The Naegleria fowleri amoeba typically feeds on bacteria in water and soil. Human digestive systems have no problem killing it, but inhaling water that carries the amoeba gives it the opportunity to work its way into the brain after it sneaks through the nasal mucus. It happens rarely, but 97% of people whose brains start swelling because of this amoeba end up dying. Like most microorganisms, N. fowleri can be neutralized with concentrated chlorine.
However, the systems we use to deliver tap water aren’t so clean. Researchers found that N. fowleri can easily survive for 24 hours when it’s mixed with the types of biofilm that tend to reside in water pipes. Increasing chlorine levels isn’t a good option, since its reaction with these biofilms can generate carcinogens.
The “brain-eating amoeba” Naegleria fowleri has grabbed headlines from New Orleans to Karachi, as its victims contract the rare but deadly pathogen after getting water up their noses. Increasingly, experts have traced the source of infection to drinking water pipes, where chlorine disinfection ought to be killing the amoeba. But a new study proves for the first time that biofilms coating drinking water pipes helpN. fowleri evade death by chlorine (Environ. Sci. Technol. 2015, DOI:10.1021/acs.est.5b02947).
N. fowleri is a free-living single-celled organism that grazes on bacteria in lakes, rivers, and soil. People can drink water containing the amoeba and not get sick because the digestive system will kill the pathogen. But if a person inhales water, N. fowleri can penetrate nasal mucus and work its way to the brain where the body’s immune response sets off brain swelling, triggering primary amoebic meningoencephalitis (PAM). The disease is rare but kills more than 97% of infected people.
Some basic information you should know about this Brain Eating Bacteria
• Since 1962, 133 people in the U.S. have been infected with Naegleria fowleri, and only three have survived.
• The amoeba enters through the nose and travels along the olfactory nerve to the brain, where it destroys brain tissue, causing swelling and death.
• Diving and jumping into water, submerging the head, or doing anything that causes water to go up the nose are swimming behaviors associated with infection.
• In very rare cases, infections have occurred when people used contaminated water to clean their nasal passages, either with a sinus rinse or in a religious practice. The largest issues with tap water have occurred in Australia, where some water pipes run miles overland and are heated by the sun.
• Symptoms: The infection at first causes a severe headache, fever, nausea and vomiting. As the infection progresses, the patient can get a stiff neck, seizures and hallucinations and go into a coma.
• Diagnosis: The rarity of the infection makes diagnosis difficult. Seventy-five percent of cases are diagnosed after death. Only a few laboratories in the U.S. perform the specific tests for diagnosis. An MRI could show signs of infection, but would not specifically indicate the amoeba was the cause.
• Treatment: An investigational breast cancer and anti-parasite drug, miltefosine, has shown promise in treating the infection. Two children in the U.S. have been treated with the drug. One made a full recovery and the other is believed to have brain damage.
• To reduce risk while swimming: The CDC advises holding the nose shut, using a nose clip or keeping the head above water.
• To reduce risk with nasal rinse: Boil, filter or disinfect the water or use distilled or sterile water.
The risk of infection the CDC has always been deemed as low however increasingly, experts have traced the source of infection to drinking water pipes, where chlorine disinfection ought to be killing the amoeba. But a new study proves for the first time that biofilms coating drinking water pipes help N. fowleri evade death by chlorine.
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