We’re a step closer toward curing a disease caused by brain-eating amoebas

A while back, I wrote about brain-eating amoebas. And it wasn’t science fiction. It was about Nagleria fowleri, a one-celled creature that is found in bodies of warm water such as lakes, rivers, streams, inadequately chlorinated swimming pools and warm water waste outflow from industrial plants. These amoebas have also been found in inadequately cleaned neti pots. In the U.S., Nagleria follow warm weather. They are more common in southern states, but can be found farther north during the summer months.

What’s the big deal about Nagleria, and some associated amoebas? For starters, they can cause primary amoebic meningitis (PAM), which is almost always fatal. To be clear, PAM is rare. There aren’t many reported cases in the U.S., but there have been some. If you swim, dive or use a neti pot, you need to be aware of it.

Nagleria fowleri, via Wikimedia Commons

Nagleria fowleri, via Wikimedia Commons

It is more common in men and boys, possibly due to doing more activities that stir up debris in water. You can’t get infected with PAM by drinking water containing these amoebas, but you can if the water containing the amoebas gets into your nose.  The amoebas swim up to the cribiform plate (the interface between the upper part of the nose and the base of the brain), and can penetrate there through a number of tiny holes that allow nerve fibers to pass out of the brain. They then enter the brain and start eating. They set up an inflammatory process and the patient subsequently dies because, until now, there was no cure.

Enter miltefosine, a drug that was used to treat leishmaniasis, a different kind of parasitic infection.  With PAM being incurable, physicians were trying other drugs that might possibly help.  They gave miltefosine a try a few years ago, with some mixed results. The drugs were hard to get, as they were manufactured in Germany, and the delay — coupled with the fact that it was a last resort measure — led to the tests being unsuccessful. However, as more cases of PAM occurred, doctors in the U.S. and other countries kept trying the drug. The results improved as more people were treated.

However, even when supplies were obtained, there were no controlled studies on miltefosine that showed, conclusively, that it did work.  So the CDC and FDA got together, and now the drug is available in the U.S., through the CDC, for the treatment of PAM and leishmaniasis, in hopes of showing that the disease can be cured once and for all.

Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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18 Responses to “We’re a step closer toward curing a disease caused by brain-eating amoebas”

  1. martin says:

    Seems like the planet may be trying to cure itself of this very dangerous infestation of humans

  2. Mike_in_the_Tundra says:

    Oh, I’m sorry. Did I write something that made you think I was being rational? Every once in awhile, something really spooks me. This is one of those things. Several years ago, there was a commercial for a toenail fungus medication. The commercial was so gross that I developed a fear of getting toenail fungus. Despite my doctor’s reassurances, it took me a long, long time to get over it. Right now, I’m using Simply Saline for my sinuses.

  3. The_Fixer says:

    Ah, I see the byline has changed and you are indeed the author, Dr. Mark. Thought it was strange that Jon was writing medical-interest articles.

    Thanks for the info, I will take your advice. I’ll get distilled water and boil that. I use these packets that are specifically made for neti pot irrigation. They have non-iodized salt and baking soda in them. They were supposedly formulated by a doctor.

    While it’s a convenience to have sterile saline water, it’s not really a problem to boil distilled water that I get from the supermarket.

    Thanks again!

  4. docsterx says:

    Mike, See the comment I did above about neti pots and making a solution to use for irrigation.

  5. docsterx says:

    The_Fixer this may help with cleaning your neti pot and preparing the liquid you use to irrigate.

    If the material that the neti pot is made from can stand it, fill it with boiling water. Let it stand for several minutes (~7), then discard water. Or immerse the neti pot in the boiling water and boil for 5-7 minutes.

    Boil tap water for at least 3 minutes. Let cool. Then add to neti pot and irrigate. If you prefer to use a saline solution for irrigation, you can mix 1 tsp of table salt (non-iodized) to 8 oz of water. Boil as above, let cool, fill neti pot and irrigate.

    Or you can ask your doctor to write you an Rx for sterile water for injection, or sterile saline (0.9%) for injection in one liter bottles. Saves you from making your own. Will cost about $7/liter.

  6. docsterx says:

    Yeah, but getting a Vv skin infection isn’t common and, most times it WILL respond to antibiotics.

  7. Indigo says:


  8. docsterx says:

    Here are some photos of people who have vibrio vulnificus skin lesions. WARNING – graphic images. http://safeoysters.uga.edu/medical/symptoms.html

  9. nicho says:

    That happens to people who use tap water.

  10. Indigo says:

    This lis tough to accept. I would just as soon spend my day at the beach body-surfing as sitting at my laptop, cybersurfing.

  11. Indigo says:

    There’s also a bacteria that thrives in salt water. Several Floridians have succumbed already this summer:

  12. The_Fixer says:

    Well, yeah, there’s the other, too, but didn’t want to get too gross on a Sunday morning.

    Later on in the day? Oh yeah, I’ll get gross :)

  13. Gindy51 says:

    People peeing is about the least thing you have to worry about in any body of water.

  14. RepubAnon says:

    So, the brain-eating amoebas are typically found in the South, and the South is heavily Republican.


  15. bkmn says:

    But if we get rid of brain eating amoebas where will the Republicans get their base?

  16. The_Fixer says:

    I have, and use, a neti pot on occasion. It’s not the cure-all that some people claim it to be, but I do find it helpful.

    After having got wind of this amoeba that eats brains like a zombie, I got extra careful about cleaning the thing. I wash it with very hot water before and after every use, and use an alcohol-based disinfectant before using it. I’m not sure if that kills the amoeba, but it’s gotta kill other stuff that’s not good for you.

    After emerging from a rural lake itching after swimming some 30 years ago, I decided that swimming in places like that was something I wasn’t going to do any more. I haven’t missed it, it’s really kind of gross to be sharing the same warm, stagnant water with strangers (some of whom may even be peeing in it!), if you think about it.

    So, I hope I’m covered. I let a friend who uses s neti pot know about this, he was clueless about it. This is one of those crazy, seemingly innocent things in life that can kill you if you’re not paying attention. This is good information to get out there, Jon.

  17. Mike_in_the_Tundra says:

    I have cleaned my neti pot to the point that it practically sparkles, and I bought distilled water. However, I can’t make myself use it since I read about those amoebas.

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