Texas woman dies from brain-eating amoeba after cleaning sinuses with tap water

www.nbcnews.com

The woman contracted a fatal infection caused by a brain-eating amoeba and died eight days after developing symptoms.

A Texas woman died from an infection caused by a brain-eating amoeba days after she cleaned her sinuses using tap water, according to a Centers for Disease Control and Prevention case report.

The woman, an otherwise healthy 71-year-old, developed "severe neurologic symptoms," including fever, headache and an altered mental status, four days after she filled a nasal irrigation device with tap water from her RV's water system at a Texas campsite, the CDC report said.

She was treated for primary amebic meningoencephalitis — a brain infection caused by Naegleria fowleri, often referred to as the "brain-eating amoeba." Despite treatment, the woman experienced seizures and died from the infection eight days after she developed symptoms, the agency said.

209 comments

So not just tap water but her RVs tap water. The attempt at scare-mongering - tap water - like it could happen to anyone is annoying.
- You can’t use tap water straight for Neti pots. I’m pretty sure every single neti pot tells you to boil the water first.
  
  I hope it tells you to let the boiling water cool, too. I feel like that's an important step.
  
  What's the difference between a neti pot and taking a shower? I'm pretty sure I get water up my nasal cavity every time I shower. Is the neti pot warning a cya thing or is there a greater risk?
- Well, they're not sure if the water came directly from the RV tank or the local water supply, so it certainly could have been tap water.
  The potable water tank, the investigation found, was filled before the woman bought the RV three months ago and could have contained contaminated water. The investigation also concluded that the municipal water system, which was connected to the potable water system and bypassed the tank, could have caused the contamination.
  The agency stressed the importance of using distilled, sterilized or boiled and cooled tap water when people perform nasal irrigation to reduce the risk of infection and illness.
  Sounds like the general idea is also just don't use tap water directly out of the tap if you want to run water through your sinuses (which is where these infections come from). They aren't saying that tap water is unsafe to drink. I don't see this as fear mongering at all.
- It could, with warming temperatures the bacteria is moving north. Showing up in areas unfamiliar with it
  But you’re way more likely to get it by swimming and just don’t pour water up your nose
- Buy Nestle's hidden-branded renamed shit instead! That's not literally just stolen tap water!
Neti pots and similar have very, very clear warnings that the water needs to be sterilized.
- Is it the powder that I'm dumping into the water every time? I was just doing it to follow instructions. If it's because of this, then thank goodness!
  [edit]I was definitely wrong, and there are some good guides on getting distilled water on YouTube! check 'em out[/edit]
  
  That powder is salt and will not sterilize the water. Used distilled water.
An investigation conducted by the agency found that the woman had not recently been exposed to fresh water but had performed the nasal irrigation using non-boiled water from the RV's potable water faucet "on several occasions" before her illness.
The potable water tank, the investigation found, was filled before the woman bought the RV three months ago and could have contained contaminated water. The investigation also concluded that the municipal water system, which was connected to the potable water system and bypassed the tank, could have caused the contamination.
A bit misleading to put so definitely "tap water" in the headline when this was 3 month old RV water.
- What's the bit about the municipal water system there for? Aren't they saying she could have used either
  
  Point is, if you're gonna flush your nose, boil the water at least. FFS.
- That's a lot of important context
- It was campsite water actually. If you read closely.
This wasn't the tap waters fault. This was the rv water tanks fault, most likely. Most people pretty much never clean\sanatize them.
- My friend, i have some baaad news for you
  
  I really don't think you do. It's an extremely rare event in treated public water systems in the US. The amoeba aren't really suited to survive in that water.
- Neti pot instructions typically state you need to use distilled or boiled water. You should follow these instructions regardless of the quality of your municipal water. It does not hurt to do so
  
  It does not hurt to do so
  Unless, like another commenter, you panic and forget to let the boiled water cool enough!
  
