Monday, July 06, 2015

Naegleria: Rare, 99% Fatal & Preventable



# 10,302


In the 42 years between 1962 and 2014 there were133 cases of Naegleria Fowleri infection reported in the United States, and sadly over the weekend California authorities announced the death of a 21 year-old woman who turned out infected with this brain invading parasite. 


Details on how she became infected have not been released (see CBS News Central California Woman, 21, Dies From Brain-Eating Amoeba).

Since it is usually acquired via swimming in warm,stagnant pools of fresh water it isn’t terribly surprising to see the southern tier of states most frequently affected, but even Indiana, and Minnesota have reported cases.   California – with a number of  thermal springs – has reported a total of 8 cases to date.


While 18 states have reported cases (others may have gone undiagnosed), Florida and Texas account for roughly half of all known cases.  Although the causative agent is the fresh water amoeba Nagleria Fowleri, the disease itself is called PAM (Primary Amoebic Meningoencephalitis).


This brain infection has nearly always been fatal, but in 2013  we saw survivors of PAM in the United States – two children – who had received an investigational drug called miltefosine. Last year the CDC announced:


Clinicians: CDC now has an investigational drug called miltefosine available for treatment of free-living ameba (FLA) infections caused by Naegleria fowleri, Balamuthia mandrillaris, and Acanthamoeba species. If you have a patient with suspected FLA infection, please contact the CDC Emergency Operations Center at 770-488-7100 to consult with a CDC expert regarding the use of this drug.


But to be effective, this infection must be recognized early, and treatment initiated as soon a possible.  Hence the need to get the word out to clinicians on this important development.


Although infections usually occur while swimming in warm, freshwater lakes and streams, 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.


Also, in 2011 we saw a new wrinkle when 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

The bottom line is that after introduction of this Free Living Amoeba (FLA) into the nasal passages, it makes a direct bee line to the brain, usually with tragic results. 


Although several states (including Florida) promote Naegleria awareness each summer, one of the best resources available online is, a USF Philip T. Gompf Memorial Fund project, which was set up by a pair of Florida doctors who tragically lost their 10 year-old son to this parasite in 2009.  



 You can also follow this site on twitter at @AmoebaSeason.




For some of my earlier blogs on Naegleria you may wish to revisit:


A Reminder About Naegleria
Reminder: COCA Call Today On Naegleria Fowleri & Cryptosporidium
MMWR: CDC Imports Investigational Drug For Amoebic Infections

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