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EPA Method 1615. Measurement of Enterovirus and Norovirus Occurrence in Water by Culture and RT-qPCR. Part III. Virus Detection by RT-qPCR
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Fatal Case of Splash Pad-Associated Naegleria fowleri Meningoencephalitis - Pulaski County, Arkansas, September 2023

Theresa M Dulski, Forrest Montgomery, Jeanette M Ramos

    MMWR. Morbidity and Mortality Weekly Report
    |March 27, 2025
    PubMed

    Insights

    A fatal case of primary amebic meningoencephalitis (PAM) in Arkansas was linked to a splash pad with inadequate disinfection. This highlights the risk of Naegleria fowleri in recreational water venues.

    Area of Science:

    • Public Health
    • Infectious Diseases
    • Environmental Health

    Background:

    • Primary amebic meningoencephalitis (PAM) is a rare but often fatal brain infection caused by Naegleria fowleri.
    • Recreational water venues, including splash pads, can pose an exposure risk if water is not adequately disinfected.

    Purpose of the Study:

    • To report a fatal case of PAM in Arkansas linked to a splash pad.
    • To emphasize the importance of proper disinfection and management of recreational water facilities to prevent Naegleria fowleri infections.

    Main Methods:

    • Epidemiologic, laboratory, and environmental data collection and analysis.
    • Public health investigation following a confirmed case of PAM.

    Main Results:

    • A fatal case of PAM was diagnosed in a child in Arkansas in September 2023.
    • Investigation identified a splash pad with inadequately disinfected water as the likely source of Naegleria fowleri exposure.
    • This is the third reported splash pad-associated PAM case in the U.S., all linked to insufficient disinfection.

    Conclusions:

    • Splash pads with inadequately disinfected water are a potential source of Naegleria fowleri exposure.
    • PAM should be considered in patients with acute meningoencephalitis and a history of freshwater exposure, including recreational water.
    • Proper design, operation, and management of splash pads are crucial for preventing Naegleria fowleri infections and other illnesses.

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