Fatal amoeba-caused meningoencephalitis case reported in Kansas

TOPEKA, Kan. – Kansas Department of Health and Environment has been notified of a fatal case of primary amoebic meningoencephalitis (PAM) caused by Naegleria fowleri, a free-living amoeba found in freshwater, in a resident of Johnson County. The investigation indicates there were several potential freshwater exposures in Kansas, so the actual source of the infection cannot be determined.

Initial laboratory examination has identified the presence of Naegleria fowleri in a specimen from the patient, and additional laboratory testing by the U.S. Centers for Disease Control and Prevention is pending. This is the second known case of PAM caused by Naegleria fowleri in Kansas. The first case occurred in 2011.

Naegleri fowleri can be found in freshwater environments around the world, but infection causing PAM is extremely rare. From 1962 to 2013, there have been 132 cases reported in the United States, with 34 of those cases occurring from 2004 to 2013. Most cases have occurred in southern-tier states. The risk of infection is very low, but increases during the summer months when water temperatures rise and more people participate in water-related activities. The infection typically occurs when the amoeba enters the body through the nose while the person is swimming underwater or diving and travels to the brain.

“It is important for the public to know that infections like these are extremely rare and there are precautions one can take to lower their risk – such as nose plugs,” said Robert Moser, MD, KDHE Secretary and State Health Officer.

Symptoms usually appear about five days after infection, but can range between one and seven days, and include headache, fever, nausea and vomiting, stiff neck, confusion, lack of attention to people and surroundings, loss of balance and bodily control, seizures, and hallucinations. This infection cannot be spread from person to person or contracted from a properly maintained swimming pool.

Though the risk of infection is extremely low, the following precautions might decrease the possibility of infection:

  • Hold your nose shut, use nose clips, or keep your head above water when taking part in water-related activities in bodies of warm freshwater.
  • Avoid putting your head under the water in hot springs and other untreated thermal waters.
  • Avoid water-related activities in warm freshwater during periods of high water temperature.
  • Avoid digging in, or stirring up, the sediment while taking part in water-related activities in shallow, warm freshwater areas.

There is no known way to control the occurrence of Naeglaria fowleri in freshwater lakes and rivers.

For more information on healthy swimming visit the CDC website at http://www.cdc.gov/healthyswimming/.

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