The dangerous amoebic infections that can harm the brain typically affect individuals in the southern parts of the United States. However, due to the impact of climate change, this organism, which invades the brain, has started spreading to regions farther up north.
Recognizing this concerning development, the Ohio Public Health Association recently released a report to inform healthcare providers in the state about this illness and increase their awareness.
“Increased incidence of N. fowleri [a species of brain-eating amoeba] in northern climates is but one of many ways climate change threatens human health and merits novel education of health care providers,” a case report said.
Intervention by the CDC
According to the Centers for Disease Control and Prevention (CDC), Naegleria fowleri is a tiny living organism that usually resides in soil, warm freshwater, and sometimes in water tanks, heaters, or pipes. In rare cases, this amoeba can enter a person’s body through their nose and make its way into the brain and spinal cord.
It’s important to note that the amoeba cannot reach the brain if it is swallowed in a gulp of water, and it does not spread from one person to another. When N. fowleri causes an infection in humans, it leads to a condition known as Primary Amebic Meningoencephalitis (PAM), which is almost always deadly.
What is PAM?
Primary Amebic Meningoencephalitis (PAM) is a relatively uncommon condition. According to the case report, there have been approximately zero to eight reported cases per year across the country since 1962.
The majority of these infections have been associated with swimming activities in the southern regions, specifically in Florida and Texas. However, starting from 2010, instances of PAM have begun to emerge in northern states as well, including Minnesota, Kansas, and Indiana, which are located in the Midwest.
Case report of a midwest woman
The case report recounts the story of a woman in her mid-30s who was brought to a hospital in an undisclosed Midwestern state in an unconscious state. She had been experiencing intense headaches, sensitivity to light, nausea, and confusion.
Initially, healthcare professionals suspected she might have bacterial meningitis, which is inflammation of the brain caused by bacteria.
However, during an interview with the woman’s spouse, a public health nurse discovered important information. It was revealed that four days before the onset of her symptoms, the patient and her family had visited a freshwater lake beach.
During their time there, she had submerged her head underwater. It is worth noting that symptoms associated with Primary Amebic Meningoencephalitis (PAM) typically appear between one to 12 days after the Naegleria fowleri amoeba enters the nose.
CSF sampling of the patient
Following the patient’s admission to the hospital, samples of her cerebrospinal fluid, which surrounds the brain and spinal cord, were examined. The results showed no presence of bacteria, leading the medical team to suspect that a viral infection might be the cause.
However, as the patient’s condition rapidly deteriorated, her nurse reached out to the Bureau of Infectious Diseases at the state Department of Health to explore other potential causes.
Treatment of PAM
Subsequently, the state department contacted the Centers for Disease Control and Prevention (CDC) for assistance. Considering the patient’s recent visit to the lake, the CDC suggested that Naegleria fowleri could be the culprit.
GM. The brain-eating amoeba, Naegleria fowleri, can enter the human body through the nose while swimming in warm freshwater, leading to a rare but deadly infection with a fatality rate of over 97%. 🦠💀 #science #art pic.twitter.com/0gcWv3kXJc
— Bayneko🔬 (@bayneko1) May 17, 2023
According to the CDC, Primary Amebic Meningoencephalitis (PAM) can be treated using several drugs, including miltefosine, which has shown effectiveness in killing Naegleria fowleri. These drugs have been utilized in the past for survivors of PAM infections.
Timely diagnosis is crucial in order to initiate these treatments promptly, potentially making a difference in patient outcomes. The report emphasizes that healthcare providers in northern states should inquire whether patients exhibiting symptoms of meningitis have recently been swimming in warm freshwater.
If PAM is suspected, providers are advised to contact the CDC at (800) 232-4636 for further guidance and support.