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Amoeba infection extremely rare, usually fatal

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By RAY REYES | The Tampa Tribune

Published: September 30, 2009

TAMPA - Smaller than a speck of dust, subsisting in the mud of warm freshwater lakes and rivers around the world, the parasite that infected a 10-year-old Plant City boy last month typically feeds on bacteria.

But in rare cases, the Naegleria fowleri amoeba enters humans through the nose, making its way to the brain and spinal cord. The microscopic organism destroys brain tissue, causing the severe infection primary amoebic meningoencephalitis.

The initial symptoms—headaches, fever and nausea—starts between one and 14 days after infection.
Then the brain swells, which leads to confusion, lack of attention, loss of balance, seizures and hallucinations, according to the Florida Department of Health.

"It's usually fatal," Hillsborough County Health Department environmental manager Eliot Gregos said.
Death can occur within a week.

So far, there is no known cure, according to the Centers for Disease Control and Prevention.
But the risks of infection are extremely low, Gregos said.

Since scientists identified Naegleria fowleri — the only species of Naegleria that threatens people — and began keeping records in 1962, only 32 people in Florida have died from the infection, Gregos said.

"It's a very, very small number of deaths," Gregos said. "Fortunately, it doesn't happen often."
In comparison, there were 36,000 drowning deaths nationwide from 1996 to 2005 and millions of recreational water exposures every year, according to the CDC.

The amoeba is blamed for two deaths this year. A 22-year-old man who went waterskiing at the Orlando Watersports complex died on Sept. 21. In August, 10-year-old Philip Gompf spent a day with his cousins tubing on Lake Arietta in Polk County and developed headaches five days later.

The next day, Philip started feeling nauseous, his father Timothy Gompf said. The Walden Lake Elementary School student died on Aug. 17. The Polk County Health Department confirmed on Monday the boy died from an amoeba infection.

Gompf, a doctor, said once his son was diagnosed with the infection, he knew the condition was untreatable.

"We really feel like if the correct treatment would have been started right away, the outcome would have been the same," Gompf said Tuesday.

Several drugs are effective against the amoeba in laboratory tests, the CDC said. But the effectiveness of those drugs is unclear because almost all infections have been fatal even when people were treated.

Health officials say the amoeba usually thrives during long hot spells in July, August and September. But there were droughts last year and scorching temperatures yet no cases of Naegleria infections, Gregos said.

"Some years we have no cases," Gregos said. "Some years we have three or four. We don't know why."

The increase in amoeba-related deaths over the last three years may be linked to environmental changes, Polk County Health Department Director Daniel Haight said.

"They have been seeing some more cases over the last few years, perhaps due to warmer climates, by increasing population, and more people utilizing recreational waters," Haight said.

In 2007, three boys who were swimming at the Orlando Watersports complex died from the infection, Gregos said. The parasite can inhabit poorly-maintained swimming pools, but "you'd have to have a pretty nasty pool to have the organism living in it," he said.

Out of the 32 cases in Florida, 16 were in Orange County, Gregos said. There have been no records of infections in Hillsborough County.

Other places the amoeba calls home are man-made lakes, stormwater holding areas, warm water discharge areas near industrial plants, hot springs and soil, the CDC said.

REDUCING THE RISK

Health officials offer these tips to minimize the chances of getting infected by the Naegleria fowleri amoeba:

•Do not swim in warm, standing water such as lakes, ponds, poorly-maintained swimming pool, stormwater holding areas or in places that are posted "No Swimming." Bacteria and other harmful organisms thrive in warm standing water.

•Wear nose clips, hold your nose shut or keep your head out of the water when swimming, jumping or diving in any fresh water.

•Avoid swimming in bodies of fresh water during hot summer months when the water is warm and water levels are low.

•Do not dig or stir up the sand and silt while swimming in shallow water. Scientists say the amoeba lives in the mud and feeds on bacteria.

The infection cannot be spread from person to person or contracted from a properly maintained swimming pool.

Source: The Florida Department of Health

Reporter Ray Reyes can be reached at (813) 259-7920.

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