A recent death caused by brain-eating amoeba has reignited fears about the organism technically known as Naegleria fowleri — but there is no need for immediate panic, according to experts.
On July 28, the Georgia Department of Public Health issued a public safety report about a Georgia resident who had contracted Naegleria fowleri, likely after swimming in a “freshwater lake or pond,” and that the person had died on July 22.
That turned out to be Georgia high school student Megan Ebenroth, 17, confirmed her mother, Christina. Megan died after contracting the amoeba, according to local ABC affiliate WJBF, which reported that the young woman spent a few days in the hospital battling the brain infection before she died.
“I do want it to be known that Doctors Hospital tried to do a spinal tap to diagnose her and that the Children’s Hospital at MCG fought aggressively for her,” Megan’s mother, Christina, told outlet WRDW.
She also told 11 Alive that her daughter experienced severe headaches, fever and loss of balance prior to her death, and that she was intubated the day she went into the hospital.
“The stage we were at was not one Megan could come back from,” Megan’s mom explained. “She was unable to communicate with us. She couldn’t walk at that point.”
What’s the issue?
Contracting a brain-eating amoeba is a serious medical emergency, as it leads to primary amoebic meningoencephalitis, the medical condition caused by the amoeba that affects the brain and spinal cord. While it is extremely rare — with 157 people known to be infected in the United States between 1962 and 2022 — only four people have survived, according to the Center of Disease Control and Prevention.
Dr. Stanley Deresinski, an infectious diseases physician and Stanford University clinical professor, tells Yahoo, “Infection occurs through the nose during underwater swimming, and the organism then tracks along the olfactory nerve pathways to invade the central nervous system.”
The first step needed to survive the disease is to identify the cause of the infection, says Deresinski. “The organism can be visualized microscopically in the cerebrospinal fluid and if the diagnosis is made early and appropriate treatment is given, survival is possible, although very limited.”
Contracting this infection is most likely fatal, says Deresinski, as it appears with a “rapidly progressive severe acute meningitis.”
As Minnesota-based physician Siyab Panhwar tells Yahoo, “Once infected, symptoms of the disease can take anywhere from one to 10 days to present, and commonly include severe headache, high fever, nausea/vomiting, stiff neck, confusion and hallucinations. Symptoms get more severe over time, and unfortunately death occurs within one to two weeks of symptoms, as a consequence of severe inflammation and brain swelling.”
He adds that the reason for calling it “brain-eating amoeba” is that the infection feeds on brain tissue.
Should I be worried?
Not especially, as contracting a brain-eating amoeba is exceedingly rare, according to data from the CDC, although it does note that “the amoeba may be present in any freshwater body in the United States, regardless of the state, especially during the warmer months of July, August, and September.”
Dr. Paul Auwaerter, clinical director of the division of infectious diseases at Johns Hopkins Medicine, tells Yahoo, “It’s a disease of warmer weather months, and predominantly in southern states or more southern-oriented states, in part because this is an organism that tends to like stagnant fresh waters. So imagine cow ponds that are sitting in hot weather and have very little turnover, or are slow-moving waters such as stagnant pools. It typically is a disease of children and young adults because older adults might not want to go in those waters.”
One should always assume a certain level of risk while wading in freshwaters, according to the Georgia DPH, which notes: “There is no routine environmental test for Naegleria fowleri in bodies of water; and because it is very common in the environment, levels of the amoebas that naturally occur cannot be controlled. The location and number of amoebas in the water can vary over time within the same body of water.”
Despite the possibility of there being Naegleria fowleri in freshwater, there are very few cases of Naegleria fowleri each year, with only three reported cases in 2022. However, Deresinski says that it’s possible this is an undercount, as “the diagnosis may be missed and the infection is only [formally reported and tracked] in a few states — Florida, Texas and Louisiana.”
Adds Panhwar, “Most infections in the U.S. were previously reported in the southern states of Florida and Texas; but we have some data that the amoeba may be found more northward as well, possibly due to climate change. … I think that overall, people in general should not be too concerned, but just be aware of the risk that is present before they decide to enter freshwater lakes or rivers.”
While swimming may be the most common way to contract a brain-eating amoeba, it isn’t the only possibility. “Infections have also occurred from ritual nasal cleaning and with sinus irrigation with tap water,” explains Deresinski, referring to neti pot usage. However, it is not caused by drinking contaminated water and is not spread from person to person.
What can I do about it?
Amoebas thrive in warm fresh water, which is why it’s a good idea to avoid swimming in hot springs, thermally polluted water (such as water by a power plant), or at times when the water level is low and therefore the temperature of the water is higher, says Deresinski.
If you are going to swim in fresh water, you can use nose clips in order to avoid getting water (and potentially a brain-eating amoeba) up your nose, as this is how it accesses your body.
The Food and Drug Administration says it’s important to engage in best safety practices when using a sinus rinse, typically with a neti pot, which many people do as a treatment for the common cold. Rinse only with distilled, sterile or previously boiled water, as tap water can increase risk for infection, such as the one caused by Naegleria fowleri.