Every year there are one or two reports of the deadly brain infection caused by the amoeba Naegleria fowleri.
Most cases have been limited to swimmers in warm, slow-moving bodies of fresh water, but for the first time ever, the Centers for Disease Control (CDC) indicate a U.S. water system in Louisiana has tested positive for the amoeba.
“Additional test results from the federal Centers for Disease Control and Prevention (CDC) confirm the presence of the rare ameba Naegleria fowleri in four locations of the St. Bernard Parish water system,” the Louisiana Department of Health and Hospitals (DHH) announced Thursday in a statement. “DHH announced last week that the encephalitis death of a child that had visited St. Bernard Parish was connected to the rare amoeba, which testing confirmed was present at the home. Because some water samples showed low residual levels of chlorine, DHH sent additional water samples to the CDC for testing last week and St. Bernard parish began flushing its water lines with additional chlorine last week, as a precautionary measure.”
Naegleria fowleri is commonly referred to as a “brain-eating” amoeba and is found in warm freshwater (for example, lakes, rivers, and hot springs) and soil.
The CDC indicates infection with the organism can only occur through the nose; it is not possible for Naegleria fowleri to infect a person’s brain through drinking contaminated water. There is still concern, however, because the drinking water supply is not just for drinking and a risk still remains for people who submerge their face for any reason like a bath, shower, or washing their face.
“We know that chlorine kills Naegleria fowleri, which is why it was critical that the parish proactively began flushing its water system with additional chlorine last week,” said Assistant Secretary for Public Health J.T. Lane. “The parish will continue this action until it raises chlorine residuals to recommended levels, and this process will continue for several weeks. DHH is working with parish officials to provide assistance and support to the parish’s staff to ensure that chlorine levels are being monitored daily.”
The low levels of chlorine are the reason why the drinking supply was able to become contaminated, and while this is the first time such a thing has happened in the U.S., experts indicate it likely won’t be the last and may have even happened before.
Currently some 40 percent of brain inflammation cases have no known cause, and researchers feel Naegleria fowleri may be to blame for some.
Louisiana residents in the St. Bernard Parish water system are being advised the risk is minimal but the following precautions should be taken:
- 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.
- DO run bath and shower taps and hoses for 5 minutes before use to flush out the pipes. This is most important the first time you use the tap after the water utility raises the disinfectant level.
- DO keep small hard plastic/blow-up pools clean by emptying, scrubbing, and allowing them to dry after each use.
- DO use only boiled and cooled, distilled, or sterile water for making sinus rinse solutions for neti pots or performing ritual ablutions.
- DO keep your swimming pool adequately disinfected before and during use. Adequate disinfection means:
o Pools: free chlorine at 1-3 parts per million (ppm) and pH 7.2-7.8
o Hot tubs/spas: free chlorine 2-4 parts per million (ppm) or free bromine 4-6 ppm and pH 7.2-7.8
o If you need to top off the water in your swimming pool with tap water,
- DO place the hose directly into the skimmer box and ensure that the filter is running.
- DO NOT top off by placing the hose in the body of the pool.
State Health Officer Jimmy Guidry said, “The water is safe to drink and there are basic precautions that families can take — such as chlorinating their pools and avoiding getting water in their noses — to protect themselves, though infection from this ameba is very rare.”
Symptoms of infection include headache, fever, nausea, or vomiting followed by stiff neck, confusion, lack of attention to people and surroundings, loss of balance, seizures, and hallucinations. Death occurs in most untreated cases within a 5-day time frame though some individuals take up to two weeks for the amoeba to cause a fatal level of damage.