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Article Type: Blog

Brain-eating Amoeba and What You Need to Know

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Source: Federico Laham, MD, Pediatric Infectious Diseases

In Florida and across the nation, amoeba makes a big splash in the news around this time of year almost every single year. And there's a good reason why: the infection they cause in humans is almost always lethal.

So what is the amoeba? Its a single-cell parasite called Naegleria fowleri, commonly found in warm freshwater such as rivers, lakes and springs, typically during the summer months.

It is thought that the infection primary amebic meningoencephalitis (PAM) occurs when the amoeba enters the nose forcefully, as in diving or during water sports in infested waters. After this, symptoms develop within a few days, and ultimately a severe brain infection leads to death. Drinking or just staying in contact with the water doesn't cause the infection.

Fortunately, however, in the case of 16-year-old Sebastian DeLeon, who had a Naegleria infection recently, he's one of the lucky few who survived. In fact, he's one of only four people known to survive Naegleria fowleri in the United States in the last 50 years.
 
With odds like that, it's crucial to have a rapid response. In Sebastian's case, his family realized something was wrong when he complained of a serious headache. When the headache was so painful that he couldn't bear to be touched, they took him to the Florida Hospital for Children's Emergency Department. A spinal tap revealed the presence of the amoeba, and the doctors knew they had a short window to fight for the 16-year-olds life.

Needless to say, it was a terrifying experience for him and his family and likely has you wondering how to protect yourself. Here are some things to keep in mind:

Where does the amoeba live?
They thrive in warm waters around the world. They can be found in rivers, lakes, hot springs and also swimming pools that are not maintained or chlorinated properly. They're commonly found in the southern-tier states in the summer, but some cases have been reported in northern states, according to US Centers for Disease Control and Prevention (CDC), with more than half of all infections occurring in Texas and Florida. Recent cases in Arkansas, North Carolina and Ohio reflect this wide distribution.

What are some signs to look for?
Initial symptoms may include headache (usually severe), fever, nausea or vomiting. Later symptoms can include stiff neck, confusion, lack of attention to people and surroundings, loss of balance, seizures and hallucinations. Typically, these symptoms occur from one to nine days after exposure.

What treatments are available?
Treatment is aimed at both killing the amoeba and reducing swelling in the brain. This involves administering a combination or cocktail of antimicrobial drugs known to kill the amoeba, as well as medical and surgical interventions that reduce elevated pressure in the brain that results from swelling.

The earliest the treatment is administered, the better chances for success. Recently, body cooling and induced drug coma have been used as well. Also, a drug called miltefosine has been added to the cocktail.

How can you protect yourself?
The one way to completely avoid amoeba infections is by not participating in water activities in warm bodies of freshwater. However, keep in mind, that there's a low level of risk. From 1962-2015, in fact, only 138 infections in the US have been reported to CDC. Each year, hundreds of millions of visits to swimming venues occur in the US that results in 0-8 infections, according to CDC.

The following actions limit the amount of infested water that can go up the nose:
Holding your nose or using nose clips when taking part in freshwater-related activities. 
Avoiding putting your head underwater in hot springs and other warm freshwater bodies. 
Avoiding water-related activities in all warm freshwater bodies during periods of high water temperature.  
Avoiding digging in, or stirring up mud and scum while taking part in water-related activities in shallow, warm freshwater areas.

 

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