Brain-Eating Amoeba (Naegleria Fowleri): All You Need to Know

The so-called brain-eating amoeba, or Naegleria fowleri, is a tiny microorganism that lives in warm freshwater bodies, such as lakes and rivers or hot springs. This single-celled parasite is harmless most of the time, but in certain situations, it can infect the human body through the nasal cavity and infect the brain, leading to a very rare but lethal infection known as primary amoebic meningoencephalitis (PAM). PAM is also a disease that progresses very rapidly. It results in a severe headache, fever, nausea, vomiting, and stiff neck. If it is not treated, it will progress to coma and death in a matter of days. This blog brings out detailed information on the brain-eating amoebas.

What is a Brain Eating Amoeba Infection?

Amoebas are single-celled organisms. The so-called brain-eating amoeba is a species described in 1965. Its scientific name is Naegleria fowleri. This ‘brain-eating ameba’ has a more descriptive name since it destroys the brain when it infects any parts of the brain.

Naegleria fowleri is seen in warm, shallow freshwater lakes, rivers, hot springs, and any other forms of waterbodies around the world. It inhabits soil as well. It is free-living because it does not require a qualified host for survival. Infection with this amoeba leads to a medical condition known as primary amoebic meningoencephalitis (PAM). PAM is extreme, affects the central nervous system, and is nearly always death-causing.

The water-entrenched nose is the fastest infection route that allows this type of amoeba to wear masks transnasally. Brain-eating amoebae are then transported through the nasal cavity to the brain. This is usually the case when one is swimming, diving, or engaging in activity such as water skiing in water infested with microbes. It is a remarkable health threat that is present even in the contemporary world. It requires measures such as avoiding polluted waters, using nose plugs when it is appropriate, and keeping away from still or warm waters.

Brain-Eating Amoeba Symptoms

The onset of signs and symptoms associated with primary amoebic meningoencephalitis (PAM) is abrupt and acute in nature, including

• Elevated body temperature.
• Dehydrating head pain.
• Expected nausea with or without vomiting.
• Aversion to eating.
• Convulsions.
• Shakiness.
• Meningeal signs include nuchal rigidity and intolerance to bright light.
• Disorientation.
• Loss of consciousness.

Note: The case mortality proportion remains in excess of 97% despite medical intervention. The incubation period after entry of N. fowleri amoebas into the nasal cavity ranges from 2 to 15 days. Most patients succumb within 3 to 7 days following the onset of symptoms. The average duration between the onset of symptoms and death is 5.3 days. Most cases of infection are known to end in death, with only a few patients from around the world being recorded to have survived.

Brain-Eating Amoeba Causes

The Centers for Disease Control and Prevention state that N. fowleri consumes only bacteria on a normal day, and this occurs within the water instead of the human host. But when it gets ingested in humans, this amoeba utilizes the brain as a source of food. Water containing the brain-eating amoeba (Naegleria fowleri) is the primary risk factor for infection with this parasite. In the majority of cases, this is via the nose since the amoeba comes into contact with the body and moves to the brain.

This infection is commonly caused by some particular elements, which include

• Engaging in water-based recreation, such as swimming or activities in any warm water body : Lakes and rivers and hot water springs pose a risk of coming in contact with Naegleria fowleri.
• Indiscriminately using chlorinated or unfiltered water for nasal irrigation : Any interaction that involves a water supply deemed to be unsafe for drinking can.
• Ingesting polluted or poisoned water : This is less frequent but still possible; consuming infected water is capable of causing an infection.

Brain-Eating Amoeba Diagnosis

With the low incidence and quick fatality of the disease, diagnosing a Naegleria fowleri infection is not an easy task. The signs and symptoms presented often overlap with those of other common infections, such as meningitis. Hence, some laboratory studies are performed for the diagnosis in order to search for the amoeba. However, some of the common methods used for diagnosis include

• Cerebrospinal fluid analyses : This test entails performing a spinal tap to obtain cerebrospinal fluid (CSF). Looking then into this fluid under the microscope helps in identifying the amoeba.
• Brain biopsy : On some occasions, it becomes essential to take a brain biopsy so as to obtain samples for testing.
• Polymerase chain reaction (PCR) test : This is a technique of molecular biology that is aimed at identifying the presence of Naegleria fowleri DNA in a given CSF or part of the tissue sample.

Brain-Eating Amoeba Treatment

The Naegleria fowleri amoebic meningoencephalitis treatment is complicated and usually consists of the medication combination. Since this condition is very aggressive in nature, the disease needs to be diagnosed and its treatment commenced without any delay. Common methods of treatment include the following:

• Antiparasitic medications : Drugs of this group are used in order to localize and exterminate the amoebas.
• Corticosteroids : These medications are effective in reducing brain edema.
• Antibacterial drugs : Since antibiotics will not work on the amoeba in most cases, they may still be prescribed to prevent or treat co-infections.

It should be emphasized, however, that the prognosis for infections caused by the brain-eating amoeba is poor even with the best that modern medicine can offer. The condition is capable of deteriorating at a fast pace, and the case fatality rate is considerably high. In the course of this, if one has any signs and symptoms that are suggestive of an amoebic infection of the brain, immediate treatment is obtained without delay.

How to Avoid Brain-Eating Amoeba Infection?

The following are some precautions in order to avoid brain-eating amoeba infection:

• Stay away from warm-bodied water sources like lakes or rivers, especially those that are affected by drought or low water levels.
• Put on nasal tape while taking a dip into warm water; ensure that no water is able to enter into the air passages of the nasal cavity.
• Do not use faucet water for nasal rinsing; use either sterile water or distilled water instead.
• Boil or filter water if having any doubt; boil it for not less than one minute or filter it with a filter whose pore size is 0.2 microns and below.
• Refrain from bathing in pools with non-flowing waters; non-flowing waters are likely to contain Naegleria fowleri.
• Particularly be careful of water fountains or splash experiences; make sure these are kept in good condition and the water is treated on a regular basis.

When to Seek Immediate Medical Attention from the Doctor

It is important to go to the hospital in case of having any of the below-mentioned warning signs:

• Intense pain in the head
• Considerable body temperature
• Feeling sick and neck tightness
• Mental disorientation
• Convulsions
• Inability to talk and more

The above signs may develop quickly, and therefore, it is important to seek medical care as soon as possible for the diagnosis and management of the condition. Do not be afraid to go see the doctor if you think you may have an infection caused by a brain-eating amoeba.

Conclusion

To sum up, Naegleria fowleri, also known as the brain-eating amoeba, poses health issues to many people, especially in water bodies. Even with modern practices in medicine, primary amoebic meningoencephalitis (PAM) is still associated with high fatality levels. As with any disease, the emphasis will be on the prevention strategy, especially in limiting exposure to untidy water, using nasal caps when required, and prompt treatment if there are any signs.

Yashoda Hospitals, Hyderabad, has also dealt with a few cases of brain-eating amoeba infection (primary amoebic meningoencephalitis, or PAM). They have a team of specialists trained to recognize and treat this rare and very aggressive condition. Yashoda Hospitals is able to offer care including evaluation, management, and rehabilitation.

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