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"You can drink the water," public health officials told residents of St. Bernard Parish in Louisiana, "as long as you don't let it go up your nose" after a four-year old died of a brain infection he caught while playing on a water slide.

Millions of Americans have been following the tragic story of four-year-old Drake Smith, Jr., who died of a brain infection he caught while playing on a water slide in his cousin's back yard.

Recently the Centers for Disease Control confirmed the presence of a deadly amoeba, Naegleria fowleri, lurking in the water pipes providing water for homes, schools, hospitals, businesses, and swimming pools in St. Bernard Parish, southeast of New Orleans.

Schools have shut down water fountains to protect children from the microbe, as residents of the Deep South of the USA follow the story with deep anxiety.

What killed four-year-old Drake Smith, Jr.?

The Louisiana boy died of primary amoebic meningoenchephalitis, an condition caused by a direct attack of a water-born microorganism on the brain. The Naegleria ameobae that cause the condition can enter the brain through the nerves in the nose.

Once in the brain, they feed on the brain's especially high levels of glucose and oxygen and quickly cause massive tissue destruction. 

Is this disease very common?

Nearly every year between 1 and 8 people contracts the infection in the United States. Of the 2000 or so people known to have come down with the disease, only 12 have ever survived it. Most cases occur in the southern United States from Texas to Florida, although there have also been cases in Arizona, Kansas, Minnesota, and Virginia. The infection also occurs in Australia, the Czech Republic, India, Mexico, New Zealand, Pakistan, and the UK.

Who gets this infection?

Usually people get the amoeba up their noses while they are swimming or diving. In 2011, there were two deaths from amoebic infections of the brain in people who had used Louisiana tap water in neti pots. There have also been cases in which the germ was caught while taking a shower.

Is it absolutely, positively safe to drink water contaminated with the amoeba?

There were two deaths caused by drinking improperly treated tap water contaminated with Naegleria in Arizona in 2003. This water came from a geothermal well; the hot, still water provided a perfect home for the amoeba. There have also been cases in which the disease was contracted by drinking contaminated water in Australia and Pakistan.

Was it really brought it by Hurricane Katrina?

No. The amoeba was in water pipes before Hurricane Katrina. Because the parish's water plants were shut down and chlorination of water stopped while people were evacuated, the microorganism had opportunity to multiply inside the pipes. Drake Smith, Jr.'s tragic case is not the first in the parish since Hurricane Katrina.

Who is most at risk for the disease?

Scientists don't know why infants, children, and young adults are most likely to get the infection. Adults exposed to the same water supply usually don't get the disease.

What are the symptoms?

Two to six days after exposure to contaminated water, there may:

  • Sudden changes in the senses of taste and smell.
  • Severe headache, usually on the front of the head, and usually on both sides of the head.
  • Extremely high fever, usually over 104 degrees F (40 degrees C).
  • Nausea, vomiting, or both.
  • Stiff neck.
  • Involuntary lifting of the legs.
  • Pain in the knees when the thighs are moved.
  • Whole-body muscle spasms.
  • Extreme sensitivity to light.

Coma and death usually occur within 2 weeks.

How can I protect my family against this disease?

The amoeba does not survive in chlorinated water. It's important, especially during the summer months, to avoid swimming in untreated water, especially if the water is stagnant, has moss or slime on its surface, and has not been treated with chlorine.

People who use neti pots should fill them with boiled or distilled water, and dry them out between uses. Avoid accidental entry of water into the nose.

Drinking water that is contaminated with the amoeba is technically safe--as long as none is snorted up the nose.

Is there any treatment for the disease?

Recently, doctors in India saved the life of an eight-month-old infant who had the disease. There is hope that aggressive treatment might sometimes save lives, but doctors have a very short time to choose the right medications and how to use them.

A vaccine to protect against the brain-eating amoeba is under development, but still in the laboratory testing stage.

  • Centers for Disease Control and Prevention. Primary amebic meningoencephalitis--Arizona, Florida, and Texas, 2007. MMWR Morb Mortal Wkly Rep. May 30 2008. 57(21):573-7.
  • Yadav D, Aneja S, Dutta R, Maheshwari A, Seth A. Youngest survivor of naegleria meningitis. Indian J Pediatr. Mar 2013. 80(3):253-4.
  • Photo courtesy of tekksavvy by Wikimedia Commons : commons.wikimedia.org/wiki/File:Bacterial_Meningitis.jpg

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