Naegleria Fowleri

Naegleria Fowleri

Primary Amebic Meningoencephalitis

(PAM)

Contracting Naegleria Fowleri

Diagnosis and Detection

- Infections are very rare with only 31 infections being reported in the US in the past 10 years

- 28 contracted the infection from recreational water and 3 from tap water

- Infections most commonly occur over the summer and in the southern states

- The infection occurs when water

containing the amoeba enters through

the nose and travels to the brain

- Cannot be contracted by drinking

contaminated water or spread among

people

- Naegleria Fowleri can invade the body and attack the nervous system and become pathogenic causing PAM, a brain infection that leads to the destruction of brain tissue

- The organism begins to consume cells of the brain by means of a unique sucking apparatus extended from its cell surface

- PAM usually occurs in healthy children or young adults with no prior history of immune compromise who have recently been exposed to bodies of fresh water.

- The fatality rate is over 99%;

in the past 50 years only

1 of 128 infected individuals

have survived

- Naegleria Fowleri can be detected in cerebrospinal fluid, biopsy or tissue specimens, and water samples by identifying morphology, nucleic acid and antigen characteristics

-Naegleria fowleri can be grown in several kinds of liquid media or on non-nutrient agar plates coated with bacteria

- 75% of diagnoses are made after the patient’s death due to its rarity and the difficulty of initial detection

- Molecular and biochemical tests:

-Direct Visualization

-Immunohistochemistry

-Polymerase Chain Reaction

-Amoeba Culture

-Flagellation test

General Information

Symptoms

- Symptoms begin to occur about 5 days after infection

- Symptoms include:

Stage 1 Stage 2

- change in taste and smell -stiff neck

-severe headaches -seizures

-fever -altered mental status

-nausea -hallucinations

-vomiting -coma

- After the start of symptoms, the infection progresses rapidly over 3-7 days, with death occurring from 7-14 days after exposure

- An amoeba: single celled organism

- Found in:

1. Bodies of warm, fresh water (lakes, rivers)

2. Geothermal water (hot springs)

3. Water residue from industrial plants

4. Poorly maintained swimming pools

5. Water heaters

6. Soil (near warm-water discharges)

-No evidence of this organism living in salt water

- Grows best at temperatures up to 115 degrees F

- Feeds off of other bacteria in the lakes and rivers

Survivor

Treatment

Victim

- Kali Harding, 12 year old from Arkansas, is the 3rd

and most recent survivor of the PAM infection

- Contracted the amoeba at Willow Springs

Water Park in Little Rock in July 2013

- Recovering since August after being treated

with experimental drugs, specifically miltefosine

- Investigative drug miltefosine, (from Germany)

originally developed to fight breast cancer, said to

play a crucial role in her recovery

- After 55 days in the hospital, Kali is now enjoying her life at home and returning to normal activities

- Research is being done to determine what factor specific to Naegleria fowleri makes it pathogenic and if these virulence factors can be targeted by drugs, no specific treatment has been determined yet

- Only 3 individuals have survived the infection

- Treatment included doses of:

• Amphotericin B- a systemic antifungal
• Rifampicin- a bactericidal antibiotic drug
• Dexamethasone- a corticosteroid

-Recently an investigational breast cancer and anti-leishmania drug, miltefosine 6, has shown some promise in combination with some of these other drugs

- Zachary Reyna was a 12 year old from South Florida

- Contracted the infection

while knee-boarding in ditch

water near his home

- He passed away August 24, 2013, 3 weeks after contracting the infection