Naegleria fowleri , aka Brain Eating Amoeba

by **purple** on Fri Sep 02, 2011 8:35 pm

The other day I was browsing a apnea manufacturers website and saw their opinion of humidifiers, virus, and bacteria and its ability to transmit to an apnea machine user. They said it could not happen. While I would not use sewage water in my humidifier, tap water in the humidifier is, by them very safe. However it may leave a residue in the humidifier chamber and cause it to need to be replaced sooner than otherwise. My use of distilled water in my humidifier would be maybe ten eleven dollars a year, a lot cheaper than replacing the plastic chamber.

If one reads the stories about these deaths from the brain eating amoeba, this bug is very prevalent in the southern parts of the country in lots of lakes and such where people frequently swim. Very few people ever get the bug because to do so one must get it up the nose, into the sinuses.

There are lots of other things that are in even chlorinated city water one does not want in ones nose. IMO, use distilled water for a Neti Pot.

by **archangle** on Fri Sep 02, 2011 4:54 pm

It's a tragedy that in the USA, there are very few autopsies done these days in cases of deaths from unclear causes.

Most coroners are political hacks, not good doctors.

by **moresleep** on Fri Sep 02, 2011 4:25 pm

As someone pointed out, the amoeba would probably starve to death in distilled water, even if it infiltrated, somehow. So, using distilled water in humifiers and for sinus rinses is a good idea. As for how to wash hoses, etc., making sure you dry them throughly when you do wash them is probably the practical solution--being dried out probably kills the amoeba. I don't wash my equipment very often these days (found it really didn't make a difference in terms of infection for me) but use an old manual CPAP to blow air through the hose until dry, when I do (I don't want to screw up the data for my current machine).

by **newname** on Fri Sep 02, 2011 3:51 pm

So are we supposed to boil our distilled water too?
What about washing everything in tap water with vinegar before filling it with distilled water? Would the vinegar kill amoeba? If not, does this make using distilled water a waste of time because the germs get in the equipment when you wash them with tap water?
Should the equipment be washed with distilled water?

by **moresleep** on Fri Sep 02, 2011 3:30 pm

hshields wrote:
. . .

The Centers for Disease Control and Prevention (CDC) acknowledge many cases of primary amoebic meningoencephalitis (PAN) – caused by Naegleria Fowleri-- have been misdiagnosed as meningitis, pneumonia, bacteremia, various encephalitis infections, etc. A spinal tap and autopsy are essential for accurate diagnosis.

Brain infections take many young lives each year. How many misdiagnosed victims of brain infections have actually died from inhaling the
the brain eating amoeba N. fowleri in sewage sludge biosolids runoff to warm, shallow surface waters ? Why don't the US EPA and CDC warn the public of this health risk from exposure to sewage and sewage sludge biosolids runoff to surface waters ?

Helane Shields, Alton, NH

Exactly, we really don't know that we have the true numbers. This "remote" threat may not be that remote a threat at all.

by **hshields** on Fri Sep 02, 2011 10:48 am

In August 2011, the brain eating parasite Naegleria fowleri (N. fowleri), killed two teenagers and a child in Virginia, Florida and Louisiana.

Naegleria fowleri, is a brain eating amoeba which is found in sewage and sewage sludge biosolids. (Bose, Ghosh, 1990; DeJonkheere, 1977; Visvesvara, et al 1990; Thomas Sawyer, 1989; Singh & Das 1972; US EPA, 2003; CDC; Joel Griffin, 2007, etc.)

This protozoa infests soils, thermal waters and sediments in warm shallow waters which are subject to runoff from land applied sewage and sewage sludge biosolids. Victims inhale the parasite up their nose where it travels to their brain and kills them.

Per CDC, between 2001 and 2010 there were 32 deaths in the US from N. fowleri. 46 percent of Florida Lakes were found to contain N. fowleri. Between 1983 and 2010, Texas reports 28 N. fowleri deaths.

There were seven victims in summer 2007, all young males between the ages of 10 and 22

CDC reported 23 cases of the condition between 1995 and 2004.

