AMEBIC MENINGOENCEPHALITIS - USA: (VIRGINIA, FLORIDA)
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[1]
Date: 16 Aug 2011
Source: Times Dispatch [edited]
<http://www2.timesdispatch.com/news/news/2011/aug/16/tdmain01-amoeba-caused-boys-fatal-infection-ar-1240873/>
The Virginia Department of Health does not know and may never know from which body of water a Virginia child contracted a deadly infection from an amoeba.
"In all likelihood, we're never going to pinpoint exactly where this amoeba was acquired," said Dr. Keri Hall, the state epidemiologist.
Her department received results from an autopsy Friday [12 Aug 2011] that confirmed the cause of death as primary amoebic meningoencephalitis, which is caused by _Naegleria fowleri_. She said the amoebas, which swim up the nose and enter the brain, live in freshwater bodies around the world.
Hall's department has not tested area lakes, ponds and rivers where the patient spent time at a fishing camp the week before his death.
Her department will "probably" do testing at various ponds and lakes in the region, but she said she doesn't know when the tests will be conducted and doesn't expect the sampling to be "particularly helpful."
The amoebas are particularly prevalent in shallow, still water during warm weather. But since the patient died, temperatures have dropped, and the amoeba population likely has fallen off as a result, Hall said.
The patient attended a camp run by the Richmond-based Virginia Fishing Adventures the week before he died and had been dunked the 1st day of camp. She believes that's when he took in the fatal, contaminated water.
The amoeba swims up the nose, through the sinuses and into the space around the brain, causing meningoencephalitis -- inflammation of the brain and its lining -- in a day to 2 weeks, said Dr. Michael Edmond, epidemiologist for VCU Medical Center and chief of infectious diseases.
He said the Virginia Department of Health asked him not to release the names of the water bodies where the patient and other campers went fishing. He said the agency did not suggest that he take his campers fishing in other locations the rest of the summer.
"The health department has told us they feel comfortable with us going back to all the places where we've been," Clarkson said.
However, he said he has made some changes in the way the camps operate, including spending more time fishing in the James River rather than in ponds, where amoebas are more likely to multiply. He has also warned campers to hold their noses if they go underwater and to try not to swallow fresh water.
Edmond said stagnant waters such as ponds and lakes pose more risks than moving waters. "Personally, I wouldn't swim in a pond, no matter what," he said. "The water isn't clean."
Though this is the 1st case of an amoeba death in Virginia since 1969, more than 100 people have died from amoebas in the U.S. since 1962.
Last week, a 16-year-old Florida girl died of an infection that officials with the Centers for Disease Control and Prevention confirmed was the same deadly amoeba. Meningoencephalitis causes brain swelling and is often fatal.
[Byline: Kristen Green <kgreen@timesdispatch.com>]
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Communicated by:
Thomas James Allen
<tjallen@pipeline.com>
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[2]
Date: Sun 14 Aug 2011
Source: Pediatrics About.com [edited]
<http://pediatrics.about.com/b/2011/08/14/teen-in-florida-dies-from-naegleria-ameba-infection.htm>
A 16-year-old girl in Brevard County Florida, near Orlando, has died from an infection with the _Naegleria fowleri_ amoeba that is commonly found in warm freshwater, including lakes, rivers, and ponds.
_Naegleria_ usually isn't found in well-maintained swimming pools or hot tubs.
The teen likely got the infection while swimming in the St. Johns River with her family.
Although these infections are very often deadly, they are fortunately very rare. There are only about 2 to 3 cases a year in the United States. This is the time of year when _Naegleria fowleri_ infections, which cause primary amebic meningoencephalitis (PAM), most commonly occur, from July to September. And they are also most likely to occur in southern states.
Water isn't usually tested for this amoeba parasite because testing takes several weeks, _Naegleria_ is commonly found in freshwater, and the numbers of amoebas in water can vary over time. Parents should therefore understand that there is a very low risk of these infections when swimming in freshwater. They should try to avoid warm freshwater when the water temperature is high and the water level is low; avoid stirring up the sediment when in shallow, warm freshwater, since that is where the amoebas are thought to live; consider holding your nose shut or using nose clips when in warm freshwater, at least when jumping into the water, since amoeba infect people by 1st entering their noses.
Again, remember that this is a rare infection, and you should keep the risk in perspective with other things that are much more high risk.
When entering the water, there is a much higher risk of drowning, and that likely isn't keeping you out of the water, although your kids are hopefully wearing a lifejacket if they can't swim well or are on a boat or jet ski, etc.
[Byline: Vincent Iannelli]
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ProMED-mail
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[Infections with free-living amoeba like _Naegleria fowleri_ occur sporadically, and the 2 cases are not related. We agree with the health authorities in Virginia that testing of lakes and ponds for free living amoebas may not be "particularly helpful." Indeed, most lakes and ponds will be expected to have these amoebas. Infections in humans are very rare, most probably due to the fact that most free-living amoebas do not grow well at a temperature of 37 C.
ProMED chose to post these latest reports and thanks readers for submitting other links to reports of the 2 cases. - Mod.EP]
[As there are usually just 2 or 3 reported cases in a year, the occurrence of 2 cases in a short period of time has one wonder if there might be an increase this year [2011] possibly related to the prolonged heat waves experienced throughout the USA, with temperatures in some areas greater than 100 degrees F (37.8 degrees C) sustained for 3 or more weeks.
For the HealthMap/ProMED map of the USA showing Virginia, see <http://healthmap.org/r/00tK>, and for Florida see <http://healthmap.org/r/00uk> - Mod.MPP]
[see also:
2009
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Amebic meningoencephalitis, organ transplant - USA (02): (MS)
20091222.4309
2007
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Acanthamoeba keratitis - USA (Multistate) 20070527.1703
2002
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Amebic meningoencephalitis - USA (Arizona) (05) 20021124.5886
2001
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Amebic meningoencephalitis, primary - USA (Calif.) 20010424.0793
1998
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Amebic meningoencephalitis, primary - Mexico 19980827.1695 Amebic meningoencephalitis, primary - USA (Florida) 19980808.1557 Amebic meningoencephalitis, primary - USA (Michigan) 19980828.1713 Amebic meningoencephalitis, primary - USA(Texas) (03) 19980808.1556
1995
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Amebic meningoencephalitis, primary - Texas, USA 19950823.0733 Waterborne pathogens 19950809.0654 Waterborne pathogens (2) 19950809.0655 Waterborne pathogens: RFI 19950808.0650] .................................................mpp/ep/msp/mpp/ll
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