A New Jersey man died after being infected with Naegleria fowleri, also known as the “brain-eating amoeba,” a rare infection that is contracted through the nose in fresh water.
The man, Fabrizio Stabile, 29, of Ventnor, N.J., was mowing his lawn on Sept. 16 when he felt ill from a headache, according to his obituary and GoFundMe page. His symptoms worsened and he was taken to the hospital after he became unable to speak coherently. A spinal tap revealed he was infected with the amoeba, and he died on Sept. 21.
It is the first confirmed case of the infection in the United States since 2016, an epidemiologist for the Centers for Disease Control and Prevention, Dr. Jennifer Cope, said on Monday.
Mr. Stabile fell ill after visiting the BSR Cable Park and Surf Resort, a surf and water park in Waco, Tex., said Kelly Craine, a spokeswoman for the Waco-McLennan County Public Health District. She said in a telephone interview on Monday that the C.D.C. sent epidemiologists to take samples from the park to test for the presence of the amoeba, and those results could come this week. There are no reports of other illnesses at the Waco park, the C.D.C. said.
What is Naegleria fowleri?
The amoeba is a single-celled organism that can cause a rare infection of the brain called primary amoebic meningoencephalitis, also known as PAM, which is usually fatal.
It thrives in warm temperatures and is commonly found in warm bodies of fresh water, such as lakes, rivers and hot springs, the C.D.C. said, though it can also be present in soil. It enters the body through the nose, and it moves on to the brain. Infection typically occurs when people go swimming in lakes and rivers, according to the C.D.C.
The amoeba got its nickname because it starts to destroy brain tissue once it reaches the brain, after it is forced up there in a rush of water. Before it enters the body, it happily feasts on the bacteria found in the water.
“It turns to using the brain as a food source,” Dr. Cope said. “It is a scary name. It is not completely inaccurate.”
The amoeba can also hide in pipes that are connected to tap water, the C.D.C. said. You cannot get infected by touching contaminated water or by swallowing it, and the infection cannot be passed from one person to another.
What are the symptoms of infection?
Signs of infection include headache, nausea, vomiting and confusion — all typical for people with any type of meningitis, Dr. Cope said.
Patients who are admitted to the hospital with these symptoms should tell a doctor if they have recently been in a freshwater park, pool or body of water, she said.
How many people have died from it?
The infection is extremely rare but almost always leads to death, according to the C.D.C. In the United States, there were 143 infections between 1962 through 2017, the last year for which data is available. All but four of them were fatal. More than half of the infections occurred in Texas and Florida, the C.D.C. said.
The amoeba is not found in salt water.
How can I avoid being infected?
Most of the infections happened when swimming in warm lakes or rivers. Swimmers or divers should take steps to prevent infection, such as blocking water from entering the nose.
“Hold your nose or use nose clips,” said Dr. Tina Tan, epidemiologist for the New Jersey Department of Health. “Avoid putting your head under water, such as in hot springs, and stirring up the dirt or the mud.”
Most of the infections occurred in Texas and Florida because they have warm climates and large populations, and water sports are popular, Dr. Cope said. Precautions should be taken for activities like diving and water skiing that have the potential to force large amounts of water into the nasal cavity.
Is nasal rinsing safe?
It depends. At least one person contracted the infection through nasal rinsing: A 47-year old man in the Virgin Islands died in 2012 after becoming infected during a nasal ablution that he performed in preparation for Islamic prayer, the C.D.C. said. The amoeba was detected in untreated groundwater from a well and rainwater from a cistern that he had used as his household water sources.
At least two cases of infection have occurred in people who used neti pots, which are ceramic or plastic pots used to clear sinuses, the C.D.C. said. Water should be boiled for one minute (or three minutes at elevations higher than 6,500 feet), left to cool and filtered before rinsing, the C.D.C. advises. Otherwise, distilled, sterile or disinfected water should be used.
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