Americans may expect more brain-eating amoeba as climate crisis accelerates

An Arkansas child died in September from Naegleria fowleri, a rare infection caused by an amoeba that destroys brain tissue, causing brain swelling and often ending in death but the unusual disease that killed the toddler could become more common in the future.

This notorious human pathogen is the causative agent of the rare but fatal primary amoebic meningoencephalitis. Another 2-year-old boy died in July, one week after he contracted the rare virus while swimming in Ash Springs, Nevada.

Doctors said Caleb Ziegelbauer was a medical miracle after the 14-year-old boy proved them wrong by surviving the brain-eating amoeba contracted after contracting the typically-fatal infection while swimming in the brackish water off Port Charlotte Beach, Florida.

Caleb’s infection caused facial paralysis and an inability to speak, and he communicated using only his eyebrows for five months but has since shared his story with others to help prevent others from going through the same thing.

The young man became only the sixth person in the United States to survive primary amebic meningoencephalitis caused by Naegleria fowleri infection.

The CDC reports that there have been five other documented survivors in North America.

After 35 years without a Naegleria survivor in the United States, during the summer of 2013, two children with Naegleria fowleri infection survived. The first, a 12-year-old girl, was diagnosed with PAM approximately 30 hours after becoming ill and was started on the recommended treatment within 36 hours. She also received the investigational drug miltefosine, and her cerebral edema and elevated intracranial pressure were aggressively managed with interventions that included therapeutic hypothermia. This patient made a full neurologic recovery and returned to school. Her recovery has been attributed to early diagnosis and treatment and novel therapeutics including miltefosine and hypothermia 5.

The second child, an 8-year-old male, is also considered a PAM survivor, although he has suffered what is likely permanent brain damage. He was also treated with miltefosine but was diagnosed and treated several days after his symptoms began. Therapeutic hypothermia was not used in this case 6.

In the summer of 2016, a 16-year-old boy was reported as the fourth U.S. PAM survivor. This patient was diagnosed within hours of presentation to the hospital and was treated with the same protocol used for the 12-year-old 2013 survivor. This patient also made a full neurologic recovery and returned to school.

Naegleria is a free-living amoeba commonly found in warm freshwater such as lakes, rivers, and hot springs or soil. It is so small that it can only be seen with a microscope. 

Viruses are the most common biological entities on our planet, infecting virtually all cellular organisms. As temperatures rise, its population tends to increase, so this disease is likely to accelerate with the ongoing climate crisis.

Only one species of the single-celled living organism infects people: Naegleria fowleri.

It is commonly called the “brain-eating amoeba” because it can cause a brain infection when water containing the amoeba goes up the nose. Only about three people in the United States get infected each year, but these infections are usually fatal.

This free-living microorganism primarily feeds on bacteria but can become pathogenic in humans, causing an extremely rare, sudden, severe, and usually fatal brain infection known as primary amoebic meningoencephalitis (PAM)

The Arkansas Department of Health concluded that the victim, a 16-month-old toddler, was likely exposed at the Country Club of Little Rock splash pad.

The state agency sent multiple samples from the pool and splash pad to the Centers for Disease Control and Prevention (CDC), which confirmed them to have viable Naegleria fowleri.

There is no ongoing risk to the public related to this exposure. The Country Club of Little Rock voluntarily closed the pool and splash pad, and they both remain closed. Naegleria fowleri cannot infect people if swallowed and is not spread from person to person. The last case reported in Arkansas was in 2013.

Only about three people in the United States get infected each year, but these infections are usually fatal.

About 300 Naegleria fowleri cases in total have been reported in 50 years since the first was reported in 1965 and it has been found worldwide including America, Australia, South Korea, Thailand, Hong Kong, and Taiwan.

The disease caused by the brain-eating amoeba, is 97% fatal, according to the CDC, but it is also preventable with simple nose plugs.