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A Case of Primary Amebic Meningoencephalitis Associated with Surfing at an Artificial Surf Venue: Environmental

Shanna Miko1, Jennifer R Cope1, Michele C Hlavsa1

  • 1U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333.

ACS ES&T Water
|May 22, 2023
PubMed

Insights

A fatal case of primary amebic meningoencephalitis (PAM) was linked to an artificial surf venue. Investigations found Naegleria fowleri in the water, highlighting risks at untreated recreational sites.

Area of Science:

  • Environmental microbiology
  • Infectious diseases
  • Public health

Background:

  • Naegleria fowleri is a thermophilic ameba causing primary amebic meningoencephalitis (PAM).
  • PAM is a rare but often fatal infection of the central nervous system.
  • Exposure typically occurs through nasal contact with warm freshwater.

Purpose of the Study:

  • To investigate the source of a fatal PAM case in Texas.
  • To identify the specific water exposure linked to the infection.
  • To assess the role of artificial recreational water venues in Naegleria fowleri transmission.

Main Methods:

  • Conducted an epidemiologic investigation of the patient's activities.
  • Performed environmental sampling at suspected water exposure sites.
  • Tested water and sediment samples for the presence of Naegleria fowleri and other thermophilic amebae.

Main Results:

  • The patient's most probable exposure was surfing in an artificial surf venue.
  • The venue's water was unfiltered, un-recirculated, and lacked documented disinfection or quality testing.
  • Naegleria fowleri and other thermophilic amebae were detected in the venue's water and sediment.

Conclusions:

  • Artificial surf venues pose a potential risk for Naegleria fowleri infection.
  • Current recreational water safety standards may not adequately address novel venues.
  • Public health officials and clinicians should consider these venues in PAM investigations.
Keywords:
Naegleria fowlerienvironmentalprimary amebic meningoencephalitisrecreational water

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