A person in Florida has died after being infected with an extremely rare brain-eating amoeba.
Only about three people in the United States get infected each year, but the infections are usually fatal.
In the Florida case, officials believe the infection may have been caused by sinus rinse practices using tap water. Sinus solutions should only be made using distilled or sterile water.
How does someone get infected?
People cannot get infected from drinking water contaminated with Naegleria fowleri. You can only be infected when contaminated water goes up into your nose, according to the CDC.
It has not been shown to spread via water vapor or aerosol droplets (such as shower mist or vapor from a humidifier). It has also never been shown to spread from one person to another.
People become infected when water containing Naegleria enters the nose, usually while swimming. The amoeba goes to the brain along the olfactory nerve and then begins to destroy the brain tissue.
Infections are most common in southern states, with almost half of all infections occurring in Texas and Florida. It is also more common in males and children. The CDC doesn’t have a clear reason for why children are more likely to become infected, but it is believed that it could be that water activities are more common among young boys.
Naegleria fowleri is found in lakes, rivers, hot springs, warm water discharge from industrial or power plants, geothermal well water, poorly maintained or minimally chlorinated swimming pools, water heaters and soil. It is not found in salt water.
It feeds on bacteria and other microbes in the environment. Samples taken from lakes in southern states indicate that it is commonly present in many southern-tier lakes in the U.S. during the summer.
Six infections in the U.S. have been linked to using water from drinking water systems to swim, using a slip-n-slide, immersing the head in a bathtub and nasal rinsing (like a neti pot).
What are the symptoms
Naegleria fowleri causes primary amebic meningoencephalitis (PAM), a disease of the central nervous system. It’s a rare disease that is almost always fatal.
Symptoms are similar to bacterial meningitis, which lowers the chance of doctors diagnosing PAM at first. According to the CDC, only four out of 154 people in the United States survived infection from 1962 to 2021.
Stage 1:
- Severe frontal headache
- Fever
- Nausea
- Vomiting
Stage 2:
- Stiff neck
- Seizures
- Altered mental status
- Hallucinations
- Coma
Treatment
The disease caused by the amoeba is usually fatal. Health officials are only aware of five cases in North America where the patient survived.
While the outlook for people who get PAM is poor, early diagnosis and new treatments might increase chances for survival. In some cases where people survived, Naegleria fowleri was less virulent. It is believed that contributed to the patient’s recovery.
PAM is treated with a combination of drugs. That combination usually includes amphotericin B, azithromycin, fluconazole, rifampin, miltefosine, and dexamethasone. Miltefosine is the newest of the drugs and has shown ameba-killing activity against free-living amebae in the laboratory.
Those drugs are used because they are thought to have activity against Naegleria fowleri and have been used to treat patients who survived.
Sinus rinsing
Many people rinse their sinuses for ritual or health reasons.
Neti pots are a popular treatment for congested sinuses, colds and allergies. They are used to rinse the nasal passages with a saline solution.
Whether you’re rinsing your sinuses for ritual or health reasons the preferred water is either distilled or has been boiled and left to cool.
If using water that has been boiled, boil it for one minute and leave it to cool. At elevations above 6,500 feet, boil for 3 minutes. If you’re buying water, it should have a label that said it contains distilled or sterile water.
Click here to learn more from the CDC.