Death Linked to Nasal Irrigation and Brain-Eating Amoeba

A woman’s routine use of nasal irrigation resulted in her tragic death from a brain-eating amoeba. Health officials recently provided details about how she contracted a deadly infection from Naegleria fowleri through contaminated tap water from a recreational vehicle.

In a report published in the CDC’s Morbidity and Mortality Weekly Report, officials in Texas shared this unusual case. The 71-year-old woman began experiencing neurological symptoms just days after using a nasal irrigation device. Unfortunately, she passed away just a week later. Although these infections are rare, officials emphasize that they can be avoided by using sterilized water for nasal irrigation.

N. fowleri is a shapeshifting amoeba found in soil and warm freshwater. It generally feeds on bacteria and is not harmful when simply ingested. However, when it enters the body through the nose, it can migrate to the brain. Once there, it feeds on brain cells, causing substantial inflammation and leading to a severe brain infection called primary amebic meningoencephalitis (PAM).

The report noted that the previously healthy woman sought medical attention for fever, headache, and altered mental status. Four days prior, she had used tap water from an RV’s water system at a Texas campground for nasal irrigation. Doctors quickly suspected PAM, but despite treatment, she suffered seizures and died eight days after her initial symptoms appeared. The odd circumstances surrounding her death led to an investigation by the Texas Department of State Health Services and the CDC.

Officials tested both the RV’s water tank and the nearby municipal water system that the RV may have been linked to. Neither source showed signs of the amoeba, but samples were collected 23 days after the woman’s exposure, meaning conditions might have changed by that point. The investigation did reveal, though, that the RV’s water system had not been adequately disinfected, which likely allowed the amoeba to contaminate the woman’s water supply.

“This case emphasizes the serious health risks associated with improper use of nasal irrigation devices, as well as the need for maintaining RV water quality and compliance with municipal water safety standards,” the officials remarked.

PAM is extremely rare, with only around 150 cases recorded since the amoeba’s discovery in the 1960s, and it is almost always fatal once symptoms manifest. Infections typically occur when people get water up their noses while swimming in warm lakes, but the amoeba can also thrive in drinking and recreational water systems that lack proper sterilization. There have been numerous instances of infections linked to contaminated tap water used for nasal irrigation, which is often employed to alleviate sinus issues in individuals with allergies or respiratory infections.

The report’s authors stress that PAM can be easily prevented by adhering to recommended nasal irrigation practices, which include using only distilled, sterilized, or boiled and cooled water. This case underscores the unique risks posed by inadequately cleaned RV water systems. In response, Texas and federal health officials have developed an infographic for RV users to help mitigate their risk of PAM and other waterborne illnesses.