-Published: Wednesday, January 8, 2020-





By the A.M. Costa Rica staff

Authorities of the Ministry of Health Tuesday confirmed the detection of a very isolated case of meningitis caused by the killer organism Naegleria fowleri, also known as the brain-eating amoeba.

According to the ministry, the case involves a 15-year-old who was infected after having inhaled water while he was swimming in a natural hot spring in Guayabo de Bagaces, Guanacaste. He died Tuesday night.

This microorganism found in warm fresh waters like lakes, rivers and hot springs, said the ministry.

"The young man who was infected by primary amoebic meningitis remains in a fragile health state at the Liberia Hospital," said the ministry said in its statement.

The organism enters through the nose to reaching and destroying brain tissue, said the authorities.

It is important to clarify that the infection is not transmitted from person to person or by drinking water or any body parts in contact with the hot spring water. It is only transmitted by the inhalation of water through the nose, said specialists.

According to the ministry, this is the second case that has been reported in Costa Rica's medical records.

The first case was in 2014, when an 11-year-old U.S. citizen youngster arrived in the country when he already had infected by the organism. The boy died after receiving medical treatment when the family immediately went back to the U.S.

According to the ministry's report, in the U.S. 34 cases of deaths from this organism have been recorded in the last 10 years. The organism is not really  amoeba but  similar single-cell member of the phylum Percolozoa.

The authorities called on the population to increase safety measures when they are swimming in hot springs because the infection is only transmitted through the nose. "A person can make use of the hot springs with the presence of said microorganism without any infection. The risk is presented when submerged since it facilitates the entry of the parasite by nasal route."

The way to avoid the organism is not to immerse the head in hot springs, or if you do, use devices that block the passage of water through the nose.

According to the U.S. Centers for Disease Control and Prevention, CDC, Naegleria is commonly found in warm fresh water and soil. Only one species of Naegleria infects people: Naegleria fowleri.

"Naegleria fowleri infects people when water containing the amoeba enters the body through the nose. This typically occurs when people go swimming or diving in warm freshwater places, like lakes and rivers. The Naegleria fowleri amoeba then travels up the nose to the brain where it destroys the brain tissue," said the CDC.

According to the specialist, people cannot be infected with Naegleria fowleri by drinking contaminated water. In very rare instances, Naegleria infections may also occur when contaminated water from other sources, such as inadequately chlorinated swimming pool water or contaminated tap water, enters the nose, "for example when people submerge their heads or cleanse their noses during religious practices, and when people irrigate their sinuses nose using contaminated tap water."

Naegleria fowleri has not been shown to spread via water vapor or aerosol droplets, such as shower mist or vapor from a humidifier, said the CDC.

According to CDC, in the 10 years from 2009 to 2018, 34 infections were reported in the U.S. Of those cases, 30 people were infected by recreational water, three people were infected after performing nasal irrigation using contaminated tap water, and one person was infected by contaminated tap water used on a backyard slip-n-slide.

The symptoms of Naegleria fowleri causes the disease primary amoebic meningoencephalitis, known as PAM, a brain infection that leads to the destruction of brain tissue. In its early stages, symptoms of PAM may be similar to symptoms of bacterial meningitis.

Initial symptoms of PAM start about five days (range 1 to 9 days) after infection. The initial symptoms may include headache, fever, nausea, or vomiting. Later symptoms can include stiff neck, confusion, lack of attention to people and surroundings, loss of balance, seizures, and hallucinations. After the start of symptoms, the disease progresses rapidly and usually causes death within about five days with a range of from one to 12 days, said the CDC.

"The fatality rate is over 97%. Only four people out of 145 known infected individuals in the United States from 1962 to 2018 have survived," said the specialists.

Personal actions to reduce the risk of Naegleria fowleri infection should focus on limiting the amount of water going up the nose and lowering the chances that Naegleria fowleri may be in the water. For more information on reducing the risk of infection in specific situations, visit the CDC site.

A.M. Costa Rica urges readers to share this alert with their contacts.



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What other recommendation would you give to avoid contact with this type of organism? We would like to know your thoughts on this story. Send your comments to news@amcostarica.com