A North Carolina teenager has died from a rare and often fatal infection caused by an amoeba found in warm freshwater, state health officials confirmed. The death follows closely behind that of an 8-year-old girl in Louisiana who succumbed to the same infection.
The illness is caused by Naegleria fowleri, a microscopic, one-celled living organism commonly referred to as a "brain-eating amoeba." It inhabits warm freshwater environments such as ponds, lakes, and rivers. The amoeba is most active during hotter months when water temperatures are elevated and the water may become stagnant, creating a favorable breeding ground.
Infections typically occur when water containing the amoeba is forced up the nose, allowing the organism to travel to the brain. This can happen when individuals jump or dive into the water or engage in water sports. According to Dr. Jeffrey Kahn, chief of pediatric infectious diseases at UT Southwestern and Children's Health in Dallas, Texas, the mortality rate for primary amebic meningoencephalitis (PAM), the brain infection caused by Naegleria fowleri, is nearly 100%.
The initial symptoms of PAM usually begin about five days after exposure, though they can appear anywhere from one to 12 days later. Early signs often include headache, nausea, fever, and vomiting. As the infection progresses, symptoms can escalate to confusion, slurred speech, stiff neck, disorientation, hallucinations, seizures, and coma. The disease progresses rapidly once symptoms appear, with most individuals dying within one to 18 days after symptom onset.
To reduce the risk of infection, health officials recommend avoiding warm freshwater environments where the amoeba is likely to be found. Alternatively, precautions such as wearing a nose clip and avoiding submerging the head underwater while swimming can help. It is important to note that Naegleria fowleri does not cause illness if swallowed, and the infection does not spread from person to person. The CDC also advises against disturbing the sediment at the bottom of lakes, ponds, and rivers, as the amoeba can be found in soil.
Treatment for confirmed cases typically involves a combination of antimicrobial and anti-amoebic medications, such as amphotericin B, azithromycin, rifampin, and miltefosine. However, Kahn noted that by the time the amoeba reaches the brain and begins to damage tissue, treatment is often too late.
Individuals experiencing sudden severe headaches, fever, stiff neck, or vomiting, especially after recent swimming in warm freshwater, should seek immediate medical attention.