- A 10-year-old Texas girl has been killed by Naegleria fowleri, a brain-eating amoeba.
- She had gone swimming in the Brazos River earlier this month.
- The amoeba causes a rare brain infection called primary amebic meningoencephalitis (PAM) that’s almost always deadly — it has a fatality rate of more than 97%.
- This is the 147th case of Naegleria fowleri in the US since 1962; only four people have survived.
- These amoebas can be found in freshwater lakes, rivers, and hot springs, and enter the brain through the nose.
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Ten-year-old Lily Mae Avant died last night at the Cook Children’s Hospital in Fort Worth, Texas after an infection attacked her brain tissue.
On September 9, Avant reportedly complained of a headache and was sent home from school with a fever. Her parents rushed her to the hospital the following morning after Avant was unresponsive, according to a Facebook post by her cousin Wendy Scott. Doctors eventually concluded that she’d contracted a deadly brain infection called primary amebic meningoencephalitis (PAM).
PAM is caused by Naegleria fowleri, a brain-eating amoeba that can be found in warm freshwater around the world. Local NBC affiliate KCEN reported that Avant had gone swimming in the Brazos River near their Valley Mills home over Labor Day weekend.
The infection causes intense brain swelling and is almost always fatal — it has a fatality rate of more than 97%. Of the 147 documented cases in the US since 1962, only four people have survived.
Earlier this year, a 59-year-old North Carolina man died of the infection after swimming at a water park. In October 2018, a California boy contracted the amoeba after entering a hot spring in the Eastern Sierras, according to a CDC report. His symptoms set in 12 days after he’d gone swimming, and he died three days later.
Naegleria fowleri enters our brain through the nose
Naegleria fowleri is not found in saltwater; rather, it’s most common in freshwater lakes, rivers, and hot springs. The amoeba prefers high water temperatures, up to 115 degrees Fahrenheit.
Infections generally occur after people go swimming in these bodies of water. When the sediment in a lake or river gets disrupted, the amoebas are stirred into the water, which swimmers can then take in through their noses. The amoeba then uses the olfactory nerve to migrate to the brain. Infections have also been known to occur after swimmers inhaled inadequately chlorinated pool water.
People can’t get infected from swallowing contaminated water, however.
Toxicologist Bill Sullivan wrote in The Conversation that the amoebas settle in our brains because they’re moist and warm, just like their ideal habitat.
“But the brain doesn’t have bacteria for the amoeba to eat, so the organism attacks brain cells for nutrients,” he wrote.
As the parasite eats the brain, our body’s immune system fights back, which causes the intense swelling and inflammation in our skulls, Sullivan added. The pressure from this swelling eventually interrupts the brain’s connection to the spinal cord.
The infection causes vomiting, seizures, brain swelling, and death
Initial symptoms of PAM can appear up to nine days after infection, and include headache, fever, nausea, or vomiting. Later symptoms can include stiff neck, confusion, loss of balance, seizures, hallucinations, and coma. After symptoms manifest, the infection progresses rapidly and usually causes death within about five days.
“The initial symptoms can easily be mistaken for a less serious illness, costing valuable treatment time,” Sullivan said.
There is no quick diagnostic test for the amoeba, he added, so patients are often treated for viral or bacterial meningitis at first instead. That was the case for Avant.
By the time the infection is identified, it is often too late for patients, since “the presence of the parasite leads to rapid and irrevocable destruction of critical brain tissue,” Sullivan wrote.
This is the 36th case reported in the US since 2009
Avant’s was the 147th case of PAM reported in the US in the last 57 years. Only four of those patients survived — one in 1978, two in 2013, and one in 2016.
Between 2009 and 2018, 36 PAM infections were reported in the US. Of those cases, 32 people were infected after swimming in recreational water, three were infected after cleaning their nasal passages with tap water that turned out to be contaminated, and one person was infected by contaminated tap water used on a backyard slip-n-slide, according to the CDC.
Typically, most Naegleria fowleri cases occur in southern states, with more than half of all infections reported in Texas and Florida.