National microbiology center could improve tracking of ocularinfections

June 1, 2006

The Fusarium keratitis outbreak might have been spotted sooner hadthere been better communication between the country's ophthalmicmicrobiology centers, according to a couple of ophthalmologists.

Because clinical laboratories work independently, it took some time for physicians nationwide to realize that they each had seen a slight uptick in the usual number of Fusarium keratitis cases. At the same time, no one has studied these cases to identify a normal rate, because they have not been tracked, according to Centers for Disease Control and Prevention (CDC) spokeswoman Christine Pearson.

He expects to begin the pilot study in the fall to determine how it would function.

The national center, which would be based in Pittsburgh, would collect and study information from at least six ophthalmic microbiology labs, he said.

"What we hope to do is to be the head of the lab just in terms of collecting the information, and analyzing the information," Dr. Mah said. "What we envision is later down the road, once everything is settled, we would actually be able to share information and different centers should have different areas of expertise."

For example, he said, the center for Fusarium research would likely be at the Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, where the warm, humid climate typically grows that fungus.

"We could all share information, share data, and increase our expertise . . . and every once in awhile we get together and talk," Dr. Mah said. "Maybe these types of things, we'd identify sooner . . . and if there's another outbreak, those things could be identified and controlled sooner."

So far, ophthalmologists at the New York Eye and Ear Infirmary, New York; Bascom Palmer Eye Institute; Massachusetts Eye and Ear Infirmary, Boston; Francis I. Proctor Foundation for Research in Ophthalmology at the University of California, San Francisco Medical Center; and Stanford University School of Medicine, Stanford, CA, have said they would like to participate.

Infections not monitored

Eduardo C. Alfonso, MD, professor of ophthalmology and the Edward W.D. Norton Chair in Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, said the idea would bolster the study of infectious ocular diseases in the country because dwindling financial support has forced some labs to close.

"There's not too many [clinical labs] around the country; it's kind of a dying breed because there's no funding," Dr. Alfonso said. "We need to keep a finger on the pulse of what are the new emerging infections, and this [Fusarium keratitis] is the new emerging infection. Unless we had the data in our lab to show there was a spike in the number of cases, it doesn't happen. No one notices."

Contrary to public belief, the CDC is not equipped to track these kinds of diseases; it is better designed to investigate outbreaks once they occur, Dr. Alfonso said.