The amoeba responsible for causing a meningitis like brain infection has been found in the water system of Terrebonne Parish near New Orleans, Louisiana. Tap water is safe to drink, but Health Department officials warn not to let the water get up your nose. The state has been sampling water systems each summer as temperatures start to go up. The positive sample just collected came from a location that also was contaminated in 2015.
Louisiana’s Department of Health confirmed the Naegleria fowleri amoeba is definitely present in the water and are asking users of the Schriever Water System “to refrain from allowing water to enter their nasal passages.” The local utility had already been using “the free chlorine method” of water treatment since June 12 as part of routine cleaning. After initial tests came back positive for the amoeba on June 20, officials decided to continue the elevated chlorine process, also called a “chlorine burn,” until September. The process should raise the level of chlorine high enough to not only kill the amoeba, but also eliminate the “bio-film” that it lives in.
Residents using the town’s water system should avoid getting water in their nose when swimming or bathing. Placing your head under water is not advised. Children should not be allowed to play in water, including hoses or sprinklers, without supervision. Those living in the affected parish are advised to run the water in taps and hoses for at least five full minutes to flush out the plumbing, especially if the water has not been run through that particular tap regularly and recently.
An increased chlorine odor and taste are expected. Putting some water in an open container in the fridge will allow the taste and smell to dissipate but will take a few hours. Water filters can also be helpful but remember to change them on the manufacturer recommended schedule.
The CDC considers eight cases per year to be the U.S. average for amoeba infections, and last year there were four known deaths. Hanna Katherine Collins, an 11-year-old was infected when she went swimming in a river near her South Carolina home. An Ohio woman visiting North Carolina died after contracting the parasite on a whitewater rafting ride at the U.S. National Whitewater center, which uses city sourced water in a closed loop system. Teen Lifeguard Hudson Adams was infected at the Texas summer camp he worked at. Kerry Stoutenburgh caught the brain eating amoeba while swimming in a Maryland stream.
The parasite is not contagious, but is almost always fatal. Entering the body through the nose, the organism works its way along the olfactory nerve to the brain. Once there, N. Fowleri destroys brain tissue and causes inflammation. Symptoms are very similar to bacterial meningitis with severe headaches, fever, nausea and neck stiffness. As the condition gets worse, it rapidly causes seizures or even coma. Humans have no natural defense and there is not an effective treatment yet.
Because cases of infection are so rare, there is very little research money to find a cure. Currently doctors use a combination of drugs that are meant to treat other conditions. “Even with the best drug combinations, the fatality rate is over 98 percent,” said Dennis Kyle, an infectious disease researcher at the University of South Florida.
Using clues from drugs created for malaria and similar diseases, Kyle and his associates have created a first-of-its-kind “high volume screening setup” to find which mixture of chemicals works best to kill the beast. Over 30,000 natural substances have been collected from across the planet for testing. Combined with synthetics and FDA approved drugs, Kyle is optimistic one that is effective will soon be found.
Out of all the people who have been infected, only three have survived. Two of those had been treated with miltefosine which is an antimicrobial drug. The treatment is still considered investigational and while two patients did survive, most treated with the drug have not. Kyle and his team are on the lookout for the organism’s natural enemies, hoping to find something faster acting the miltefosine
A second group is working in Seattle under the direction of Robin Stacy, senior project manager for the Seattle Structural Genomics Center for Infectious Disease. Instead of Kyle’s bottom up screening approach, The Seattle group is working top down to model the structure of the amoeba’s proteins with X-rays and engineer compounds designed to target those structures.
The risk of infection by the amoeba is very rare, with only 37 reported infections in the ten years between 2006 and 2015, compared with over 34,000 drownings. Most cases involved recreation water that had been contaminated. Swimming, especially with your head under water, jumping in feet first, excessive splashing or anything else that would tend to accelerate the flow of water into the sinus cavity will increase the chances for infection.