We only appreciate basic sanitation when we feel it on our skin. In the case of Katya, she felt it in one of the most sensitive areas of the human body: in the eyes. He felt until he stopped feeling.

Her vision gradually blurred. The diagnosis was made when she was already blind in her right eye. The contamination was due to Acanthamoeba, a microorganism that lives in water and is found in abundance in areas with basic sanitation problems. It is a type of amoeba found in the sea, in rivers, and even in tap and shower water.

Katja Plotz Frois after being infected with microorganisms – Photo: Anderson Coelho/North Dakota

Katja Plotz Freuss, 58, lives in Campeche, Florianopolis, and was unaware of the existence of this amoeba until April 2020. After becoming a widow, she dedicated time to her health and diabetes care.

The architect planned to devote herself entirely to writing as soon as she operated on a cataract that had developed in her left eye. “My left could only see 3% due to diabetic retinopathy. But my right was perfect.”

Just a few weeks before the operation, the right eye became cloudy. “It was little by little until I woke up not seeing anything. I’m telling it in an almost literary way because it’s a horror story. My eye nearly popped out of my face. I would have to use a prosthesis, a glass eye.” She does not know where the infection occurred, whether it was through contact with water at home, in the pool or on the beach.

The Acanthamoeba that struck Katya’s vision is a type of protozoan that, like bacteria and viruses, has existed on Earth for millions of years and is part of the ecological balance. But when in contact with a person, these microorganisms can cause disease.

Environmental vulnerability is a determining factor in pollution. In places with low collection network coverage, the population is more vulnerable to pathologies.

In the case of Katya, she was also vulnerable. Although these cases are little known in the country, foreign studies show that 85% of people infected with Acanthamoeba use contact lenses.

This is a type of amoeba that finds in this jelly-like environment an ideal place to penetrate the corneal fissures and cause an infection. “Telling this story makes me very emotional. I still sincerely believe that I will see again. I can only pray and believe that it will happen.”

For 32 months I have been trying to cure blindness in my right eye. During this period, he sought treatment in São Paulo, and his case was studied in an American laboratory that sent drugs.

“I have lost a lot of weight. I weighed 44 kilograms,” he says. She also had 3 corneal surgeries that were unsuccessful. “It’s all because of the protozoa that live in the water and people have no idea.”

reporter’s report

Vanessa da Rocha

Katya’s story touched me. She is a beautiful woman, full of life and strength. I wondered if I should tell this story and how to tell it as it could cause panic about a rare disease.

But this doubt disappeared as soon as I determined that this amoeba thrives in areas with poor sanitation. In addition, her story should be known mainly because she promotes one of the functions of journalism, which is to acquaint us with new realities.

In her case, the sad reality of losing her sight, but one that touches and motivates her because of her strength to move forward, to fight.

Diseases related to water quality are little known in Brazil.

The disease that took Katya’s eyesight was classified as “acanthamoeba keratitis”. The first cases were reported in England and the United States, and in the late 1980s in Brazil.

The incidence is 33 per million contact lens wearers. In Brazil, cases have been reported in several states. Janice de Fatima Zanella, Doctor of Biotechnology from the University of Caxias do Sul, has been researching Acanthamoeba for 4 years.

She says that acanthamoeba keratitis is considered the most common disease caused by amoebas. But there are also cases of infections that are not permanent in other areas of the body.

According to the researcher, this type of amoeba is resistant and, in addition to polluted water, can also be found in various environments such as air and soil particles.

“(Studies have shown that) more than 50% of the population have antibodies against Acanthamoeba, indicating that it is a common organism in our environment,” he says.

According to Zanella, the main problem with acanthamoeba eye infections is late diagnosis (in the case of Katya, 4 ophthalmologists who were not specialists in the cornea made incorrect diagnoses. It was difficult for her to find specialists in the midst of a pandemic quarantine).

“In most cases, the diagnosis indicates the presence of herpes, fungi and bacteria.” For this reason, Zanella recommends that the substance be exposed, mainly so that the public can protect themselves until sanitation meets safety standards.

“The main way to avoid this is to inform the public about the dangers of swimming in waters that do not meet basic sanitary requirements,” he says.

Eye keratitis is not charted by the National Health Foundation.

Funasa (National Health Foundation) has cataloged the 22 most common illnesses associated with unreliable basic sanitation. A survey by the Center for Data and Investigative Journalism (NDI) found 3,358 hospitalizations last year for these conditions and 271 deaths. The most common cases are the gastrointestinal tract.

Ophthalmologist Christina Lunarelli says cases of vision loss due to Acanthamoeba are rare and only happen when diagnosed late.

“In 20 years of working at the Celso Ramos hospital, there has not been a single case of blindness due to this reason. The cases I have treated for Acanthamoeba have been restored.”

Lunarelli, a member of the Brazilian Contact Lens Society, emphasizes the importance of hygiene warning without causing panic and undue concern.

She says everyday activities such as going to the beach and going out to sea are possible for contact lens wearers. “For example, a surfer can go out to sea with lenses if he cleans his lenses properly with the right products. There are also disposable lenses for these situations,” he says.

However, Lunarelli notes that it is always necessary to pay attention to lens hygiene and understand that “every case is individual” and that the presence of an ophthalmologist is necessary during the adaptation process.

“Many people need a lens to see and live. This is not a purchase in a pharmacy and that’s it. You need to have professional accompaniment,” he says.

What are the simplest

These are microbes that are invisible to the naked eye and have a unicellular structure. Inhabits wet areas, usually water. They feed on organic matter, bacteria, and even other protozoa.