Death by a brain-eating amoeba – a line that reads like something out of a sci-fi movie script. In Florida, however, that is exactly what has become a reality. As the health department in Charlotte County announced, a person recently died there after becoming infected with the protozoa. Accordingly, the patient was probably doomed by a nasal douche.

Naegleria fowleri is the name of the species of amoeba which, once it has made it into the human brain, can cause such damage that infection with it is usually fatal. However, such infections are very rare. Because the amoeba can only get into the human body via one route: with water through the nose. From there, the protozoa can penetrate into the brain, where it triggers infections. Since this destroys brain tissue, the protozoa is also commonly referred to as a brain-eating amoeba. Drinking contaminated water, on the other hand, is harmless and cannot cause an infection.

According to the Robert Koch Institute (RKI), Naegleria infections are “all associated with bathing, especially diving, in warm (over 30°C) fresh water”. The protozoa prefers warm fresh water such as lakes and rivers. The Florida case, however, is probably different. The authorities there do not assume that an infection occurred while bathing, instead the CDC cites a solution prepared with tap water for rinsing the nose as a possible cause.

Infection with Naegleri fowleri is extremely dangerous. The disease, called primary amoebic meningoencephalitis or PAM for short, initially manifests itself with symptoms such as high fever, vomiting and a stiff neck, over the course of which those affected become comatose and die within a few days.

The Robert Koch Institute speaks of around 250 known PAM cases worldwide, with a high number of unreported cases being assumed. In the USA, 154 infections are known between 1962 and 2021, only four of those affected survived. According to the CDC, the death rate is over 97 percent.

PAM remains difficult to treat. The CDC recommends a combination of different active ingredients. Due to the rapid course of PAM, however, timely and therefore efficient therapy has only rarely been successful, according to the RKI.

Those: RKI, CDC, Charlotte County