  Yeah. And q-tips say not to use them in your ears. Everyone wants to avoid a lawsuit.
Blows my mind, all the people that use anything besides freshly filtered boiled and/or filtered water for this.
- It blows my mind, that the richest country in one of the most developed areas on the globe is unable to provide save tap water.
  
  tap water from her RV's water system
  So basically water from a cistern. Not the public water system.
  
  In most if not all places, the municipal tap water is perfectly safe (old lead service lines, neglected areas, and occasional local boil-water advisories notwithstanding). Private wells are another matter, but there's often little regulation on those, but there is lots of guidance available.
  N. Fowelri requires something like 30 times the standard chlorine dose to kill. In municipal water systems, the most common source is biofilm that builds up in pipes in the water system and more often in the home/customer-side service line. This is especially true for older homes and poorly maintained apartment buildings.
  I know it's all the rage right now to shit on the US when and where one can, but our water system isn't the place to do it.
  Refs:
  https://www.epa.gov/ground-water-and-drinking-water
  https://www.epa.gov/dwreginfo/drinking-water-regulations
  https://www.epa.gov/ground-water-and-drinking-water/lead-and-copper-rule-improvements
  
  apparently she was using stale water thats been sitting around for quite some time, this breeds bacteria, and amoebas. amoebas love to eat bacteria so they are found where tons of bacteria are. this is the case for legionaries disease, the bacteria love to infest amoebas.
  the other kind of amoeba that can similar symptoms that also resulted in a brain eating form, is balumuthia amoeba.
  
  Dude, i live in a city with some of the best tap water in the world. That has fuck all to do with this.
  
  Why? Countries become rich by greed.
  I bet every "richest country in the world" in the history of earth had horrible poverty. How else would they become the richest country in the world? It's kinda an expected prerequisite
  
  Blame it on the idiots banning Flouridation and the like. Sadly, there's likely a large overlap with Netti-pot users.
  There's useful paranoia, and then there's this.
- Well it shouldn't. We're taking a lot of knowledge for granted when normally, we aren't all that bright in the first place.
  A lot of the theory learned isn't met in practice, so it's difficult to understand or recognize it.
  I mean, come on, how often does 'brain-eating amoeba' even come up as a subject in day to day life? Hard to pay attention to stuff that doesn't frequent your area of activities.
  
  I see stories about it at least once a year, and its the sort of thing that sticks out, even though I rarely flush my sinuses.
  
  I have heard of getting brain eating amoebas, mostly from swimming in lakes or still water. I think this is the first time I've heard about them coming from using a nettle pot. Looking it up, it looks like a lot of cases come from nettle pots, but "a lot" is relative. There are only a dozen or so cases a year from any source. I still wonder if any of those cases really come from city water or if they are from well and cistern water like this lady used. Either way, following the instructions that come with the pot would have saved those people.
  
  Yeah, but i also dont put water up my nose to cleanse what my mucous membranes already do.
- Blows my mind
  Not as much as it blows their minds.
  
  Save me a seat at your table in Hell.
- They even make nasal irrigation devices with built-in filters! Mine's a store brand from a local pharmacy.
  
  You want sterile, not filtered, water
I'm seeing many, many comments from people who have never used a neti pot or have questions. There are some basic answers, from a man who has, at times, safely used a neti pot.
You only use a neti pot with distilled water or previously boiled water. I use water fresh off a boil, cooled down just enough to where my nose can tolerate it. You can use that expensive gentle salt or table salt or sea salt, anything is fine.
You guys have no idea how satisfying it is when your head is all stuffed up with snot, blowing with a tissue is impossible....and you cycle some warm saline solution in your sinuses & a massive glob of 3-4 tablespoons of snot effortlessly glides out your other nostril into the sink & you can breathe again. It is a disgusting miracle when you're sick, it is amazing.
Let's clarify a few things -- always use distilled or previously boiled water, as the brain-eating amoeba is present in most of North America's waters. It can potentially survive water processing plants, and possibly domestic hot water tanks. The brain-eating amoeba can only survive in warm, moist environments....like your sinuses right next to your brain....it must be forcibly injected into there, so no cannonballs into the lake. No snorting untreated lake water. Normal swimming is okay.
You can use the neti pot too much. I was using it to aggressively clear out my sinuses for a year with limited success, and it turns out I am allergic to a mold or fungus at my workplace. Very frequent use of the neti pot only irritated my nose further, causing it to become inflamed (but not dangerous), and it would never ever cure the root problem: allergies. That was only fixed by pills & anti-histamine spray.
There is no need to be afraid of the neti pot, or the brain-eating amoeba, so long as you use the neti pot responsibly. Correctly.
- It's always been tempting to try a neti pot as my sinuses are always clogged and no amount of trying to blow my nose brings anything out
  But stories like the amoeba scare me to hell and back, even if I did everything right it would still scare me.
  
