H5N1

US: Brain-eating amoeba forces closure at North Carolina waterpark after death

Via The Guardian: Brain-eating amoeba forces closure at North Carolina waterpark after death. Excerpt:

A North Carolina waterpark has shut down rafting activities after an Ohio teenager was killed by a brain-eating amoeba.  

Lauren Seitz, 18, died last Sunday after she was exposed to the amoeba at the US National Whitewater Center (USNWC), a Charlotte-area center where she went with a church group earlier this month. According to officials from the Centers for Disease Control and Prevention (CDC), Seitz died of a rare brain infection caused by the amoeba Naegleria fowleri.  

“Initial test results found Naegleria fowleri DNA was present in the whitewater system,” the USNWC said in a statement. At a press conference, Mecklenburg County health director Marcus Plescia said most of 11 samples tested by the CDC this week showed preliminary evidence of the amoeba.  

“On behalf of the USNWC, I wish to express our sincere condolences and sympathies to Lauren and her family,” chief executive Jeffrey Wise said in a separate statement. “Our focus is always on stressing safety and risk in the most appropriate manner possible.”  

State health officials noted that the amoeba is common in warm lakes, rivers and springs in summer, and said in a statement that it does not cause illness if swallowed, but can be fatal if forced up the nose. The one-celled organism does not survive in saltwater and cannot infect a person who drinks contaminated water. 

In the event of brain infection, the amoeba causes illness up to nine days after exposure. Symptoms include headache, fever, vomiting, confusion, seizures, loss of balance and hallucination. Death usually follows within five days. The fatality rate, according to the CDC, is more than 97%.

US: Minnesota boy dies of Naegleria

Via CBS News: Brain-eating amoeba kills Minnesota boy. Excerpt:

A Minnesota teenager who contracted a brain-eating amoeba while swimming in a lake has died of the rare infection, relatives said. 

Hunter Boutain, 14, contracted the disease on Tuesday as he swam in Lake Minnewaska, Minnesota Health Department officials said. He remained in critical condition at the University of Minnesota Medical Center where he died Thursday morning, CBS Minnesota reported. 

"Hunter's condition deteriorated throughout the night and he was declared brain dead this morning," said his uncle Bryan Boutain, in a statement. "Hunter died surrounded by his family. It is a deeply emotional time for all us. We ask for privacy and prayers as we remember our beloved Hunter." 

The disease is caused by an amoeba often found in freshwater and can enter the brain in water inhaled through the nose. 

There have been just 35 confirmed cases of the freshwater amoeba, nationwide, in the past decade. Two of those were in Minnesota.

For more on Naegleria fowleri, see this 2012 blog post by Rosemary Drisdelle.

US: Child visiting St. Bernard Parish dies from rare encephalitis infection

Via NOLA.com: Child visiting St. Bernard Parish dies from rare encephalitis infection, CDC confirms. Excerpt:

The federal Centers for Disease Control and Prevention on Thursday confirmed that a 4-year-old child visiting a St. Bernard Parish home died from primary amebic meningoencephalitis, a brain infection that leads to the destruction of brain tissue. It is a rare infection that previously had been associated with two deaths traced to water in Louisiana in 2011, according to the state Department of Health and Hospitals. 

The 4-year-old allegedly contracted the illness in late July while in the Violet area and then died in August, according to parish President Dave Peralta. The DHH just recently received the water tests results back from the CDC. 

"The kids were playing on a Slip 'n Slide over a period of 10 to 12 hours," Peralta said. "And from what the CDC has told us, it grows in fresh, hot or warm water and is introduced in the nasal passages and then affects the brain. 

"But we are taking many precautions, flushing the parish water system and we will continue to take every precaution," Peralta said. "Before it was even confirmed, we started immediately testing at all sites across the parish. 

"There is absolutely no reason for us to believe that this stuff was ever in our water system." 

In the 10 years from 2001 to 2010, only 32 infections were reported in the United States, according to the CDC. Of those cases, 30 people were infected by contaminated recreational water and two people were infected by water from a drinking water supply. 

Only about 120 U.S. cases — almost all of them deaths — have been reported since the amoeba first was identified in the early 1960s, according to the CDC. About three deaths are reported each year, on average. In August, a 12-year-old Florida boy died after contracting the infection. 

Earlier in August, a 12-year-old Arkansas girl survived the infection after being given an experimental breast cancer drug and having her body temperature lowered. Officials believe she is only the third person to survive this infection. 

The DHH states that people cannot contract the infection by drinking contaminated water, because stomach acid will kill the amoeba. Naegleria fowleri -- which can cause encephalitis -- infects people by entering the body through the nose.

Vietnam's 2nd case of deadly brain-eating amoeba still puzzling

Via Thanh Nien Daily: Vietnam's 2nd case of deadly brain-eating amoeba still puzzling. Excerpt:

Doctors in Ho Chi Minh City have revealed surprising findings about Vietnam’s second case of a rare brain-eating amoeba, but much about the recent death is still a mystery. 

Speaking at a conference on Tuesday, Dr. Phan Van Hieu, director of HCMC Center for Forensic Science, said the number of the amoeba, Naegleria fowleri, in the brain of the six-year-old victim, and the extent of the damage to his brain, suggested that the organism had entered his body just over one week before he died on August 12. 

