Naegleria fowleri made headlines in August 2013, when the death of a 4-year-old boy staying near Violet, Louisiana, was linked to the deadly amoeba. The child had been playing on a Slip ‘N’ Slide connected to the St. Bernard Parish’s water system that was later found to be contaminated with the amoeba.

According to NBC NEWS Sept. 16, 2013 –

Deadly brain amoeba infects US tap water for the first time”

Naegleria fowleri infects people when water containing the amoeba enters the body through the nose. This typically occurs when people go swimming or diving in warm freshwater places, like lakes and rivers. The Naegleria fowleri amoeba then travels up the nose to the brain where it destroys the brain tissue. It has now attacked a potable water system in the United States. Despite the “First Time” Headline given to this recent incident by NBC NEWS, the amoeba has been seen here before, showing up in an untreated geothermal well used for drinking water in Arizona.

After the death in August, the Louisiana Department of Health and Hospitals (DHH) asked the Centers for Disease Control and Prevention (CDC) for assistance due to the fact that they could not find a lab in the continental United States to test for the amoeba.

De Soto Parish Water Works District #1 had a 2011 Naegleria fowleri-related death as well, so the CDC agreed to test the water in both parishes. The CDC confirmed the presence of the rare Naegleria fowleri amoeba in five locations in DeSoto Parish Waterworks District #1. When temperatures are in the range between 90 and 115 degrees Fahrenheit, this deadly amoeba grows very active as the growing number of victims due to this unregulated contaminant documents. Naegleria fowleri cysts can persist for weeks even in freezing temperatures, so this killer amoeba can overwinter in the soils and waters of most of the US.

After publishing an article about the St. Bernard Parish incident, I was contacted by Jacob Groby who works for their water system. Mr. Groby informed me that the amoeba was never actually found in his system. He said the Slip ‘N’ Slide water hose had been hooked up to a house trailer that had previously been a FEMA trailer. The trailer sat unused for an extended period of time, then put back in service and connected to the St. Bernard Parish water system. According to Mr. Groby, it was the trailer that was the source of contamination, not the water system.

After the St. Bernard Parish incident the Louisiana Department of Health and Hospitals (DHH) required all Louisiana water systems to increase chlorine levels to .5 milligrams per liter as this is an effective way to eradicate the amoeba.

In August of 2014, Naegleria fowleri was found in another Louisiana system, St. John the Baptist Parish, which is 46 miles north of New Orleans. The DHH was performing testing of the Parish’s water to ensure that they had the appropriate amount of chlorine residual to combat the amoeba. When they found that the chlorine residual was lower than expected, they had the water tested for Naegleria fowleri and it was confirmed that it was present in their system.

One of the reasons Naegleria fowleri has not been found in other United States water systems, is that it is simply not tested for. The Naegleria fowleri amoeba is a parasite that occurs naturally in soil and water, grows well in warm temperatures, and survives for extended periods at low temperatures.

The amoeba can only grow in a water system if the water is untreated or is vulnerable due to depleted chlorine. Free chlorine or chloramine residuals of 0.5 mg/L or higher will control the amoeba. St. Bernard Parish has flushed its water system with extra chlorine (known as a chlorine burn) to kill the amoeba. The DHH and local officials are now monitoring the chlorine levels on a regular basis.

The CDC web page on Naegleria fowleri has a link to “Amoeba Response Guidelines” from Australia. It turns out that Australia has had more experience with Naegleria fowleri than anyone. During the 1970’s and 1980’s, Australia had multiple deaths that were linked either to swimming, or to having nasal exposure linked to contaminated drinking water.

8-23-2012 – Fox news reported Health officials link brain-eating amoeba deaths to tap water. “The victims, a 28-year-old man and a 51-year-old woman from different parts of the state (LA), died from Primary Amebic Meningoencephalitis (PAM) – an almost universally fatal infection – after using neti-pots filled with tap water to irrigate their sinuses.”

In the October 2014 issue of the AWWA Journal, an article titled: Naegleria fowleri: An Emerging Drinking Water Pathogen, states that the free–living amoeba can readily attach to, and grow rapidly in, biofilm. It is also stated in the article that uncertainty remains in regards to the ability of secondary disinfectant to control Naegleria fowleri in biofilms, tank sediments and other problematic parts of distribution system operations. If this deadly, parasitic amoeba can find a safe haven in the sediment on the floor of a water tank, keeping potable water tanks clean may be more important now than ever.

The article also states that there remains a knowledge gap in regards to the effective management of the parasite in premises (i.e. water pipes in homes & businesses, water heaters, shower heads, sink drains, etc.,). Given the fact that Naegleria fowleri enters the body through the nose and travels to the brain where it attacks the brain tissue, and knowing that we don’t know how to effectively combat the amoeba “in premises”, you might want to use a swimming “nose clip” when you shower if the following criteria are met: 1. It is summertime 2. The temperature is between 90-115 degrees Fahrenheit.

For more information on Naegleria fowleri amoeba in drinking water see:

http://www.cdc.gov/parasites/naegleria/public-water-systems.html

NOTE: You cannot be infected with Naegleria fowleri by drinking contaminated water. In very rare instances, Naegleria infections may also occur when contaminated water from other sources (such as inadequately chlorinated swimming pool water or contaminated tap water) enters the nose. (For example: when people submerge their heads or cleanse their noses during religious practices, and when people irrigate their sinuses (nose) using contaminated tap water.)

– Centers for Disease Control and Prevention (CDC)

http://www.cdc.gov/parasites/naegleria/general.html