<i>Notes from the Field</i>: Primary Amebic Meningoencephalitis Associated with Exposure to Swimming Pool Water Supplied by an Overland Pipe — Inyo County, California, 2015

Johnson, Richard O; Cope, Jennifer R.; Moskowitz, Marvin; Kahler, Amy M.; Hill, Vincent R.; Behrendt, Kaleigh; Molina, Louis; Fullerton, Kathleen E.; Beach, Michael J.

doi:10.15585/mmwr.mm6516a4

Cited by 17 publications

(9 citation statements)

References 3 publications

(2 reference statements)

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“…In June 2015, a 21-year-old California resident died of PAM after swimming in a privately-owned pool located in a desert environment [16]. The source water for the pool was piped overland for approximately 1.5 miles from a mountain spring via an aging metal pipe that was rusted out and compromised by root systems in many places.…”

Section: Epidemiology Of Pammentioning

confidence: 99%

Primary Amebic Meningoencephalitis: What Have We Learned in the Last 5 Years?

Cope

Ali

2016

Curr Infect Dis Rep

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Primary amebic meningoencephalitis (PAM) is a devastating infection of the brain caused by the thermophilic free-living ameba, Naegleria fowleri. Infection can occur when water containing the ameba enters the body through the nose, usually during recreational water activities such as swimming or diving. Historically, in the United States, cases were mostly reported from the warmer southern-tier states. In the last five years, several notable changes have been documented in PAM epidemiology including a northward expansion of infections and new types of water exposures. The recent reports of two PAM survivors provide hope for improved outcomes with early diagnosis and aggressive treatment. Advanced molecular laboratory tools such as genome sequencing might provide more insight into the pathogenicity of Naegleria fowleri. Clinicians treating patients with meningitis and warm freshwater exposure are encouraged to consider PAM in their differential diagnoses.

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Section: Epidemiology Of Pammentioning

confidence: 99%

Primary Amebic Meningoencephalitis: What Have We Learned in the Last 5 Years?

Cope

Ali

2016

Curr Infect Dis Rep

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“…After this first report, PAM cases have been recorded worldwide, reaching a total of around 440 officially diagnosed cases [16,17]. Currently, the most affected countries are the United States and Pakistan; for example, in the US, 143 cases were reported during the period of 1962–2016 [18].…”

Section: Introductionmentioning

confidence: 99%

In Vitro Activity of Statins against Naegleria fowleri

et al. 2019

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Naegleria fowleri causes a deadly disease called primary amoebic meningoencephalitis (PAM). Even though PAM is still considered a rare disease, the number of reported cases worldwide has been increasing each year. Among the factors to be considered for this, awareness about this disease, and also global warming, as these amoebae thrive in warm water bodies, seem to be the key factors. Until present, no fully effective drugs have been developed to treat PAM, and the current options are amphotericin B and miltefosine, which present side effects such as liver and kidney toxicity. Statins are able to inhibit the 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, which is a key enzyme for the synthesis of ergosterol of the cell membrane of these amoebae. Therefore, the in vitro activity of a group of statins was tested in this study against two types of strains of Naegleria fowleri. The obtained results showed that fluvastatin was the most effective statin tested in this study and was able to eliminate these amoebae at concentrations of 0.179 ± 0.078 to 1.682 ± 0.775 µM depending on the tested strain of N. fowleri. Therefore, fluvastatin could be a potential novel therapeutic agent against this emerging pathogen.

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“…www.nature.com/scientificreports www.nature.com/scientificreports/ In Thailand and Japan, Naegleria and Acanthamoeba species were detected in hot springs frequented by tourists and local residents 36,37 . In Italy, New Zealand, and California of the United States, N. fowleri was detected in a river area used for swimming and in a swimming pool [38][39][40] . In Taiwan, the nearest Asian country, N. fowleri was isolated from hot springs, and Acanthamoeba and Naegleria spp.…”

Section: Discussionmentioning

confidence: 99%

Molecular detection of free-living amoebae from Namhangang (southern Han River) in Korea

Kang

Sohn

Seo

et al. 2020

Sci Rep

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the free-living amoebae Naegleria spp. and Acanthamoeba spp. exist in the natural environment and are sometimes causal agents of lethal primary amoebic meningoencephalitis (PAM), amoebic keratitis (AK) and granulomatous amebic encephalitis (GAE) in humans, respectively. To ascertain the existence of free-living amoebae in Korea, water samples were collected from the Korean hydrosphere, Namhangang (southern Han River), an active location for water skiing and recreation. Samples underwent two-step filtration and were cultured on non-nutrient agar medium with inactivated E. coli. The remaining samples were subjected to PCR for primarily the 18S small ribosomal RNA gene and gene sequencing. Similarities in 18S rDNA sequences, in comparison with various reference amoebae in GenBank, showed 86~99% homology with N. gruberi, N. philippinensis, N. clarki, A. polyphaga, A. castellannii, and Hartmannella (Vermamoeba) vermiformis. Therefore, this study will be useful for seasonal detection of free-living amoebae from various Korean hydrospheres in future studies. The free-living amoebae (FLA) Naegleria spp. and Acanthamoeba spp. are mainly distributed in ponds, rivers, and fresh waters worldwide. Their existing stages are trophozoite and cyst and additional biflagellate form in in case of Naegleria. Trophozoites shows moving, feeding, and proliferation activity. However, cysts are formed in poor environments, such as under abrupt temperature changes, drying, and food depletion, and can survive for long periods 1,2. N. fowleri is a pathogenic agent that causes primary amoebic meningoencephalitis (PAM), which is fatal to humans and laboratory animals 2,3. Acanthamoeba spp. and Balamuthia mandrillaris cause chronic granulomatous amebic encephalitis (GAE) 4-6. Further, A. castellanii and A. polyphaga can infect the eye, resulting in acanthamoeba keratitis (AK) 2,7,8. PAM is mainly associated with activities in amoeba-contaminated water (swimming or water leisure activity), use of Neti-pots in rhinitis treatment, and religious ceremonies in some Asian countries 5,9,10. The amoeba enters through the nasal cavity to invade the mucosal membrane. Subsequently, it moves into the olfactory bulb and meninges via the nasal nerve system, leading to development of meningoencephalitis 11-13. Symptoms of PAM include acute headache, anorexia, nausea, vomiting, high fever (38-40 °C), and limb dysfunction symptoms. It also progresses acutely, with a mortality rate of over 95%. Amphotericin B is mainly used as a therapeutic agent, as a combination treatment by mixing with micronazole, rifampin, and doxycycline; however, only limited therapeutic effects have been demonstrated 1,2,14-16. AK usually occurs after wearing contaminated contact lenses, improper ophthalmic surgery, or corneal injury in various cases. With the popularization of contact lenses and careless lens management, the number of AK patients continues to increase 2,7,17,18. PAM due to N. fowleri occurs annually worldwide. In the United States, 143 cases of PAM occurred from 1962 to...

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Notes from the Field: Primary Amebic Meningoencephalitis Associated with Exposure to Swimming Pool Water Supplied by an Overland Pipe — Inyo County, California, 2015

Cited by 17 publications

References 3 publications

Primary Amebic Meningoencephalitis: What Have We Learned in the Last 5 Years?

Primary Amebic Meningoencephalitis: What Have We Learned in the Last 5 Years?

In Vitro Activity of Statins against Naegleria fowleri

Molecular detection of free-living amoebae from Namhangang (southern Han River) in Korea

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