Cambodia plagued by epidemic of drug-resistant conjunctivitis

Photo by: TRACEY SHELTON
The eye of a patient recovering from conjunctivitis on Thursday.

The Phnom Penh Post
http://www.phnompenhpost.com

Written by Nathan Green
Friday, 01 May 2009

Ophthalmogists say they are keeping their eyes on a strain of the ailment that is proving particularly resistant to routine antibiotics

AN eye health specialist from the Ministry of Health warned Thursday that people suffering from a particularly tough-to-treat strain of conjunctivitis sweeping Cambodia should seek medical help rather than trying to cure it using over-the-counter medications.

Do Seiha, the coordinator of Cambodia's national eye care program and the resident ophthalmologist at Phnom Penh's Naga Clinic, said that most infections clear up on their own, but treatment with antibiotics is required if the infection persists.

However, the bacteria that are often responsible for the condition seemed to have developed resistance to the steroidal antibiotic eyedrop Maxitrol that is traditionally used.

"We don't know why, but the infection is resistant to routine treatment," he said. "It usually can be treated in one week, but now treatment is taking up to three or four weeks." He added that around 10 percent of sufferers develop a severe form of the condition.

Do Seiha recommended doctors use a two-pronged antibiotic drug response, prescribing Maxitrol drops alongside drops containing the third-generation synthetic antibiotic Moxifloxacin, which has only been available in Cambodia since December.

While these medicines can be bought over the counter, Do Seiha said they should only be prescribed by a medical doctor, as not all eye irritations are conjunctivitis, and not all conjunctivitis is bacterial. The condition can also be triggered by viruses or an allergic reaction, neither of which would respond to antibacterial treatment, while prolonged use of Maxitrol could damage the eyes.

They could also compound other conditions, such as causing ulcers in the eyes of those suffering from keratitis, an inflammation of the cornea, or worsening glaucoma.

Conjunctivitis outbreaks tend to hit Cambodia in November and December, but this dry season the epidemic came later in January and shows no sign of abating yet, Do Seiha said. He treated about 300 cases over the last three weeks in his ophthalmology practice at Naga Clinic, he added.

The infection is highly contagious and can be spread through person-to-person contact, picked up off surfaces and spread by dust - hence its prevalence in the dry season. Many people became infected when travelling to the provinces for Khmer New Year, Do Seiha said, picking it up from relatives or through exposure to dust-borne bacteria.

"Once one person in a family gets it, everybody will get it," he said. "To limit the risk, infected people must wash their hands regularly and avoid sharing towels." Recovered individuals also have a high risk of reinfection.

He expected the epidemic to persist until the rainy season arrived and reduced dust particles, which can carry conjunctivitis-causing bacteria.