A case of Naegleria fowleri, most commonly called the brain-eating amoeba, has been confirmed by the Florida Department of Health in Charlotte County.
The agency said the infection was possibly as a result of sinus rinse practices utilizing tap water.
The Centers for Disease Control and Prevention describes the Naegleria organisms as free-living amoebae (a single-celled living organism). It is so small that it can only be seen with a microscope and is commonly found in warm freshwater (such as lakes, rivers and hot springs) and soil. Only one species of Naegleria infects people: Naegleria fowleri.
Infection with Naegleria fowleri is RARE and can only happen when water contaminated with amoebae enters the body through the nose. You CANNOT be infected by drinking tap water.
In rare situations, the amoeba can cause an infection of the brain called primary amebic meningoencephalitis (PAM).
The Florida Department of Health in Charlotte County, as part of a multiagency response, is continuing to investigate how the infection occurred and is working with local public utilities to identify potential links and make necessary corrective actions.
Residents in Charlotte County should follow the instructions below:
- When making sinus rinse solutions, use only distilled or sterile water. Tap water should be boiled for at least 1 minute and cooled before sinus rinsing.
- DO NOT allow water to go up your nose or sniff water into your nose when bathing, showering, washing your face, or swimming in small hard plastic/blow-up pools.
- DO NOT jump into or put your head under bathing water (bathtubs, small hard plastic/blow-up pools) – walk or lower yourself in.
- DO NOT allow children to play unsupervised with hoses or sprinklers, as they may accidentally squirt water up their nose. Avoid slip-n-slides or other activities where it is difficult to prevent water going up the nose.
- Keep small hard plastic or blow-up pools clean by emptying, scrubbing, and allowing them to dry after each use.
- Keep your swimming pool adequately disinfected before and during use.
The department is working with health care facilities to monitor any indications of additional infections. If you experience any of these symptoms after swimming in warm lakes or rivers, or after a nasal water exposure such as a sinus rinse, seek medical assistance immediately:
- Headache
- Fever
- Nausea
- Disorientation
- Vomiting
- Stiff neck
- Seizures
- Loss of balance
- Hallucinations
The CDC said that because PAM is so rare, and because the infection progresses so quickly, effective treatments have been challenging to identify. There is some evidence that certain drugs may be effective, but we are still learning about the best drugs to treat these infections.
Currently, PAM is treated with a combination of drugs, often including amphotericin B, azithromycin, fluconazole, rifampin, miltefosine, and dexamethasone. These drugs are used because they are thought to be effective against Naegleria fowleri and have been used to treat patients who survived. Miltefosine is the newest of these drugs. It has been shown to kill Naegleria fowleri in the laboratory and has been used to treat three survivors.
An NPR report in 2022 stressed that the amoeba doesn't mainly eat brains.
Although commonly known as the "brain-eating amoeba" — and it does indeed destroy brain tissue — the amoeba mainly eats bacteria, not brains, and those organisms are plentiful in the sediment of lakes and rivers. Infections in humans are devastating but rare.
"To get infected, the amoeba has to get to the ceiling of your nose – way, way up there," the late epidemiologist Raoult Ratard told NPR in 2013, when the amoeba was found for the first time in a city water supply in the U.S.
"At the top of the nose you have a little paper-thin plate made of bone with a bunch of holes, a little bit like a mosquito net," Ratard said. "The holes are for the olfactory nerve. So the amoeba is crawling up the nerve and gets into the brain."
For update, visit the CDC website at cdc.gov/parasites/naegleria/general.html.
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