Rare brain eating amoeba Naegleria fowleri kills woman: How a tiny amoeba in tap water can kill you and how to stay safe

Time of India

07-06-2025

A woman in Texas died after contracting a deadly brain infection from a microscopic amoeba in tap water used for a nasal rinse, U.S. health officials have confirmed.
The 71-year-old was reportedly staying at a local campground and had used water from her RV's tap in a nasal irrigation device. Just four days later, she developed severe neurological symptoms and died within eight days of falling ill. The U.S. Centers for Disease Control and Prevention (CDC) has identified the infection as
primary amebic meningoencephalitis
(PAM), caused by
Naegleria fowleri
— a rare but nearly always fatal amoeba.
'This case reinforces the potential for serious health risks associated with improper use of nasal irrigation devices, as well as the importance of maintaining RV water quality and ensuring that municipal water systems adhere to regulatory standards,' the CDC stated.
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What is Naegleria fowleri?
Naegleria fowleri is a single-celled organism that lives in warm freshwater bodies such as lakes, rivers, and hot springs. It can also survive in poorly maintained swimming pools and untreated tap water. It is referred to as a "brain-eating amoeba" because, once it enters through the nose, it travels along the olfactory nerve into the brain, where it destroys brain tissue.
Despite its terrifying name, the amoeba is extremely rare. Between 1962 and 2023, only 164 cases were recorded in the U.S., with just four known survivors.
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Tammy Lundstrom, Chief Medical Officer and infectious disease expert at Trinity Health, told Fox News Digital, 'The risk of brain-eating amoeba is very low. Fewer than 10 people in the U.S. every year get infected — but unfortunately, most cases are fatal. There are only a handful of survivors of known cases.'
How the woman got infected
The CDC's Morbidity and Mortality Weekly Report detailed that the woman had used a nasal irrigation device multiple times over four days. It was filled with unboiled tap water from the RV's internal plumbing. After symptoms such as fever, headache and altered mental status emerged, she was hospitalised and treated for a suspected PAM infection.
However, her condition rapidly worsened. She suffered seizures and died eight days after the symptoms began. Testing of her cerebrospinal fluid confirmed the presence of Naegleria fowleri.
Although the amoeba itself was not detected in the RV water supply, investigators found the system had not been adequately disinfected.
Symptoms to watch for
Early
symptoms of PAM
often appear within five days of exposure, though onset can range from one to 12 days. These include:
Headache
Fever
Nausea
Vomiting
As the infection advances, it can cause:
Confusion
Stiff neck
Seizures
Hallucinations
Coma
'Early symptoms should prompt a medical evaluation, as they are also signs of bacterial meningitis,' said Lundstrom.
The disease progresses swiftly. On average, death occurs five days after symptoms begin, but it can happen in as little as one day or as long as 18.
How to protect yourself
The CDC advises that only sterile, distilled or previously boiled and cooled water should be used for nasal rinsing. Improperly treated water, especially from RVs or municipal systems lacking adequate disinfection, can pose a risk.
When swimming, experts recommend keeping your head above water or using a nose clip. 'Infection occurs when water harbouring the amoeba goes up a person's nose, usually during swimming,' Lundstrom explained. 'It is not known why some people get infected and others, even swimming companions, do not.'
Drinking contaminated water is not a risk factor, as the infection only occurs via nasal exposure. It also does not spread between people.
Because the amoeba thrives in warm temperatures — typically over 30°C — and can survive in sediment, swimmers are advised not to disturb the bottom of lakes or rivers.
How it spreads and survives
Naegleria fowleri has three life stages: cyst, trophozoite (the active stage), and flagellate. The active form can infect humans but under less favourable conditions, it reverts to a cyst and clings to surfaces in plumbing or pools.
It grows best at temperatures up to 46°C and can survive briefly even in hotter conditions. Most infections occur in southern U.S. states, though cases are being reported further north — possibly linked to climate change.
To limit the spread, many southern utilities perform annual chlorine burns at the start of summer to flush out biofilms where the amoeba might hide.
Can it be treated?
Treatment options are limited due to the rapid progression and severity of PAM. Doctors typically use antifungal and antibiotic drugs, such as rifampin and azithromycin, alongside miltefosine, a newer antifungal that has shown some promise in lab tests.
But Lundstrom cautioned, 'The effect of all of these drugs on actual infected people is unknown due to the high fatality rate.'
Prompt diagnosis remains difficult because early symptoms resemble other, more common infections.
The warmest months are when Naegleria fowleri is most active, especially in southern regions. Splash pads, lakes, and even backyard kiddie pools can become risky if water is left untreated or stagnant.
Though infections are rare, families are urged to take simple precautions. Use sterile water for nasal care. Be cautious in warm freshwater environments. And remember, the amoeba doesn't pose a risk in saltwater or from drinking.
'Millions of people enjoy swimming every summer, but only a few become infected,' said Lundstrom. 'Awareness and prevention are your best tools.'