Wednesday, July 8, 2015

Primary amoebic meningoencephalitis

A rare swimmer's infection that killed two children in Washington County is suspected in the critical illness of a child who had been swimming in a western Minnesota lake.  The child developed a brain infection after swimming at Lake Minnewaska in Pope County. The Minnesota Department of Health is investigating whether the infection is a case of primary amoebic meningoencephalitis, the disease that killed two children who swam at Lily Lake in Stillwater in 2010 and 2012.  If the disease is confirmed in this case, it will be further evidence that the amoeba that causes it is strengthening its foothold in the Northern states. Before the 2010 Minnesota case, the PAM infection had not been detected north of Missouri, according to the Department of Health.

Symptoms including headache, fever, nausea and stiff neck start within a week, usually at about five days after swimming. The disease progresses rapidly to cause confusion, loss of balance, seizures and, often, death within another week.  Seven-year-old Annie Bahneman died of PAM in August 2010 after swimming in Lily Lake. It was an unusually warm summer and officials weren't immediately certain that Bahneman was infected in Lily Lake, so the beach remained open until 2012, when 9-year-old Jack Ariola Erenberg died of the same infection after swimming there...

The amoeba Naegleria fowleri thrives in warm bodies of freshwater and sediment. Infections are most common between July and September, when air and water temperatures have been high for prolonged periods.The amoeba causes a deadly infection only when it enters the body through the nose. From there, the parasite travels through olfactory glands to the brain. It cannot spread from person to person.

The only certain way to escape infection is to avoid swimming and other activities in warm freshwater.

If you swim, avoid getting water up your nose by keeping your head above water, holding your nose shut or wearing nose clips. Also avoid stirring up the sediment.

Courtesy of a friend


  1. A 14-year-old boy is critically ill after he contracted a brain-eating amoeba while swimming in a lake.

    Hunter Boutain, of Alexandria, Minnesota, is in a coma at University of Minnesota Medical Center in Minneapolis after swimming in Lake Minnewaska on Tuesday.

    He is being treated for suspected primary amebic meningoencephalitis (PAM), a rare and often fatal brain infection caused by the Naegleria fowleri amoeba which is found in warm freshwater.

    Bryan Boutain, Hunter's uncle, said on Wednesday: "As of this afternoon, Hunter is still in the hospital and remains in critical condition.

    "This is a difficult time for our family. We are grateful for the support we've received, and welcome everyone's continued prayers."


  2. A brain-eating amoeba might be behind the death of a 14-year-old boy in Minnesota, health officials say.

    Hunter Boutain became ill after swimming in Lake Minnewaska, in the west-central area of the state. He died Thursday.

    “Hunter’s condition deteriorated throughout the night and he was declared brain dead (Thursday) morning,” the Boutain family said in a statement. “Hunter died surrounded by his family. It is a deeply emotional time for all us.”...

    It is a very rare, but deadly brain infection caused by the Naegleria fowleri amoeba.

    A California woman died from the same infection earlier this month.

    But there were only 35 cases in the United States between 2005 and 2014. Since 1952, there have been about 133 known cases. According to the Centers for Disease Control and Prevention, only three people survived.

  3. A brain-eating amoeba that killed two people in two weeks ago has turned up in the water supply of a Louisiana county near New Orleans for the second time in two years.

    The water supply of St. Bernard Parish (Louisiana counties are called parishes), which is located five miles outside of downtown New Orleans, is undergoing a 60-day chlorine “burn” to eradicate Naegleria fowleri, the Louisiana Department of Heath and Hospitals announced.

    Officials say the burn is being conducted “out of caution,” adding that the tap water is safe to drink because you cannot become ill by drinking infected water. However, they warn that residents should avoid getting water in their noses because it can infect people via that route. It travels up the nose and into the brain, where it typically causes an infection of the lining around the brain (meningitis) and inflammation of the brain (encephalitis). Symptoms often include severe headaches, fever, and a stiff neck.

    Infection with the amoeba is often deadly. A teenage boy died this month after developing an infection believed to have been caused by Naegleria fowleri that he came into contact with while swimming in a lake. Hunter A. Boutain, 14, died from primary amoebic meningoencephalitis (PAM), a rare infection of the brain caused by the amoeba, just 48 hours after he went swimming in Minnesota’s Lake Minnewaska. He was hospitalized after his swim and was unresponsive hours later.

  4. Officials now say a Minnesota teenage boy who died suddenly in early July was not killed by a brain-eating amoeba, as previously suspected.

    Hunter A. Boutain, 14, died from streptococcal meningoencephalitis, a form of bacterial meningitis, the Minnesota Department of Health announced on Monday.

    A spokesman for the department told CNN that Boutain suffered a skull fracture before he was infected, which can make a person more susceptible to meningitis.

    It was previously believed that Boutain died from primary amoebic meningoencephalitis (PAM), a rare infection of the brain caused by the deadly, fresh water-dwelling amoeba Naegleria fowleri. Boutain had been swimming in Minnesota’s Lake Minnewaska and died just 48 hours later. He was hospitalized after his swim and was unresponsive hours later, The Associated Press reports.

    However, the Minnesota Department of Health warns that the brain-eating amoeba is still a threat: “The results also do not change the fact that there is always a very low-level risk of infection with Naegleria fowleri when swimming in fresh water.”

    The news of Boutain’s death was eerily similar to a report that surfaced in July of a 21-year-old woman who died of PAM after swimming in a lake in Reno, Nevada.