The Centers for Disease Control and Prevention (CDC) acknowledge many cases of primary amoebic meningoencephalitis (PAN) – caused by Naegleria Fowleri-- have been misdiagnosed as meningitis, pneumonia, bacteremia, various encephalitis infections, etc. A spinal tap and autopsy are essential for accurate diagnosis.

Brain infections take many young lives each year. How many misdiagnosed victims of brain infections have actually died from inhaling the
the brain eating amoeba N. fowleri in sewage sludge biosolids runoff to warm, shallow surface waters ? Why don't the US EPA and CDC warn the public of this health risk from exposure to sewage and sewage sludge biosolids runoff to surface waters ?

Helane Shields, Alton, NH

by **sleepysmurf** on Tue Aug 23, 2011 7:12 pm

chunkyfrog wrote:In Louisiana, I would only drink the beer.

Preferably from a tap.....Snobbish I know -lol!

by **OutaSync** on Mon Aug 22, 2011 12:55 pm

Yes, it does seem like a remote possibility, until it happens to someone that you know. Here is my question. At his request, the family donated his organs. How can the doctors be so sure that the amoeba that destroyed his brain is not floating around in his body and being transferred in his donated organs?

From what I understand, they went back to the pond where the boy fished and since there have been heavy rains in the area they could not find any amoeba. So the pond has been cleared as safe for children to swim in.

by **Paper_Nanny** on Mon Aug 22, 2011 12:49 pm

archangle wrote:And just to make it even more unpleasant, apparently, it eats eyeballs too if you get it in your eyes.

From http://www.birdandhike.com/Hike/LAME/Goldstrike/Naegleria.htm

Prior to 1985 amoebae had been isolated from diseased eyes only rarely; cases were associated with trauma to the eye. In 1985-1986, 24 eye cases were reported to CDC; most of these occurred in people wearing contact lenses. Many of these infections resulted from the use of home-made saline solutions for the contact lenses. Some of the lenses had been heat treated and others had been chemically disinfected. The failure of the heat treatment was attributed to faulty equipment, since the amoebae are killed by 65C (149F) for 30 minutes.

I added the bold to that. 65 C = 149 F = 338 K.

archangle wrote:Remember the 1976 legionnaire's disease outbreak from a cooling tower?

I vaguely remember it happening at the time. July 1976-- I was 10 years old, living in a suburb of Pittsburgh PA, ready to start fifth grade, much more concerned about whether my friends would be in the same class as me than in national news and also insulated from the larger world by the lack of access to television.

I do remember my father going on a business trip shortly after that outbreak and me being worried about him contracting and dying from legionairres disease while he was gone. I had enough information to know people at a convention had died and not enough information to know why. So, I figured convention attendance in and of itself put people at risk.

by **GrumpyOne** on Mon Aug 22, 2011 12:43 pm

I love all this techno babble. Kelvin, Celsius, Fahrenheit, Cookie -- some of the greatest scientific minds of our age brought together by a humble one-celled organism. I realize I could take all the precautions on the world, never meet a Naegleria fowleri, and be struck by a meteorite on my 152nd birthday.

by **Paper_Nanny** on Mon Aug 22, 2011 12:29 pm

RandyJ wrote:I agree that "twice as hot" is misleading, because in Celsius 100 is more than 2 x 47, but in Fahrenheit 212 is not more than 2 x 116.6. I am sure a chemist would say that such expressions ("twice as hot") are meaningless out of context and I shouldn't have used it. It works in cookies, though. If you have 1 cookie and I give you another, you will have 2 cookies (twice as many as before!)

I think the Kelvin scale would be the temperature equivalent of the Cookie scale, as both are based on a point of absolute zero. Zero cookies is zero cookies. Zero Kelvin is zero thermal motion.

by **RandyJ** on Mon Aug 22, 2011 7:54 am

archangle wrote:
RandyJ wrote:
It seems that this amoeba is found in waters cooler than 47 degrees Celsius (acc to CDC), so is it logical to extrapolate that water more than twice that hot (boiling = 100 deg C) would kill it? I'm guessing yes...