  So I'm an environmental microbiologist. If it's any consolation, these incidents are very rare despite people doing similar things frequently. Even if you do snort water that's home to Naegleria fowleri, infection isn't common. If you take basic precautions, you really don't have anything to worry about.
  
  As a former permastuff allergy sufferer, I can't recommend enough trying out triamcinolone (nasacort). I had tried nasal sprays in the 90s and early 2000s without any luck. About 5 or so years ago, my allergist recommend I give it a try again as a lot of formulas have come around since then and could work for me now. I couldn't believe it, no more permastuffed and there's smells everywhere. Learned that I love the smell of star jasmine flowers.
  For me, a puff in each nostril in the morning and another puff as needed when blowing my nose doesn't suffice (which is rare) has turned this perma-stuffed allergy sufferer into a not-perma-stuffed person.
  
  you can buy medical saline from the grocery store.
  
  To use a neti pot you use a saline solution. If you don't trust the water you got at home (boiled first, naturally, both to sterilize and allow for easier dissolution of the salt), you can just buy a bag of NaCl solution in any pharmacy instead.
  Just put the sealed bag into a pot of warm water first to bring it up to room temperature or slightly above. Flushing your sinuses with cold water ain't fun.
- Everything made sense at "Texas".
- I use saline I buy at the drug store for something like $1 a liter. No brain amoebas for me!
Campsite water system for RV's. I'm wondering if it was well water, and wasn't chlorinated?
- Very likely, but you're not even supposed to drink, let alone netipot yourself, the water directly from the water tank in a RV even if it was filled with chlorinated water. Sitting water always has the potential be become contaminated.
  
  You can't drink the water you put in a RV? Never heard that before.
Isn't precaution number one when using neti pots to never do it with plain tap water?
- Yes, but precaution number one when driving or riding in a motor vehicle is putting on your seatbelt and tons of folks dgaf about that either
- it's normal to use tap water anyway.
  
  "Normal" and "supposed to" don't always line up.
she filled a nasal irrigation device with tap water from her RV's water system at a Texas campsite
oh, that sounds gross. Way to many points of possible contamination.
If you read the fucking instructions you'll find it says use distilled water. But why read the instructions on a medical device when you can get your brains eaten instead?!
- To be fair, I made this error before. I was like why do they have those dumbass neti pots when you can just use shower water for free? Then that night I read about brain eating amebas and freaked tf out. In a panic I tried to boil some water to rinse my sinuses with, and since I was so panicked, I didn't wait long enough to let the water cool completely, and I'm pretty sure I burnt my sinuses and maybe even the part of my brain that's right there. I had a splitting headache for like a month and thought I was gonna die n had the brain eating ameba. I think in hindsight what's more likely is my sinuses and everything were burnt and my body was freaking out trying to fix it. 0/10 do not recommend.
  Use a neti pot and use boiled or distilled water. Don't be a dummy like me.
  
  I won't, I'll be a different kind of dummy.
  
  You just gave me a secondhand headache. Please be careful.
  
