Woman, 71, dies from brain-eating infection days after rinsing her nose with tap water
The 71-year-old from Texas, whose identity hasn't been disclosed, is thought to have fallen victim to an amoeba, a single-celled organism.
After she died last year, it was suggested she'd contracted the infection after using tap water from an RV's system at a campground to rinse her sinuses.
The amoeba she was infected by is Naegleria fowleri, known as the brain-eating amoeba, which thrives in warm freshwater lakes, rivers, and hot springs, according to a report in Morbidity and Mortality Weekly Report.
Centers for Disease Control and Prevention (CDC) and Texas investigators said the woman developed severe neurological symptoms, including fever, headache, and an altered mental state, within four days of using a nasal irrigation device filled with the tap water.
Despite medical treatment for suspected primary amoebic meningoencephalitis - a rare but severe and usually fatal brain infection caused by Naegleria fowleri - she developed seizures and later died eight days after her symptoms first appeared.
A follow-up epidemiologic investigation conducted by the Texas Department of State Health Services found the woman had no recreational exposure to fresh water, such as swimming.
But she had reportedly performed nasal irrigation several times using non-boiled water from the RV water faucet during the four days before she fell ill.
Two potential water sources for the N. fowleri infection were suggested.
The first was the RV's water tank for drinking, which flowed directly to the faucets and shower.
The tank had been filled with water collected on an unknown date before the patient bought the RV three months earlier.
The second possible source of contamination was the municipal water system, which was connected by a hose and water filter to the RV's potable water system.
To explore these potential sources further, investigators collected 12 environmental samples.
These included samples from the squirt bottle that the woman used for nasal rinsing, water from the RV water heater, swabs from the shower head and bathroom and kitchen sink faucets, water from the RV's potable water tank, and water from the campsite's municipal water supply.
The scientists didn't find N. fowleri DNA or viable amoeba in the samples, but they found the water supply wasn't adequately disinfected.
The authors wrote: "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."
Despite the alarming incident, The Texas Department of State Health Services reassured the public the area's tap water remains safe to drink.
They emphasised infections from amoebas are extremely rare and can only infect humans through the nose.
2
Sinus rinsing, also known as nasal irrigation or sinus flushing, is popular for relieving sinus congestion and other respiratory issues.
It's generally recommended to use boiled and cooled water for sinus rinsing, along with distilled or sterile water.
Boiling water kills bacteria and other microorganisms that may be present in tap water, reducing the risk of infection.
It's also advised to avoid water entering your nasal passages in general, especially when swimming or engaging in water activities.
Are you at risk of Naegleria fowleri?
Naegleria fowleri infections, leading to primary amoebic meningoencephalitis (PAM), typically present with symptoms like severe headache, fever, nausea, vomiting, and stiff neck.
These initial symptoms, which can resemble those of bacterial or viral meningitis, progress rapidly to confusion, hallucinations, lack of attention, and seizures.
The disease progresses to coma and death within one to 18 days after symptoms appear, with the median being five days.
Diagnosis can be challenging due to the rarity of the infection and the difficulty in initial detection.
Rapid identification through laboratory tests is crucial for effective treatment.
While PAM is rare, exposure to warm freshwater is a risk factor.
Avoiding swimming in warm, stagnant water and practising safe water practices can help reduce the risk of infection.
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