Person in Florida dies after brain-eating amoeba infection, possibly due to sinus rinse with tap water, health officials warn

A computer-generated representation of Naegleria fowleri in its ameboid trophozoite stage, in its flagellated stage and in its cyst stage, is pictured here. (Centers for Disease Control and Prevention)

A person in Charlotte County, Florida, has died after being infected with the rare brain-eating amoeba Naegleria fowleri.

The infection possibly resulted from "sinus rinse practices utilizing tap water," according to a news release from the Florida Department of Health in Charlotte County. The release was issued in February to alert the public about the infection.

On Thursday, the department confirmed that the infected person has died and officials are continuing to investigate the case.

"An Epidemiological investigation is being conducted to understand the unique circumstances of this infection. I can confirm the infection unfortunately resulted in a death, and any additional information on this case is confidential to protect patient privacy," Jae Williams, press secretary for the Florida Department of Health, said in an emailed statement.

Infection with Naegleria fowleri "can only happen when water contaminated with amoebae enters the body through the nose," according to the department's news release.

The Florida Department of Health in Charlotte County warned residents to only use distilled or sterile water when making sinus rinse solutions. Tap water should be boiled for at least a minute and cooled before using it for sinus rinsing, which typically involves a neti pot.

Tap water that has not been sterilized isn't safe to use as a nasal rinse since it's not adequately filtered or treated, and so it may contain low levels of microorganisms, such as bacteria and protozoa, including amoebas, according to the U.S. Food and Drug Administration's website. Yet people cannot be infected by drinking tap water, as stomach acid typically kills those organisms.

WHAT IS THE BRAIN-EATING AMOEBA?

Naegleria fowleri is an amoeba, a single-celled living organism, that can be found in soil and warm freshwater, such as lakes, rivers and hot springs throughout the United States. Commonly called the "brain-eating amoeba," it can cause brain infections, which typically happens when amoeba-containing water travels up through the nose, such as while swimming.

According to the U.S. Centers for Disease Control and Prevention, about three people in the United States get infected each year, and these infections are usually deadly.

From 1962 to 2021, only four out of 154 people in the United States survived a brain-eating amoeba infection, according to the CDC. Just last year, a boy died who was infected after swimming at Lake Mead, another child in Nebraska died who was infected after swimming, and a Missouri resident died with the infection after visiting a beach in Iowa.

Signs and symptoms of infection are initially severe headaches, fever, nausea and vomiting and they can progress to a stiff neck, seizures, hallucinations, and coma. The infection is treated with a combination of drugs, including the antibiotic azithromycin, the antifungal fluconazole, the antimicrobial drug miltefosine and the corticosteroid dexamethasone.