    The woman, whose identity has not been released by her family, first experienced a headache, nausea, and vomiting on June 16, the Reno Gazette-Journal reports. She was hospitalized and diagnosed with meningitis, before experiencing cardiac arrest and dying on June 20. (Testing conducted by the Centers for Disease Control and Prevention was positive for Naegleria fowleri.)

  5. Michael Riley Jr., an energetic honors student and runner, has qualified for Junior Olympics three times in cross country.

    But the 14-year-old was in critical condition Monday night at Texas Children’s Hospital battling a rare brain-eating amoeba and fighting for his life.

    Michael was placed into a medically induced coma and his family said Monday night he had more swelling around his brain.

    Doctors believe the amoeba, called Naegleria fowleri, entered through the child's nose and swam into his brain when Michael, on a trip with his new high school track team and coach, jumped into a lake at the Sam Houston National Forest on Aug. 13. A week later, the youngster was disoriented, had a fever, a severe headache and neck pain, symptoms similar to those of meningitis. The severe brain infection is known as primary amebic meningoencephalitis (PAM).

    Doctors at Texas Children’s Hospital recognized Michael's symptoms from another case in the area. That child didn’t survive.

    Officials with the Center for Disease Control and Prevention in Atlanta say the condition is fatal 95% of the time and so far three people have died from it this year.
    Courtesy of:


  6. A Texas teenager who contracted a rare brain-eating disease after swimming in a lake about 70 miles (110 km) north of Houston has died, according to his family and local media.

    The 14-year-old Michael Riley Jr., a junior Olympian and honor student, seemed to have contracted the disease after he went swimming on Aug. 13 with his track team, his father Mike Riley told KTRK earlier this week.

    Courtesy of

  7. A 13-year-old Arkansas girl, who is one of only three people in the United States known to have survived a brain-eating amoeba, is back enjoying swimming after contracting the infection at a water park last year.

    “I have a swimming pool in my backyard. I go swimming in that as much as I can,” Kali Hardig told ABC News’ “20/20.” “In fact I was in it yesterday for I don't know how long.”

    Hardig was swimming at Willow Springs Water Park in Little Rock, Arkansas, last summer, when she became sick with a fever, nausea and severe headaches.

    “I started with a real bad headache, and all of the sudden the headache just started getting worse, so I told momma,” Hardig said.

    “And I knew when her eyes rolled back in her head, I knew something bad was wrong,” Traci Hardig, Kali’s mother, told “20/20.”

    Traci Hardig and her husband raced their daughter to Arkansas Children’s Hospital in Little Rock, where she was diagnosed with having contracted primary amoebic meningoencephalitis – a rare form of meningitis caused by the amoeba Naegleria fowleri.

    “Naegleria is an infection that you can’t get by just swallowing some water. The water actually has to get splashed up your nose,” said Dr. Matthew Linam, who treated Kali at the time. “The amoeba, when it’s out in the environment, uses bacteria as a food source. Once it gets in the brain, it doesn’t have those bacteria for food so it starts attacking nerve cells as food.”

    Kali Hardig was in critical condition for weeks but eventually recovered and went home last September. According to the Centers for Disease Control and Prevention, there have been only 133 known infections like Kali Hardig’s in the United States in the past 50 years.

    After her ordeal, Hardig said she was scared to come in contact with water, even to take showers, at first.

    “I was afraid to take a shower because I know that I got it from water, and I was thinking that it could be from all kinds of water, that it could be in the shower,” she said.

    After undergoing treatment and intensive cognitive and physical therapy, Hardig now is looking forward to playing for the volleyball team when school starts.

    When asked about whether she wishes to forget the ordeal, Hardig said, “Actually I hope I never forget it because it's something that I've got to experience but never want to experience again."

  8. Brain-eating amoebic meningioencephalitis may not be as rare a disease as thought, delegates at the American Medical Association’s annual meeting in Chicago, IL said today.

    Known more formally as “primary amoebic meningioencephalitis” or PAM, the illness is caused when freshwater amoebae get into the brain through the nasal passages.

    That can happen by breathing in contaminated fresh water, or tap water.

    Three organisms, Naegleria fowleri, Balamuthia mandrillaris, and Acanthamoeba can cause PAM.

    The AMA is considering a resolution to alert physicians nationally to be on the lookout for this disease, once thought to be incurable but now seen to respond to rapid treatment.

    Effective treatment calls for early diagnosis and the US Centers for Disease Control and Prevention (CDC) has set up hotlines where physicians who suspect PAM can get rapid diagnosis.

    It is caused by amoebae that live in warm fresh water and once they migrate through the nose can set up in the brain as encephalitis.

    “It looks like encephalitis but the patient will often be unsalvageable,” a delegate from the American Association of Public Health Physicians reported. “We’ve got the potential to save lives but the CDC needs to work really fast to tell people not to swim without nose clips and not to use Neti cups [devices made to clear the sinuses by deliberately inhaling water] unless they boil the water first, because the amoeba can survive public water treatment.”

    One strategy under consideration nationally is making PAM a reportable disease. Though cases are still rare, the fact that they could go unrecognized and be dismissed as encephalitis of unknown origin means the disease may be far more common than recognized.

    There have been recent reports of patients quickly diagnosed and treated surviving PAM, the delegates learned.

    The experimental drug miltefosine has shown promise in treating PAM, according to the CDC.

    Delegate Jim Caruso, MD told the delegates “I’ve made the diagnosis twice, but at autopsy—I’m a pathologist.”

    About a dozen cases are reported in the US annually, which Caruso said is likely “the tip of the iceberg.”

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