Rare Freshwater Amoeba Case in North Carolina – Teen Critically Ill With Brain Infection

A teenager in central North Carolina is critically ill after developing a rare infection caused by Naegleria fowleri, a microscopic amoeba that can attack the brain, state health officials said Thursday.

The North Carolina Department of Health and Human Services (NCDHHS) confirmed the infection but did not disclose where the teenager may have been exposed to the organism. Authorities also withheld identifying information to protect the family’s privacy.

Known as the “brain-eating amoeba,” Naegleria fowleri is typically found in warm freshwater environments, including lakes, rivers and ponds. Infection is extremely uncommon but can be devastating.

How the infection occurs

People become infected when water containing the amoeba enters the body through the nose. This can happen when someone dives, jumps or otherwise plays in warm freshwater, forcing contaminated water into the nasal passages.

The organism does not infect people simply by swallowing contaminated water. Health officials also noted that Naegleria fowleri is not found in saltwater and does not survive in properly maintained and chlorinated swimming pools.

State Epidemiologist Dr. Zack Moore expressed sympathy for the teenager’s loved ones while emphasizing the rarity of the infection.

“Our hearts go out to this teen’s family, friends and loved ones as they navigate this difficult time,” Moore said.

Symptoms can progress rapidly

The infection caused by Naegleria fowleri is called primary amebic meningoencephalitis, or PAM. It is a serious disease that attacks the brain and can progress rapidly.

Early symptoms may include:

Severe headache
Fever
Nausea
Vomiting

As the illness advances, patients can develop a stiff neck, seizures and coma.

Health officials say the disease is usually fatal within approximately five days after symptoms begin. Fewer than 10 cases are typically reported annually in the United States, making infections exceptionally rare.

Hot weather can increase the risk

The risk of exposure tends to increase during prolonged periods of hot weather, particularly when freshwater temperatures rise and water levels drop.

The amoeba thrives in warm water and can survive at temperatures reaching approximately 115 degrees Fahrenheit.

North Carolina health officials are urging residents who use lakes, ponds and other warm freshwater areas to take precautions.

How to reduce the risk

NCDHHS recommends several measures for people swimming or playing in warm freshwater:

Hold your nose shut or use nose clips to prevent water from entering the nose.
Keep your head above water when swimming or playing in freshwater.
Avoid putting your head underwater in hot springs and other thermal waters.
Avoid diving or jumping into warm freshwater when water temperatures are particularly high and water levels are low.
Avoid disturbing sediment by digging or stirring up the bottom of lakes, ponds and rivers.

While Naegleria fowleri infections remain extraordinarily uncommon, health officials say the case serves as a reminder that the amoeba is present in North Carolina and other parts of the United States.