With the weather starting to heat up, nothing sounds more refreshing than taking a swim in a nearby lake or river. Before you head out, you must be aware of a rare but usually fatal illness caused by a water-born amoeba called Naegleria fowleri that resides in all lakes, streams, rivers and ponds in Texas.
Primary Amebic Meningoencephalitis, or PAM, is a disease caused by Naegleria fowleri, the amoeba that is found in almost all untreated, fresh surface water and in soil. The amoeba thrives in freshwater that is warmer than 80 degrees and stagnant or slow-moving. The Texas Department of State Health Services (TDSHS) reports that most PAM infections happen when the temperatures are hot and water levels are lower. As we head into what is expected to be an average hot Texas summer, be aware that this is a disease that can easily be prevented.
PAM only infects people when water containing the amoeba enters through the nose, usually from diving or jumping into freshwater. The infection cannot be spread from person to person or by drinking contaminated water. The amoeba travels up the nose and makes its way into the brain along the olfactory nerve, destroying brain tissue.
Those infected with PAM will usually start showing symptoms about 5 days after the infection. It can often be mistaken for the flu or bacterial meningitis, as early symptoms include headache, fever, nausea or vomiting and can then progress to loss of balance, a stiff neck, seizures and hallucinations. The disease progresses quickly once the symptoms start and usually causes death within two weeks of the initial infection.
If you, a family member or a friend start showing symptoms after getting water up the nose, please get checked by a medical professional immediately. Most importantly, you must inform the medical professional that you may have been exposed to the amoeba by having freshwater forced up your nose. Specific tests are required to diagnose the illness in time.
While the disease is rare, identified cases thus far have almost always been fatal and mainly occur during the summer months. According to the Centers for Disease Control and Prevention, only 4 people in the U.S. out of 145 have survived the infection from 1962 to 2018.
The Brazos River Authority does not test for the Naegleria fowleri amoeba. Because it is common in all surface water throughout the world, those who live in warmer-weather states such as Texas should assume that there is a risk when entering all warm freshwater bodies.
The TDSHS has reported 33 PAM cases in Texas from 1979 to 2017. One of these cases includes 7-year-old Kyle Lewis, who died a few days after a swimming trip with his family in 2010. After Kyle’s passing, his family started the Kyle Lewis Amoeba Awareness Foundation, which spreads awareness about the disease and informs people about how to prevent the disease. To learn more about the Kyle Lewis Amoeba Awareness Foundation, please click here.
The outlook for people who contract this disease is poor; however, early diagnosis and new treatments might increase the chances for survival. Several drugs are proving to be effective against the Naegleria fowleri amoeba in the laboratory. Recently, two people with PAM survived after being treated with a new drug called miltefosine that was given along with other drugs and intense management of brain swelling. On June 17, 2016, Cook Children’s in Fort Worth became the first hospital in Texas to carry miltefosine.
So how can you protect yourself and your family? Fortunately, there are precautions that you can follow to help prevent infections. If you do decide to partake in water activities, use nose clips or hold your nose shut while jumping into water. With the amoeba often found in soil, it’s best to avoid stirring up underwater sediment.
Texas Health and Human Services recommends avoiding water activities in bodies of warm freshwater with low water levels. Health officials recommend people avoid stagnant or polluted water and take “No Swimming” signs seriously. Swimming pools and hot tubs that are properly cleaned, maintained and chlorinated are generally safe, as is saltwater.
If water does get up your nose while swimming in warm freshwater, monitor yourself for flu-like symptoms. If you do start showing symptoms, going to a medical professional and informing them of your recent activities may be able to save your life.
For more information about PAM, please click here or contact the Texas Department of State Health Services Public Information Office at (512) 458-7400.