It’s rare, but people who use neti pots can become infected with a brain-eating amoeba if the water they use isn’t safe. Researchers have recently linked a second kind of deadly amoeba to nasal rinsing.
According to the Associated Press, the CDC published a report that links Acanthamoeba infections to neti pots and other nasal rinsing devices. The study found that in 10 cases with an invasive Acanthamoeba infection, nasal rinsing may have been how the person became infected.
Acanthamoeba is a microscopic, free-living ameba that is found in the environment. It can cause rare, but severe illness and death. It is found all over the world, but is most common found in soil, dust, fresh water, brackish water, and sea water. It can also be found in swimming pools, hot tubs, drinking water systems, and HVAC systems.
The study highlighted the importance of educating people on how to ensure that the water they’re using for nasal rinses is safe. The CDC wants people to know that rinsing their sinuses with tap water is not safe. That’s because low levels of microscopic organisms can still be found in tap water in the U.S. This is usually safe to drink or cook with, but it can be dangerous when it is used in a humidifier or for a nasal rinse.
The CDC wants people to use boiled, sterile, or distilled water.
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How does someone get infected?
Acanthamoeba infection has only recently been linked to nasal rinsing, but has previously been linked to poor hygiene in people who use contact lenses.
Acanthamoeba keratitis is an infection of the eye that has been linked to contact lens use. While it is most commonly found in people who wear contact lenses, anyone can develop an infection.
The CDC said poor contact lens hygiene or wearing contact lenses while swimming or showering may increase a person’s risk of infection. The CDC provided the following examples:
- Storage and handling lenses improperly
- Disinfecting lenses improperly (such as using tap water or homemade solutions to clean the lenses)
- Swimming, using a hot tub, or showering while wearing lenses
- Coming into contact with contaminated water
- Having a history of trauma to the cornea
Acanthamoeba is not known to spread from person to person.
What are the symptoms?
Acanthamoeba can cause rare, but severe illness and death. Acanthamoeba causes three main types of illness that involve the eye, the brain and spinal cord, and infections that spread through the entire body.
The symptoms vary from person to person, but the CDC says to watch out for:
- Eye pain
- Eye redness
- Blurred vision
- Sensitivity to light
- Sensation of something in the eye
- Excessive tearing
Disseminated infection is possible with and without Granulomatous Amebic Encephalitis (GAE). This means it is possible for the germ to enter the body through a single point and then travel throughout the person’s body. This type of infection may or may not include a serious infection of the brain and spinal cord.
A disseminated infection usually includes symptoms of inflammation of the lungs or sinuses, and/or skin infections. It has the potential to spread to the brain. Skin infections caused by Acanthamoeba can show up as reddish nodules, skin ulcers, or abscesses in the skin.
Symptoms of GAE include:
- Mental status changes
- Loss of coordination
- Fever
- Muscular weakness or partial paralysis affecting one side of the body
- Double vision
- Sensitivity to light
- Other neurologic problems
What is the treatment?
The CDC said that it is extremely important to diagnose Acanthamoeba keratitis early. There are several prescription eye medications available, but the infection can be difficult to treat. The best treatment options should be determined by an eye doctor. If you believe your eye is infected with Acanthamoeba, see an eye doctor immediately.
Skin infections caused by Acanthamoeba that have not spread to the central nervous system can be treated. It is still a serious infection and people affected usually have weakened immune systems, so early diagnosis is the best path for a cure.
Most cases of brain infection with Acanthamoeba (Granulomatous Amebic Encephalitis) are deadly.
How to prevent an infection
The CDC provided the following guidelines for contact lens users:
- Visit your eye care provider for regular eye examinations.
- Wear and replace contact lenses according to the schedule prescribed by your eye care provider.
- Remove contact lenses before any activity involving contact with water, including showering, using a hot tub, or swimming.
- Wash hands with soap and water and dry before handling contact lenses.
- Clean contact lenses according to instructions from your eye care provider and the manufacturer’s guidelines.
- Never reuse or top off old solution. Use fresh cleaning or disinfecting solution each time lenses are cleaned and stored.
- Never use saline solution or rewetting drops to disinfect lenses. Neither solution is an effective or approved disinfectant.
- Be sure to clean, rub, and rinse your lenses each time you remove your lenses. Rubbing and rinsing your contact lenses will aid in removing harmful microbes and residues.
- Store reusable lenses in the proper storage case.
- Storage cases should be rubbed and rinsed with sterile contact lens solution (never use tap water), emptied, and left open to dry after each use.
- Replace storage cases at least once every three months.
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.
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