An ongoing outbreak of a rare eye infection has been discovered in contact lens wearers in the UK, a new study reveals.
Researchers at University College London found that rates of Acanthamoeba keratitis, an infection of the cornea, have nearly tripled since 2011 in the southeast of England.
Infection with Acanthamoeba, a cyst-forming microorganism, causes an inflammation of the cornea. Symptoms include excessive pain and compromised vision.
The disease is mostly preventable, said Dr. John Dart, a consultant ophthalmologist at Moorfields Eye Hospital who led the research.
“It was clear that there is a problem,” he said. “Acanthamoeba keratitis is one of the worst corneal infections.”
Studies suggest that about 2 in 100,000 contact lens wearers in the UK are affected each year, aided by the way water is stored and supplied there, according to Moorfields Eye Hospital, meaning case numbers are higher in the UK than in other parts of the world.
In the United States, the Centers for Disease Control and Prevention estimates occurrence at one or two cases in every million lens wearers; 85% of cases will occur in lens wearers.
The new study identified a surge in the UK.
Dart’s team analyzed incidence data collected by Moorfields, where cases across the southeast of England are treated, and found an average of 50.3 cases of Acanthamoeba keratitis per year between 2011 and 2016, up from an average of 18.5 in prior years, between outbreaks.
“Acanthamoeba keratitis is a rare infection, but when it occurs, it has a devastating effect for a long period of time on the patient’s life,” Dart said.
“Only 70% of patients were cured within 12 months. For the remaining 30%, the treatment took over a year.”
The researchers say their findings apply across the UK, given that Moorfields Eye Hospital treats more than 35% of the country’s cases.
Acanthamoeba keratitis is 20 times less likely than bacterial infections among contact lens wearers. Severe occurrences take up to 10 months to treat with antiseptic eye drops followed by 38 months of followup visits, according to the new study.
The most severe cases also lead to a permanent 75% decrease in vision because of scarring of the cornea, with a quarter of patients requiring corneal transplants, Dart said.
He explained that corneal transplant surgeries are sometimes necessary to treat holes in patients’ eyes due to ulcers caused by the infection or to restore vision.
Irenie Ekkeshis, a 39-year-old daily disposable contact lens wearer, was diagnosed with Acanthamoeba keratitis in 2011, despite strict lens hygiene.
She remembers waking one morning in January that year with horrific pain and a sore eye “that was very sensitive to bright light.” The pain worsened over time, and Ekkeshis knew that something was “very wrong” with her eye.
Her treatment took three years because the standard treatment with antiseptic eye drops was not effective. She had to undergo several other procedures, including two corneal transplant surgeries, she said.
Dr. Frank Larkin, senior lecturer at the UCL Institute of Ophthalmology and Imperial College School of Medicine, said current treatments are “not good enough.”
“The Acanthamoeba organism is very resistant to drugs, which is the main reason some patients’ treatments take such a long time,” said Larkin, who was not involved in the new study.
Almost eight years after her diagnosis, Ekkeshis regularly visits Moorfields because of problems linked to her cornea transplant.
She now campaigns to increase awareness of the infection, specifically advocating for a written warning on contact lens packaging on the importance of avoiding their contamination with water — one way to prevent the infection.
Ninety percent of Acanthamoeba keratitis cases in the UK are discovered in contact lens wearers, due to most risk factors being related to lens hygiene, Dart said.
The infection is most commonly found in hard-water areas, where lime scale allows for an optimal environment for the Acanthamoeba microorganism to grow.
A separate analysis in the study on more than 270 people who use reusable contact lenses found that the risk of developing the disease was more than three times higher among those with poor contact lens hygiene, people who did not always wash and dry their hands before handling their lenses, those who used disinfectant products containing Oxipol (now phased out by the manufacturer), and people who wore their lenses in swimming pools or hot tubs.
Showering and face-washing while wearing contact lenses are also likely to be risk factors, the study found.
“There is an increased risk with a particular disinfectant, Oxipol, and it is good news that the manufacturer has phased it out,” said Dr. Ravi Goel, a US ophthalmologist and spokesman for the American Academy of Ophthalmology, who was not involved in the new study.
“Any infection related to contact lens use is serious. [This] is a rare form of infection, so we need to raise our patients’ awareness.”
“You cannot point at just one risk factor. … That is the most important part of the study.”
Dart advises contact users to buy daily disposable contacts or else ensure that lenses and their containers are not contaminated by tap water.
Larkin thinks “contact lens wearers should be concerned.”
“There has been a gradual and large increase in AK in contact lens wearers, despite more people are using disposable contact lenses, which carry a lower risk of the infection.”
Public officers above 58 years and with pre-existing conditions told to work from home: The Standard
Head of Public Service Joseph Kinyua. [File, Standard]
In a document from Head of Public Service, Joseph Kinyua new measure have been outlined to curb the bulging spread of covid-19. Public officers with underlying health conditions and those who are over 58 years -a group that experts have classified as most vulnerable to the virus will be required to execute their duties from home.
However, the new rule excluded personnel in the security sector and other critical and essential services.
“All State and public officers with pre-existing medical conditions and/or aged 58 years and above serving in CSG5 (job group ‘S’) and below or their equivalents should forthwith work from home,” read the document,” read the document.
To ensure that those working from home deliver, the Public Service directs that there be clear assignments and targets tasked for the period designated and a clear reporting line to monitor and review work done.
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Others measures outlined in the document include the provision of personal protective equipment to staff, provision of sanitizers and access to washing facilities fitted with soap and water, temperature checks for all staff and clients entering public offices regular fumigation of office premises and vehicles and minimizing of visitors except by prior appointments.
