Details:

Alternative Title:
Clin Infect Dis
Personal Author:
Cope, Jennifer R. ; Ratard, Raoult C. ; Hill, Vincent R. ; Sokol, Theresa ; Causey, Jonathan Jake ; ... More +
Cope, Jennifer R. ; Ratard, Raoult C. ; Hill, Vincent R. ; Sokol, Theresa ; Causey, Jonathan Jake ; Yoder, Jonathan S. ; Mirani, Gayatri ; Mull, Bonnie ; Mukerjee, Kimberly A. ; Narayanan, Jothikumar ; Doucet, Meggie ; Qvarnstrom, Yvonne ; Poole, Charla N. ; Akingbola, Olugbenga A. ; Ritter, Jana ; Xiong, Zhenggang ; da Silva, Alexandre ; Roellig, Dawn ; Van Dyke, Russell ; Stern, Harlan ; Xiao, Lihua ; Beach, Michael J. Less -
Description:
Background

Naegleria fowleri is a climate-sensitive, thermophilic ameba found in warm, freshwater lakes and rivers. Primary amebic meningoencephalitis (PAM), which is almost universally fatal, occurs when N. fowleri–containing water enters the nose, typically during swimming, and N. fowleri migrates to the brain via the olfactory nerve. In August 2013, a 4-year-old child died of meningoencephalitis of unknown etiology in a Louisiana hospital.

Methods

Clinical and environmental testing and a case investigation were initiated to determine the cause of death and to identify potential exposures.

Results

Based on testing of CSF and brain specimens, the child was diagnosed with PAM. His only reported water exposure was tap water; in particular, tap water that was used to supply water to a lawn water slide on which the child had played extensively prior to becoming ill. Water samples were collected from both the home and the water distribution system that supplied the home and tested; N. fowleri were identified in water samples from both the home and the water distribution system.

Conclusions

This case is the first reported PAM death associated with culturable N. fowleri in tap water from a U.S. treated drinking water system. This case occurred in the context of an expanding geographic range for PAM beyond southern tier states with recent case reports from Minnesota, Kansas, and Indiana. This case also highlights the role of adequate disinfection throughout drinking water distribution systems and the importance of maintaining vigilance when operating drinking water systems using source waters with elevated temperatures.


Subject:
[+]
Amebiasis
Article
Brain
Central Nervous System Protozoal Infections
Cerebrospinal Fluid
Child, Preschool
Drinking Water
Fatal Outcome
Free-living Ameba
Humans
Louisiana
Male
Naegleria Fowleri
Oligopeptides
Primary Amebic Meningoencephalitis

Source:
Clin Infect Dis. 60(8):e36-e42.
Pubmed ID:
25595746
Pubmed Central ID:
PMC4627687
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:6b492f04d9f4a93e2bb030c76e799176f294b9874cfc7c73737713fd89a19c94
File Type:

Supporting Files

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