increases the risk that a patient will not survive this infection. However, several patients with this infection have been treated successfully in the past.”
Nasal rinse, medical devices and tap water
Sokol said using tap water for nasal irrigation or cleaning nasal irrigation devices with tap water is a known risk factor for sinus and brain infections caused by Acanthamoeba.
“Tap water should not be used for irrigation of the nose or sinuses,” Sokol said. “It can really pose a risk of serious illness.”
Sokol said nasal irrigation devices are safe to use with water labeled sterile or distilled. Boiled and cooled tap water can also be used, she explained.
She said people who use other medical devices that use water, such as a CPAP machine, should follow the manufacturer’s instructions and use potable water.
Sokol said sinus and brain infections usually occur in people with weakened immune systems. She said these conditions include HIV, AIDS, history of organ transplant, cancer and diabetes, among others.
“People suffering from a disease that weakens their immune system should be especially aware of using safe water in nasal irrigation devices or other medical equipment,” Sokol said.
Sokol said people can still shower with tap water. She said the infection is not associated with swallowing or drinking tap water.
“There is no need to worry,” Sokol said. “This is not how Acanthamoeba infections occur.”
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