Brain Coma Fresh water HEALTH AND SAFETY Naegleria fowleri Nasal irrigation Seizures Swimming Temperature

How Washing With Fresh Warm Water Can Lead To Sudden Death

Normal activities with fresh warm water like bathing, washing of face, swimming, nasal irrigation, e.t.c. can expose you to a deadly infection that kills victims within one week! It is real. Many such deaths have been confirmed and reported. It is also believed that many have occurred

unreported due to lack of quick, accurate diagnosis and very short time between onset of symptoms and death. You can contact it even right under your shower! Good news is, it is preventable! Mr Anikwo Emeka shares with us what could lead to this sudden death and what can be done to avoid it.

It is caused by a brain-eating amoeba calledNaegleria fowleri (a.k.a. Brain-Eating Amoeba). It is an amoeba of about 8 to 15 micrometers in size, depending on its life stage and environment. As typical with amoebas, N. fowlerireproduces by cell division when the environment is favorable, but when the environmental conditions are not friendly, they form an inactive stage known as cyst which will also become active (trophozoite) when the environment becomes favorable. Naturally, the organism eats bacteria but when it finds itself in a human system, it uses the brain as food source, hence the name Brain-Eating Amoeba. There are several species of Naegleria but only the fowleri subtypes are pathogenic.

Naegleria thrives in very warm water; being able to survive in water temperatures above 100OF. N. fowleri thrives and multiplies in fresh water including warm lakes, warm slow-flowing rivers (especially shallow ones), untreated swimming pools (under chlorinated or unchlorinated) and spas, under chlorinated splash pads, untreated public water systems and wells, aquariums etc.

How can one contract the organism?
Humans are infected with the organism through the nose usually during water activities such as swimming, diving, water skiing and other water sports in which water is forced into the nose. Infections can also occur through nasal rinsing with neti-pots filled with ordinary tap water that are not distilled or boiled. The infection is not spread from person to person.
Studies suggest that N. fowleri are attracted to the chemicals that nerve cells use to communicate with one another and therefore travel from the nose into the frontal lobe of the brain through the olfactory cell axon where they cause the fatal brain infection known as Primary Amoebic Meningoencephalitis (PAM). PAM is uncommonly reported however, but it has a 99% fatality rate and usually affects young, active healthy people. Initial symptoms resemble bacterial or viral meningitis which show 1 to 15 days after contact. The symptoms include fever, headache, stiff neck, loss of appetite, vomiting, seizures, altered mental state, and coma. Infections linked to fresh water swimming mostly occur during the heat of summer (at the peak of water temperature and when water levels are low). Infections can increase during heat wave years as water temperatures increases.

Currently, there is no guaranteed cure for PAM as only few patients survive even when treated with drugs that killed N. fowleri invitro. There is also no rapid diagnostic test yet for diagnosis of the infection as it still takes weeks to identify the amoeba. Like Bacterial meningitis, diagnosis requires a spinal tap (lumber puncture) to identify the organism. PAM is said to be 99% fatal but 100% preventable.
Preventive measures:
  • If possible, avoid water activities in fresh water when water is warm.
  • Do not allow fresh water into your nose or sniff water into your nose when bathing, showering, washing your face etc.
  • If you must swim, please ensure the swimming pool is properly treated.
  • It will be safer to avoid swimming under water, diving, skiing and jumping in warm, still water during late summer.
  • Do not allow children play with hoses or sprinklers unsupervised to avoid squirting water up their nose.
  • If you are cleansing your nostrils, be sure to fill your neti-pot or squeeze bottle with distilled or sterile water instead of tap water. You can also treat the water by boiling for about three minutes and then cooled.
  • You can wear a nose clip when swimming, boating or playing in or on warm water and avoid stirring up mud in the water. 

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