Photo Credit Florida DOH
While extraordinarily rare, each summer we usually hear about one or more cases of infection with Naegleria fowleri, dubbed the `brain eating amoeba’ by the media.
Yesterday the Arkansas Department of Health (ADH) confirmed earlier local media reports of a case of PAM (primary amebic meningoencephalitis) due to this parasite in a 12 year-old girl who recently swam in the Willow Springs water park in Little Rock.
First stop, the ADH announcements (2), after which I’ll have more:
Friday, Jul 26, 2013
Little Rock -- The Arkansas Department of Health (ADH) has confirmed a case of a rare form of parasitic meningitis. A case of primary amebic meningoencephalitis (PAM) -- a very rare form of meningitis caused by an ameba associated with warm rivers, lakes and streams -- was confirmed with the assistance of the Centers for Disease Control and Prevention.
Based on our ongoing investigation, the most likely source of infection is the Willow Springs Water Park. There was another case of PAM possibly connected with Willow Springs in 2010. Based on the occurrence of two cases of this rare infection in association with the same body of water and the unique features of the park, the ADH has asked the owner of Willow Springs to voluntarily close the water park to ensure the health and safety of the public.
The organism that causes PAM is known as Naegleria fowleri. It is commonly found in warm freshwater and soil all over the world and can cause a rare but severe brain infection that is usually fatal. Naegleria cannot be passed from person-to-person. The organism typically infects people by entering the body through the nose as they are swimming and diving. Individuals cannot be infected with Naegleria by swimming in properly cleaned, maintained and disinfected swimming pools.
While infection with Naegleria can occur anywhere, it usually occurs in the warm southern U.S. From 2003-2012, there have only been 31 reported infections in the U.S. This case is only the sixth case in Arkansas in 40 years.
Friday, Jul 26, 2013
Little Rock -- The Arkansas Department of Health (ADH) would like to remind the public that infection from naegleria fowleri, or parasitic meningitis, is very rare. If you swam at Willow Springs Water Park more than 8 days ago, you are NOT at risk for the infection. Even if you swam at Willow Springs in the past week, your risk of infection is exceedingly low.
“If you do not have symptoms, there is no test or preventive antibiotic or treatment needed,” said Dirk Haselow, MD, State Epidemiologist at ADH.
Persons with infection will develop symptoms such as fever, vomiting, stiff neck, headache, light sensitivity, irritability, sleepiness, confusion, or mental status changes within 7 days. If you develop two or more of these symptoms, please contact your doctor.
The Arkansas Department of Health (ADH) has confirmed a rare case of primary amebic meningoencephalitis (PAM) caused by an ameba associated with warm rivers, lakes and streams. The organism that causes PAM is known as Naegleria fowleri. It is commonly found in warm freshwater and soil all over the world and can cause a rare but severe brain infection that is usually fatal.
Naegleria cannot be passed from person-to-person. The organism typically infects people by entering the body through the nose as they are swimming and diving. Individuals cannot be infected with Naegleria by swimming in properly cleaned, maintained and disinfected swimming pools.
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Local media describes this girl’s condition as `stable’, and that she in a medically induced coma. Historically, the prognosis with this type of infection has been very poor, with only 1 patient out of 128 diagnosed in the United States surviving (cite) over the past 50 years.
Although the primary route of infection is from swimming in shallow, warm, (usually stagnant) fresh-water lakes and streams, in 2011 we saw a couple of cases in Louisiana related to the use of Neti Pots for nasal irrigation (see FDA Advice On Safe Use Of Neti Pots).
Photo Credit FDA
Daily nasal irrigation is also practiced by many in the Muslim community, and that has led to dozens of deaths in recent years in Karachi, Pakistan where tap water standards are suspect. The most recent report I can find comes from late June:
KARACHI: The deadly waterborne infection, which is caused by an amoeba Naegleria fowleri claimed another life in the city on Saturday. With this case, the death toll, caused by this fatal infection, is now three since January 2013.
Sadia Shakoor, Mohammad Asim Beg, Syed Faisal Mahmood , Rebecca Bandea, Rama Sriram, Fatima Noman, Farheen Ali, Govinda S. Visvesvara, and Afia Zafar
We report 13 cases of Naegleria fowleri primary amebic meningoencephalitis in persons in Karachi, Pakistan, who had no history of aquatic activities. Infection likely occurred through ablution with tap water. An increase in primary amebic meningoencephalitis cases may be attributed to rising temperatures, reduced levels of chlorine in potable water, or deteriorating water distribution systems.
Since millions of people swim in waters where this amoeba naturally occur (or practice nasal irrigation) and only a small handful of infections result, the odds of acquiring this infection are exceedingly low.
Still, as this infection is almost always fatal, is largely avoidable, and often involves kids - the state of Florida - which has had its share of cases over the years, takes the threat seriously.
The following short video comes from from the Volusia County Health Department.
Photo Credit – Florida DOH