However, diagnosis of an abscess – a pus-filled cavity formed from inflammation in response to bacterial infection – in the brain suggested that the brain could have been attacked by the amoeba for at least one month, Hieu said. 

The forensic center’s report presented by Hieu at the conference stirred and puzzled experts, VnExpress reported.  

Usually people develop first symptoms of amebic meningoencephalitis (PAM) - a brain inflammation and nervous system disease caused by the organism - within one to seven days since exposure, and they die within one to 12 days since the first symptoms. 

Dr. Truong Huu Khanh, head of the infection and neurology department at Children Hospital 1, even raised doubts about the earlier diagnosis that concluded that the boy died because of PAM caused by Naegleria fowleri. 

But that suspicion was soon rejected by Dr. Dinh Nguyen Huy Man, chief of testing department at the HCMC Hospital for Tropical Diseases, which conducted the tests together with the forensic center, the news website said. 

Meanwhile, Dr. Nguyen Van Vinh Chau, director of the tropical diseases hospital, said that if the findings were really true, it would be one of the world’s rarest cases of the disease. He stressed that there has been only one case in which a patient survived as the amoeba weakened and finally died. 

In fact, Hieu said he would probably present the findings at conferences on the amoeba in other countries, according to VnExpress. 

As much as it was shocking, the latest report still failed to find out where the boy contracted the organism – a question that has puzzled local experts and officials since the case was reported.

Pakistan: No risk of Naegleria if water boiled or chlorinated, say experts

Via The News International: No risk of Naegleria if water boiled or chlorinated, say experts. Excerpt:

Outbreaks of bird flu, dengue fever and now the ‘brain-eating’ Naegleria fowleri have all made people very concerned about their health, but this brain infection, caused by the amoeba Naegleria entering through the nose, can be avoided.   

This was the consensus of experts who spoke at a public health awareness programme organised by Aga Khan University Hospital (AKUH) on Thursday.   

They advised the people to keep their head out of the water while swimming and prevent water going up the nose during showering and bathing.   

Moreover, experts recommended the use of only boiled or chlorinated water when cleaning the nose for religious practices or other reasons.   

“A person cannot get an infection from drinking or bathing in contaminated water. Nor does the infection spread through person-to-person contact.”   

Speaking to the audience, Dr Syed Faisal Mahmood, consultant infectious diseases, said Naegleria causes a very rare form of brain infection, primary amoebic meningoencephalitis (PAM) that leads to the destruction of brain tissue and brain swelling.   

Initial symptoms of PAM include headache, fever, anorexia, vomiting and later progress to a stiff neck, altered mental status, seizures and coma.   

“Unfortunately, PAM is a fatal disease for which no effective treatment exists anywhere in the world. While amoeba-killing medicines are always given to patients, these usually do not work and death occurs almost 99 percent of the time. Only a small number of Naegleria cases have been reported worldwide, with a dramatic increase in Karachi recently,” he said.

Pakistan: More on the Naegleria deaths

Via BBC News: Karachi: Brain-eating amoeba kills 10. Excerpt:

A rare brain-eating amoeba is responsible for at least 10 deaths in the Pakistani city of Karachi in recent months, health officials believe. 

The source of the parasite is not yet known, but it is thought victims may have been exposed to it when using water to rinse their nasal passages. 

The amoeba, Naegleria Fowleri, lives in warm water and kills its victims by destroying brain tissue. Officials are now increasing the amount of chlorine in the public water supply. 

The deaths are in various locations across Karachi, Pakistan's biggest city. 

Dr Shakeel Mallick, who works for the provincial health department, said nine of those killed were men, while one victim was a child of four. 

Officials suspect other cases may have gone undetected. Dr Mallick said hospitals were now being "vigilant".

'Brain-eating amoeba' kills 10 in southern Pakistan

Via CBC News: 'Brain-eating amoeba' kills 10 in southern Pakistan. Excerpt:

A waterborne parasite commonly known as "brain-eating amoeba" has killed 10 people in Pakistan's largest city, a Pakistani official with the World Health Organization says. 

The amoeba — Naegleria fowleri — lives in warm, unclean water. It can infect the human nervous system, though this occurs rarely. In those cases it is difficult to treat and can lead to death in about a week. 

Musa Khan, in charge of WHO's Disease Early Warning System in Pakistan, said Tuesday that the deaths were reported in the city of Karachi from March to September. 

He said municipal authorities launched a campaign in the area to ensure the supply of clean water to residents. Health officials are carrying out a public awareness campaign to educate and guide people and doctors across Karachi about the disease, he said. 

Other parts of Pakistan have also been alerted but so far no cases have been reported elsewhere, Khan said. 

"There is no need to panic over these deaths," he stressed. "There is a remote chance for the spread of this deadly disease." 

He said people don't usually get the brain-affecting form of the disease by drinking water, but by swimming in dirty water or cleaning their nostrils with contaminated water. 

From the nostrils, the parasite travels to the brain where it destroys tissue. Symptoms include fever, nausea, vomiting, stiff neck and headaches.