In the past few months, few cases of ‘Brain-eating’ amoeba-related death were reported. Some patients were suspected to be related to nasal rinse using tap water. It is suggested that people use only distilled or sterile water when making sinus rinse solutions. Otherwise, tap water should be boiled for a few minutes and cooled before using it. Since tap water that has not been sterilized isn’t safe, it may contain certain microorganisms such as bacteria and protozoa, including amoebas. Yet people cannot be infected by drinking tap water as stomach acid typically kills those microorganisms.
Why is ‘Brain-eating’ amoeba so deadly? What are the symptoms? How to lower the risk of infection?
Naegleria fowleri is a single-celled organism known as an amoeba. It can cause a rare but severe brain infection called primary amebic meningoencephalitis (PAM) when it enters the human body through the nose. It is commonly found in warm freshwater and soil, particularly in the southern United States. Still, it can also be found in other parts of the world.
When Naegleria fowleri enters the body through the nose, it travels to the brain. It causes inflammation and destruction of brain tissue, leading to PAM. Symptoms of PAM typically begin within 1-7 days of infection and include severe headache, fever, nausea, vomiting, and seizures. The condition is usually fatal, with death occurring within 3-7 days of symptom onset.
While there have been rare reports of Naegleria fowleri causing eye infections, such as keratitis, these cases are much less common than PAM. They typically occur in people with recent eye trauma or using contaminated contact lenses. Eye infections caused by Naegleria fowleri may present with symptoms such as redness, pain, and blurred vision.
According to the US Centers for Disease Control and Prevention (CDC), there have been only 148 reported cases of PAM in the United States from 1962 to 2020, with an overall case-fatality rate of over 97%. Most of these cases have occurred in southern states such as Florida, Texas, and Arizona, where warm freshwater environments are more common.
Preventative measures against Naegleria fowleri infection include avoiding swimming or diving in warm freshwater, especially during low water levels and high temperatures, and using nose plugs or holding the nose shut when participating in water activities. It is also important to avoid stirring up sediment in freshwater areas, as this can increase the risk of exposure to Naegleria fowleri.
There is currently no specific cure for primary amebic meningoencephalitis (PAM) caused by Naegleria fowleri. However, early diagnosis and treatment can help improve the chances of survival.
The recommended treatment for PAM includes using a combination of drugs that can penetrate the brain and kill the amoeba. These drugs include amphotericin B, miltefosine, and azithromycin. Treatment typically involves the intravenous administration of these drugs. Sometimes, they may be given directly into the cerebrospinal fluid surrounding the brain and spinal cord.
In addition to drug treatment, supportive care such as mechanical ventilation and management of intracranial pressure may be necessary.
It’s important to note that even with treatment, PAM is often fatal, and the prognosis is generally poor. Therefore, prevention is the most effective way to avoid infection.
Detecting the presence of Naegleria fowleri can be challenging, as it is a single-celled organism typically found in low numbers in environmental samples. However, several methods can be used to detect the amoeba in water or soil samples, including:
Direct microscopy: This involves examining a sample of water or soil under a microscope to look for the presence of Naegleria fowleri. This method can identify the amoeba’s characteristic shape and movement.
Culture: Culturing involves growing the organism in a laboratory setting to confirm its presence. This method can be time-consuming, as the amoeba may take several days or weeks to grow in the culture.
Molecular methods: Molecular methods, such as polymerase chain reaction (PCR), can detect the presence of Naegleria fowleri DNA in environmental samples. This method can be more sensitive and specific than microscopy or culture.
The symptoms of Naegleria fowleri infection can be similar to those of bacterial meningitis, making diagnosis challenging. Symptoms typically appear within 1 to 9 days after exposure to the amoeba. They can include severe headache, fever, nausea and vomiting, stiff neck, loss of appetite, changes in taste and smell, sensitivity to light, confusion or altered mental status, seizures, and hallucinations. As the infection progresses, symptoms may worsen, and the patient may experience altered consciousness, coma, and respiratory failure.
It’s important to note that the symptoms of Naegleria fowleri infection can be similar to other conditions. Diagnosis requires specific laboratory tests to confirm the presence of the amoeba. Suppose you have been exposed to contaminated water or soil and are experiencing symptoms. In that case, it is crucial to seek medical attention immediately. Early diagnosis and treatment can improve the chances of survival.