  Your Alzhaimer's chance just increased dramatically.
Gotta say, brain-eating amoebas are one of my fears.
- Irrational fear is one of the first symptoms
  
  Oh good, this is a very rational fear so we should be safe.
As a fellow American who hasn't had to put up with this nonsense in my state but still lives in this era of fascist billionaire overrun, I now have a better idea what it must feel like to live in Texas. But Jesus fuck, fix your ~~water~~ ~~utilities~~ ~~government~~ ~~education~~ ~~society~~ shit.
I'll just keep chilling out safely over here on Team Blow Your Nose With A Tissue.
- You can use steam to break up mucus, making it easier to use a tissue
I only clean my head holes with hard liquor.
My libertarian uncle swore basically anything could be cured with a neti pot. He forced me to use one when I was having issues with allergies.
It didn't help one bit and was one of the most uncomfortable experiences in my life. This just turns me off to it even more.
- Yeah, you’re not supposed to use it when you’re fully congested because the water will just get trapped and sit.
  There’s a bit of a learning curve and people hesitating can end up with the uncomfortable sensation of “water up your nose” but it really is awesome and life changing once you figure it out.
  
  I'll take your word for it. I'm never doing it again.
  
  you’re not supposed to use it when you’re fully congested
  Yes, ideally you use it BEFORE precisely to prevent this kind of state.
- most uncomfortable experiences in my life
  I'm not a medical doctor... but yeah, a neti pot won't fix a broken bone. That being said it should NOT be unpleasant at all! You should be able to breath, talk, heck even sing while using it. The water MUST be at exactly the right temperature (if you pour it on the back of your hand, it should not feel warm or cold) and the salt must be precisely the measured amount, not a gram more or less. This way it will not burn your nostril or give you any kind of reaction, just water flowing. If you do this right, which honestly takes a minute more, then it's not disturbing at all.
Where I live (France) the recommendation is to take lukewarm water, add salt, and that's it.
Is texas water catastrophically bad or am I totally wrong (or both)?
- I don't know the state of French plumbing, but there's always the possibility of contamination unless it's sterilized as it comes out of the tap.
  But yes, Texas water probably is pretty bad.
- It was from the water tank of an rv.
  But also, the quality of water systems in the us are more localized to smaller regional areas and not uniform state wide. Especially not in a large state like texas.
  
  It was from the wster tank of an rv.
  Holy hell, yeah I would be cautious to drink it 😬
- Every neti pot I’ve ever had recommends either:
  A) Warming distilled water and adding salt
  Or
  B) Boiling filtered tap water, adding salt, and letting it cool down to warm.
  
  What country 😁 ?
- Same thing in Germany. Just checked — no warning anywhere on the packaging and I've never heard about anything like this happening.
- Same thing in Belgium. ENT confirms that if you are in a normal random city you can use tap water, as-is.
  If you are traveling to another country or in a temporary setup then yes take extra precaution, like boiling and/or distilled.
- Most water is from underground aquifers but some cities like Austin use surface water from rivers or lakes. Underground water is naturally filtered, although there are some things that live there like the blind salamander, but surface water has stuff like amoeba. Normal tap water is chlorinated and pressurized but any time there is a power outage the water might have amoebas so they do a boil water notice.
- In the US, the labels suggest using distilled water or to boil tap water.
  Some water is great in TX, however this could have been well water that wasn't treated the same way as a city. Ive also lived on Louisiana, where they would issue boil advisories for tap water because the swamp water could have potentially mixed in with the water going into the treatment facility, increasing the chance of amoeba. It also depends on the pipe system being used. Given how expensive it is, cities don't regularly change out all the pipes unless there's a break in the water main and homeowners also don't normally change out piped until a problem is noticed. If there's a leaking pipe that you aren't aware of, there could be contaminants making their way into the cracks.
  The article says that this wasn't just tap water, but tap water from her RV. So if she hadn't cleaned the pipes or water storage tank in the RV, then the bug that killed her could have been on the RV side and not the tap.
  I normally see a couple articles every year about people dying from a brain eating bacteria or amoeba from using tap water in a nasal rinse. It's just safer to use distilled water, so that you know that nothing is in it.
- That's not safe. You should boil the water.
  