No. Just because it doesn't grow in 47C water doesn't mean it will die in 47C water. It probably won't grow in 0C water either, but that doesn't mean it will die in it. Some organisms will form spores if they don't like the environment and come back to "life" when the environment gets better.

By the way, 100C is not twice as hot as 50C. Would you say 2C is twice as hot as 1C? How about if you state it in Fahrenheit? Is 35.6 degrees F twice as hot as 33.8F?

Naegleria probably DOES die at 100C. I just haven't seen "sure kill" numbers for Naegleria yet. Since it's an amoeba, and we're used to bacteria or viruses as "germs," our "gut feel" about killing by boiling can't be trusted.

By the way, where did the 47C number come from?

Sorry if I made an error... I did say "I'm guessing" not "I'm sure."

I agree that "twice as hot" is misleading, because in Celsius 100 is more than 2 x 47, but in Fahrenheit 212 is not more than 2 x 116.6. I am sure a chemist would say that such expressions ("twice as hot") are meaningless out of context and I shouldn't have used it. It works in cookies, though. If you have 1 cookie and I give you another, you will have 2 cookies (twice as many as before!) So it is twice as hot in Celsius but not in Fahrenheit.

The 47C number comes from the CDC's website article on Naegleria. They are apparently not found in water warmer than that temperature, which as you point out does not mean that a higher temperature will kill them, only that they probably cannot thrive and reproduce in a higher temperature.

by **archangle** on Mon Aug 22, 2011 1:38 am

Paper_Nanny wrote:Is breathing droplets enough to cause infection? All the descriptions I have read make it sound like the water has to be going up the nose more forcefully than what would happen from breathing in the droplets.

Good point. Since there are so few cases, I suspect that there's not a whole lot of evidence to draw conclusions from. It sounds like Naegleria in drinking water is pretty uncommon anyway. Most of the cases refer to getting it from untreated water in lakes and streams.

And just to make it even more unpleasant, apparently, it eats eyeballs too if you get it in your eyes.

Aerosols of contaminated water are one of the really scary things for spreading disease around. Remember the 1976 legionnaire's disease outbreak from a cooling tower?

by **Paper_Nanny** on Mon Aug 22, 2011 1:20 am

archangle wrote:Me, I'm probably still going to use regular tap water unless I hear more news about Naegleria around here. I'm breathing tap water droplets all the time when I take a shower anyway.

Is breathing droplets enough to cause infection? All the descriptions I have read make it sound like the water has to be going up the nose more forcefully than what would happen from breathing in the droplets.

Not that I have read all that much... And not that I am objectively reading what little I have read... I know what I am reading is being coloured to some extent by my visualisation of these things breaking through my cribiform and burrowing into my olfactory nerve as they migrate toward my brain.

by **archangle** on Mon Aug 22, 2011 12:30 am

RandyJ wrote:
It seems that this amoeba is found in waters cooler than 47 degrees Celsius (acc to CDC), so is it logical to extrapolate that water more than twice that hot (boiling = 100 deg C) would kill it? I'm guessing yes...

No. Just because it doesn't grow in 47C water doesn't mean it will die in 47C water. It probably won't grow in 0C water either, but that doesn't mean it will die in it. Some organisms will form spores if they don't like the environment and come back to "life" when the environment gets better.

For instance, botulinum bacteria will not reproduce in 100C water, but they turn into spores and go dormant. You can boil certain foods while canning, but botulinum will survive and grow once the jars cool down. This is how people get botulism from home canned foods if they don't prepare them properly. It takes 121C for several minutes to reliably kill botulinum spores.

By the way, 100C is not twice as hot as 50C. Would you say 2C is twice as hot as 1C? How about if you state it in Fahrenheit? Is 35.6 degrees F twice as hot as 33.8F?

Naegleria probably DOES die at 100C. I just haven't seen "sure kill" numbers for Naegleria yet. Since it's an amoeba, and we're used to bacteria or viruses as "germs," our "gut feel" about killing by boiling can't be trusted.

By the way, where did the 47C number come from?

Naegleria fowleri , aka Brain Eating Amoeba

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