Officers who contract the virus and come back to work after quarantine or isolation period will be required to follow specific directives such as obtaining clearance from the isolation facility certified by the designated persons indicating that the public officer is free and safe from Covid-19. The officer will also be required to stay away from duty station for a period of seven days after the date of medical certification.
“The period a public officer spends in quarantine or isolation due to Covid-19, shall be treated as sick leave and shall be subject to the Provisions of the Human Resource Policy and procedures Manual for the Public Service(May,2016),” read the document.
The service has also made discrimination and stigmatization an offence and has guaranteed those affected with the virus to receive adequate access to mental health and psychosocial supported offered by the government.
The new directives targeting the Public Services come at a time when Kenyans have increasingly shown lack of strict observance of the issued guidelines even as the number of positive Covid-19 cases skyrocket to 13,771 and leaving 238 dead as of today.
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Principal Secretaries/ Accounting Officers will be personally responsible for effective enforcement and compliance of the current guidelines and any future directives issued to mitigate the spread of Covid-19.
Uhuru convenes summit to review rising Covid-19 cases: The Standard
President Uhuru Kenyatta (pictured) will on Friday, July 24, meet governors following the ballooning Covid-19 infections in recent days.
The session will among other things review the efficacy of the containment measures in place and review the impact of the phased easing of the restrictions, State House said in a statement.
This story is being updated.
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Drastic life changes affecting mental health
Kenya has been ranked 6th among African countries with the highest cases of depression, this has triggered anxiety by the World Health Organization (WHO), with 1.9 million people suffering from a form of mental conditions such as depression, substance abuse.
Globally, one in four people is affected by mental or neurological disorders at some point in their lives, this is according to the WHO.
Currently, around 450 million people suffer from such conditions, placing mental disorders among the leading causes of ill-health and disability worldwide.
The pandemic has also been known to cause significant distress, mostly affecting the state of one’s mental well-being.
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With the spread of the COVID-19 pandemic attributed to the novel Coronavirus disease, millions have been affected globally with over 14 million infections and half a million deaths as to date. This has brought about uncertainty coupled with difficult situations, including job loss and the risk of contracting the deadly virus.
In Kenya the first Coronavirus case was reported in Nairobi by the Ministry of Health on the 12th March 2020. It was not until the government put in place precautionary measures including a curfew and lockdown (the latter having being lifted) due to an increase in the number of infections that people began feeling its effect both economically and socially.
A study by Dr. Habil Otanga, a Lecturer at the University of Nairobi, Department of Psychology says that such measures can in turn lead to surge in mental related illnesses including depression, feelings of confusion, anger and fear, and even substance abuse. It also brings with it a sense of boredom, loneliness, anger, isolation and frustration. In the post-quarantine/isolation period, loss of employment due to the depressed economy and the stigma around the disease are also likely to lead to mental health problems.
The Kenya National Bureau of Statistics (KNBS) states that at least 300,000 Kenyans have lost their jobs due to the Coronavirus pandemic between the period of January and March this year.
KNBC noted that the number of employed Kenyans plunged to 17.8 million as of March from 18.1 million people as compared to last year in December. The Report states that the unemployment rate in Kenya stands at 13.7 per cent as of March this year while it stood 12.4 per cent in December 2019.
Mama T (not her real name) is among millions of Kenyans who have been affected by containment measures put in place to curb the spread of the virus, either by losing their source of income or having to work under tough guidelines put in place by the MOH.
As young mother and an event organizer, she has found it hard to explain to her children why they cannot go to school or socialize freely with their peers as before.
“Sometimes it gets difficult as they do not understand what is happening due to their age, this at times becomes hard on me as they often think I am punishing them,”
Her contract was put on hold as no event or public gatherings can take place due to the pandemic. This has brought other challenges along with it, as she has to find means of fending for her family expenditures that including rent and food.
“I often wake up in the middle of the night with worries about my next move as the pandemic does not exhibit any signs of easing up,” she says. She adds that she has been forced to sort for manual jobs to keep her family afloat.
Ms. Mary Wahome, a Counseling Psychologist and Programs Director at ‘The Reason to Hope,’ in Karen, Nairobi says that such kind of drastic life changes have an adverse effect on one’s mental status including their family members and if not addressed early can lead to depression among other issues.
“We have had cases of people indulging in substance abuse to deal with the uncertainty and stress brought about by the pandemic, this in turn leads to dependence and also domestic abuse,”
Sam Njoroge , a waiter at a local hotel in Kiambu, has found himself indulging in substance abuse due to challenges he is facing after the hotel he was working in was closed down as it has not yet met the standards required by the MOH to open.
“My day starts at 6am where I go to a local pub, here I can get a drink for as little as Sh30, It makes me suppress the frustration I feel.” he says.
Sam is among the many who have found themselves in the same predicament and resulted to substance abuse finding ways to beat strict measures put in place by the government on the sale of alcohol so as to cope.
Mary says, situations like Sam’s are dangerous and if not addressed early can lead to serious complications, including addiction and dependency, violent behavior and also early death due to health complications.
She has, however, lauded the government for encouraging mental wellness and also launching the Psychological First Aid (PFA) guide in the wake of the virus putting emphasis on the three action principal of look, listen and link. “When we follow this it will be easy to identify an individual in distress and also offer assistance”.
Mary has urged anyone feeling the weight of the virus taking a toll on them not to hesitate but look for someone to talk to.
“You should not only seek help from a specialist but also talk to a friend, let them know what you are undergoing and how you feel, this will help ease their emotional stress and also find ways of dealing with the situation they are facing,” She added
Mary continued to stress on the need to perform frequent body exercises as a form of stress relief, reading and also taking advantage of this unfortunate COVID-19 period to engage in hobbies and talent development.
“Let people take this as an opportunity to kip fit, get in touch with one’s inner self and also engage in reading that would help expand their knowledge.