  You are correct, but there seems to be a strain of commeters here that don't even understand the difference between filtered and boiled water let alone germ theory or the fact that brain eating amoebas aren't everywhere on the planet...
You're supposed to use distilled water, genius as stupid mistakes go, that one's pretty low on the dumb-fuck-o-meter.
- you can also boil the water for 5 minutes
I don't know if brain eating amoebae are a common occurrence in tap water, but it woud explain a lot about Texas.
This is safe, if you boil the water.
- Yeeeeooowch!
The potable water in the Deregulated Texas Oblast is safe. Right? Did she have United Healthcare supplemental insurance?
I know I have an extremely biased experience set having been a health inspector in a place full of RV slums, but I would never trust any portion, interior or exterior, including internal systems, of a used RV.
- I won't even drink the water I put in my RV, even if it's from my house, let alone shove it up my nose.
This is why I only use river water
I'm getting convinced kennedy's worm caused this.
Anyone know if you can inhale these from a humidifier?
- the nose usually does a very good job at filtering stuff in the air, just don't rush in a cup of water directly in the sinuses
- Yep.
- Yes, you could, but you’re not gonna.
  Most humidifiers these days use sound pulses to aerosolize the water, my brain (without any need to look this up to confirm) likes to think anything living in the water gets blasted.
  I’m not gonna go snorting lines of humidifier air though
  
  Sound waves won't do anything about bacteria or spores. You'll need something like UV treatment.
  
  I watch Technology Connections so I use a wicked humidifier. But I also put sanitizer in the water.
  
  I kind of do that.....
- no.
  Humidifiers work by heating water to steam (boiling). This kills the aomeba
  
  Not cool mist humidifiers.
  
  Yeah thay would make sense for those types. I have a sonic one. It just kind of vibrates the air into mist. Saw a cool slow mo video on it.
Skill issue, didn't watch House M.D.
- she didn't die from lupus though
She has just been nominated to be RFK jr's deputy.
Can this happen in Sweden as well? 'Cos I clean mine with shower water almost every shower.
- Yep! It's the reason that every netty pot tells you to use distilled water.
  
  I don't use those, I just sorta throw it up there with my hands and a deep inhale. Feel it coming down my throat.
- Use distilled ONLY. With good chlorinated city water systems it's still very unlikely to happen, but it's such a horrible way to go, just get some distilled from the store.
  
  The amoeba can survive chlorination, that's why boiled or distilled is necessary
  
  Fine!
- I believe the amoeba grows in warm water, which is why hot springs in New Zealand are at risk. So hopefully you're more safe! You might want to check better info than me though!
What I don't get about this is that a gallon of distilled water is like .99 cents at your local grocery store in the US. This is not a huge problem to acquire safe water to do this.
For as much as I despise the pool water that comes out of my tap I can at least feel safe using my neti pot.
- pool water or no, it's safer distilled water.
  
  Thanks, dad.
Apparently this is why you can’t actually go in the Roman Baths in Bath.
Just pick your nose like a normal person. Sheesh.
Snorfing amoebae up one's nose turns out to have consequences.
I wonder if she'd just had rhinoplasty. A friend of mine is in recovery from that; she has to do this kind of sinus irrigation thing twice a day.
New fear unlocked!
Water from her RV. Yuck.
This was also literally the plot of an episode of House.
Dunno why the downvote, the episode in question was 8.17, titled "We Need The Eggs". The patient developed a brain-eating amoeba infection by using tap water in a neti pot.
Stop cleaning your sinuses in general, your body creates that mucus for a reason.
- It creates mucus to trap germs and other irritants. Nothing wrong with helping your body remove these from your body.
  
  Yeah, you have two methods to deal with the mucus: expectorating or digestion. I prefer to aid the expectoration. I use the NeilMed bottle, works better than any neti pot I tried, thing is a godsend when I need it.

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