Enters body through the nose
The Naegleria fowleri amoeba has to enter the body through the nose. You cannot be infected with Naegleria fowleri from drinking contaminated water.
There have now been 14 confirmed deaths in Pakistan this year (2014) from Naegleria fowleri.
Infection from Naegleria fowleri is often difficult to diagnose, as early symptoms often appear to be Viral Meningitis. Therefore, it is essential that doctors know immediately when patients are admitted to a hospital if the patient recently swam in warm fresh water.
The Center for Disease Control (CDC) has conceded that Naegleria fowleri can be found in all warm fresh water globally, including lakes, rivers, hot springs, retention ponds, streams, ditches, soil and un-chlorinated swimming pools. There have even been cases with the amoeba present in public drinking water and water heaters when the water supply is under chlorinated.
Naegleria fowleri is a heat-loving organism and is highly active at temperatures from 106 to 115 degrees F.
Naegleria fowleri grows best at temperatures up to 115 degrees F and can survive for short periods up to 149 degrees F.
The Center for Disease Control (CDC) states that no data exists to accurately estimate the true risk from Primary Amebic Meningoencephalitis (PAM) and it is unknown why certain people are infected and others swimming with them are not. There are no known means of controlling naturally occurring Naegleria fowleri levels in lakes and rivers.
Studies have been conducted in Texas lakes with water samples (80 per lake) taken along the edge of the lake, 10 feet from shore, 300 feet from shore and in the middle of the lake in 300 feet of water and Naegleria fowleri was positive in 87% of the samples, including in the middle of the lake.
Naegleria fowleri cannot survive in sea water and has not been found in sea water.
Because Naegleria fowleri is found in 3 different stages: trophozoite, cyst and flagellated stages. They are resistant to adverse environmental changes such as temperatures from 122-149 degrees for short periods of time, or very cold temperatures for long periods of time.
Physicians M. Fowler and R. F. Carter first identified and described a disease caused by amoeba-flagellates in Australia in 1965 that affected 4 patients. The amoebas could effectively live both freely in the environment and in a human host. The earliest known confirmed case of Naegleria fowleri was a patient from Virginia in 1937, but the case wasn’t filed until 1968, when Dos Santos identified the patient after reviewing autopsy samples.
Children and Young Adults
Naegleria fowleri Primary Amoebis Meningoencephalitis (PAM) is primarily a disease afflicting children and young adults (84% of cases under the age of 18) with a median age of 11.5 years, infecting males over females at a ratio of 3:1. The majority of infections are in the 5-14 age groups. The youngest person infected was 5 months old and the oldest was a 64 year old male.
Contaminated Public Water Systems
There have been six confirmed Primary Amoebis Meningoencephalitis (PAM) cases in the U.S. from contaminated public water systems infected with Naegleria fowleri. The cases included immersion of the head in a bath tub, using a slip-n-slide and mixing solutions for nasal irrigation using tap water. PAM infections also occurred in Australian public water systems during the 1980s from showering and swimming in pools that had infected water added.
Primary Amoebis Meningoencephalitis (PAM) symptoms
Primary Amoebis Meningoencephalitis (PAM) symptoms begin 1-7 days after swimming or other nasal exposure to water containing Naegleria fowleri. People die 1-12 days after symptoms begin; the median is 5.3 days. Signs of symptoms of the infection are: severe frontal headache, fever, nausea, vomiting, stiff neck, eventually followed by altered mental status, hallucinations, seizures and finally coma.
Primary Amoebic Meningoencephalitis
Primary Amoebic Meningoencephalitis Reported Cases
Through 2013, the state-by-state case reports show Florida with the most cases of Primary Amoebic Meningoencephalitis (PAM).
The breakdown is as follows:
Florida – 34
Texas – 32
Arizona, California, South Carolina & Virginia – 7
Arkansas, Oklahoma – 6
Georgia – 5
Louisiana, North Carolina – 4
6 states – 1
Primary Amoebic Meningoencephalitis Survivors
The only survivor of Primary Amoebic Meningoencephalitis (PAM) in the United States was correctly diagnosed with PAM within 30 hours of the onset of symptoms. It is critical that patients be taken to the emergency room as soon as symptoms appear (headache, stiff neck and vomiting) after swimming in warm fresh water.
Primary Amoebic Meningoencephalitis Diagnosis and Treatment
The Center for Disease Control (CDC) has representatives available 24/7 for diagnostic assistance and treatment recommendations.
Contact the Center for Disease Control (CDC) at 770-488-7100.
The Center for Disease Control (CDC) now has an investigational drug called miltefosine available for treatment of Primary Amoebic Meningoencephalitis (PAM). It is critical that the emergency room personnel are made aware that the patient recently swam in warm fresh water.
Primary Amoebic Meningoencephalitis International Cases
Primary Amoebic Meningoencephalitis (PAM) is a global issue, not just a problem in the United States.
Cases have been reported in the following countries:
- Czech Republic – between 1962-65 – 16 young people died from PAM as a result of swimming in an indoor pool.
- India – there have been two reported cases in infants.
- Iran – the first reported case was in 2012 in an infant.
- New Zealand – 1968-78 eight reported cases from swimming in hot springs.
- Pakistan – in 2012 there were 44 reported cases within a single week! At least 13 cases have been reported in Karachi (14 in 2014) from cleansing sinus cavities.
- Taiwan – one case in 2011 from bathing in hot springs.
- United Kingdom – in 1979 one child died after swimming in Roman baths.
- Costa Rica – in 2014 one child died after swimming in hot springs.
- Venezuela – first case reported in 1998 and two more in 2006.