Monday, May 18, 2015

A Reminder About Naegleria


Photo  Credit Florida DOH


# 10,060


Last week a small news item appeared out of Baton Rouge, LA regarding a pair of municipal employees who apparently falsified records and failed to check the local water supply for adequate levels of chlorine designed to keep Naegleria fowleri in check. 


An amoeba that, when ingested through the nose, can cause a fatal brain infection.  


2 plead guilty in failure to test St. John water sites for deadly amoeba

May 12, 2015 - 6:50 pm EDT

 BATON ROUGE, Louisiana — Two former employees of a south Louisiana water system have pleaded guilty to covering up their failure to properly collect and test water samples from sites where a dangerous type of amoeba was found.

(Continue . . . )


Long time readers will recall that in 2013 we saw a 4 year-old infected in Louisiana through contact with the municipal water supply. Subsequently we saw the St. Bernard Parish Water Supply Tests Positive For Naegleria Fowleri, which prompted an increase in chlorination.


Prior to that, in 2011, 2 people in Louisiana became infected through the introduction of tap water into their sinuses using a neti pot. These incidents caused the Louisiana Health Department to recommend that people `use distilled, sterile or previously boiled water to make up the irrigation solution’ (see Neti Pots & Naegleria Fowleri).

Is Rinsing Your Sinuses Safe? - (JPG)

Photo Credit FDA


While extraordinarily rare in the United States, every year Pakistan reports a dozen or more infections from this `killer amoeba’ , as chlorination of their water supplies is often inadequate, and for many, nasal ablutions are part of their daily ritual.


Even though it is unlikely to lurk in most modern municipal water supplies, the advice to boil water for use in neti pots is prudent given the almost universal fatal outcome from infection.


As rare as it is, it is more common for people to acquire this infection while swimming in warm, usually stagnant fresh water lakes and ponds. After introduction of this Free Living Amoeba (FLA) into the nasal passages, it makes a direct bee line to the brain, where is causes PAM (Primary Amebic Meningoencephalitis). 


Up until recently, there was little that could be done for someone infected, and the illness was almost always fatal. 


Last summer the CDC held a COCA Call On Naegleria Fowleri & Cryptosporidium for clinicians, with guidance on a new investigational drug called miltefosine, which – for the first time on record -  was used to successfully treat a victim of  PAM or Primary amebic meningoencephalitis last summer (see MMWR: CDC Imports Investigational Drug For Amoebic Infections).


While progress, this remains a largely fatal infection.


Naegleria infection happen almost anywhere, but in the United States is most common in the warmer southern states. Every year the State of Florida issues warnings to people on how to avoid this rare, but deadly, parasite.  This from last summer’s campaign.


FOR IMMEDIATE RELEASE         Contact: Communications Office

June 4, 2014                  (850) 245-4111


TALLAHASSEE -The Florida Department of Health cautions those who swim frequently in Florida’s lakes, rivers and ponds during warm temperatures about the possible presence of  Naegleria fowleri. Contact with this amoeba is rare, but the organism targets a person’s brain and usually results in death. Adverse health effects on humans can be prevented by avoiding nasal contact with the waters, since the amoeba enters through the nasal passages. Though there are only 34 reported casesin Florida since 1962, Naegleria fowlerican cause Primary Amebic Meningoencephalitis(PAM) disease which usually leads to death once infected.  As a precaution, health officials recommend the following:

  • Avoid water-related activities in bodies of warm freshwater, hot springs and thermally polluted water such as water around power plants.
  • Avoid water-related activities in warm freshwater during periods of high water temperature and low water levels.
  • Hold the nose shut or use nose clips when taking part in water-related activities in bodies of warm freshwater such as lakes, rivers, or hot springs.
  • Avoid digging in or stirring up the sediment while taking part in water-related activities in  shallow, warm freshwater areas.
  • Please note exposure to the amoeba may also occur when using neti pots to rinse your sinuses of cold/allergy-related congestion or conducting religious rituals with tap water.
  • Use only boiled and cooled, distilled, or sterile water for making sinus rinse solutions for neti pots or performing ritual ablutions.

If you experience any of these symptoms after swimming in any warm body of water, contact your health care provider immediately:headache, fever, nausea, disorientation, vomiting, stiff neck, seizures, loss of balance, or hallucinations. It is essential to seek medical attention right away, as PAM usually becomes fatal within five days of exposure.

Remember, this disease is rare and effective prevention strategies can allow for a safe and relaxing summer swim season.


For more information on the Naegleria parasite, you can also visit the CDC’s Naegleria webpage.

No comments: