6 Fast Facts About Brain-Eating Amoebae

iStock.com/Dr_Microbe
iStock.com/Dr_Microbe

If “brain-eating amoebae” isn't the most terrifying combination of words you’ve ever heard, it will be by the time you finish reading this article. Although infection from the Naegleria fowleri amoeba is rare, it does happen from time to time. Just last month, a 29-year-old man died from a brain-eating amoeba after visiting a wave pool in Waco, Texas. The CDC is currently investigating the incident. Here are a few things you should know about this pernicious organism.

1. THEY LIVE IN WARM FRESH WATER.

Warm bodies of fresh water like lakes, rivers, and hot springs are usually where the single-celled amoebae like to hang out. They can also be found in soil, and in extremely rare cases, in contaminated tap water or swimming pools that haven’t been properly chlorinated. While most people encounter the amoebae in lakes or rivers, the CDC reports found that between 2007 and 2016, one person became infected after using a backyard slip-n-slide and three people became infected after using a nose irrigation device. Contaminated tap water was to blame in all four cases.

2. YOU WON’T GET INFECTED FROM SWALLOWING CONTAMINATED WATER, THOUGH.

Infection only occurs when water containing Naegleria fowleri enters the nose. In other words, accidentally swallowing river water while swimming doesn’t put someone at risk, but getting water up one’s nose does. Although the presence of Naegleria fowleri in fresh water is common, infections still remain rare.

3. THEY’RE NOT USUALLY ATTRACTED TO HUMANS.

These amoebae don’t go out of their way to feast on human brains. In fact, they’re usually content to eat bacteria found in the soil or sediment of lakes or rivers. “Normally, it’s totally harmless, doing its own thing in the mud, eating whatever it finds there, going about its business, not bugging anybody,” biologist Dan Riskin told Mental Floss in 2017. However, once it enters a new environment (such as an unsuspecting victim’s nasal cavity), it resumes eating whatever it can find.

4. AFTER ENTERING THE NOSE, THEY TRAVEL UP THE OLFACTORY NERVE.

Once inside the nasal cavity, an amoeba starts eating away at the olfactory bulbs, which are responsible for processing information about odors. “It makes its way up that olfactory nerve, reproducing and eating, until it hits the brain,” Riskin said. “And once it’s in the brain, it’s game over for the kid that had it shoved up his nose.” That’s because the amoebae eat brain tissue and cells, resulting in brain swelling, necrosis, and usually death.

5. THE DISEASE IT CAUSES IN HUMANS IS ALMOST ALWAYS FATAL.

Once infected, a disease called primary amebic meningoencephalitis (PAM) sets in. Early symptoms include severe headache, fever, nausea, and vomiting, and some of the stage-two symptoms are seizures, hallucinations, altered mental state, and coma. Generally, people start to show symptoms about five days after infection and die five days after that. The fatality rate is more than 97 percent, but again, infection is rare. Of the 143 cases of infection reported between 1962 and 2017, only four people survived, according to the CDC. But don't worry, your odds of contracting a brain-eating amoeba are about 1 in 70 million.

6. YOU CAN REDUCE YOUR RISK BY PLUGGING YOUR NOSE.

Brain-eating amoebae shouldn't be at the top of your list of concerns while swimming—drowning, for instance, is a far greater danger—but there are still a few things you can do to protect yourself. Try squeezing your nose shut while jumping or diving, or keep your head above water while taking a dip.

A Generic EpiPen Coming in Early 2019 Could Save You Money

Brand-name EpiPens at a Congressional hearing on the escalating cost of the drug in 2016
Brand-name EpiPens at a Congressional hearing on the escalating cost of the drug in 2016
Alex Wong/Getty Images

For an incredibly common, life-saving medication, EpiPens (epinephrine auto-injectors) are surprisingly difficult for many consumers to get ahold of. Their cost has skyrocketed in recent years from less than $100 for a pack of two to more than $600. They’ve gotten so expensive that some EMTs have resorted to using syringes to manually administer epinephrine rather than purchasing the standard auto-injectors, which are almost exclusively made by the pharmaceutical company Mylan. Generic options have been slow to come to market, but according to Business Insider, a recently approved EpiPen rival is coming in the first few months of 2019, and it could save consumers a significant chunk of change.

The drug’s developers have had an unusually hard time getting the new EpiPen alternative, called Symjepi, onto store shelves. The drug was approved in 2017, but the company, Adamis Pharmaceuticals, had trouble finding investors. Now, Novartis, the Swiss-based pharmaceutical giant that manufactures drugs like Ritalin, is releasing the drug through its Sandoz division (perhaps most famous for it role in discovering LSD in the 1930s).

Symjepi will cost $250 out-of-pocket for a pack of two doses. That’s 16.6 percent less than the Mylan-authorized generic EpiPen or Teva’s generic EpiPen, which both sell for $300. It differs a bit from its rivals, though, in that it’s a pre-filled, single-dose syringe rather than a spring-loaded auto-injector. Auto-injectors are plastic, pen-like devices that keep the needle shielded until the moment of injection, and are specifically designed to help make it easier for untrained (even squeamish) people to use in an emergency. With this version, patients will need to remove a needle cap and inject the needle. Just like the EpiPen, though, it’s designed to be injected in the upper thigh, through clothing if necessary.

If you have health insurance, the difference in cost may not matter as much for you as a consumer, depending on your plan. (I personally picked up a two-pack of Mylan-authorized generic Epipens at CVS recently for $0, using a manufacturer’s Epipen coupon to knock down what would have been a $10 copay.) But it will matter considerably for those with high-deductible plans and to insurers, which, when faced with high costs, eventually pass those costs on to the consumer either through higher co-pays or higher premiums. It also affects agencies that buy EpiPens for emergency use, like local fire departments. And since EpiPens expire after just a year, the costs add up.

However, there’s currently a shortage of EpiPens on the market, according to the FDA, making it more important than ever to have other epinephrine drugs available to those at risk for serious allergic reactions.

[h/t Business Insider]

Brain-Eating Amoeba Kills Seattle Woman Who Used Tap Water in Her Neti Pot

CDC/Dr. Govinda S. Visvesvara, Wikimedia Commons // Public domain
CDC/Dr. Govinda S. Visvesvara, Wikimedia Commons // Public domain

If you use a neti pot to clear out your sinuses, there's one important rule you should always follow: Don't fill it with tap water. Doing so could land you a sinus infection, or worse, a potentially fatal disease caused by a brain-eating amoeba. Although the latter scenario is exceptionally rare, a 69-year-old woman in Seattle died from doing just that, The Seattle Times reports. Experts are also warning that these infections could become more common as temperatures in the northern hemisphere continue to rise.

Physicians at Seattle's Swedish Medical Center initially thought the woman had a brain tumor. She was brought into the emergency room following a seizure, and a CT scan of her brain seemed to reveal a tumor-like mass. The only other known symptom she had was a red sore on her nose, which was previously misdiagnosed as rosacea. When surgeons operated on her the following day, they noticed that "a section of her brain about the size of a golf ball was bloody mush," neurosurgeon Dr. Charles Cobbs told The Seattle Times. "There were these amoeba[e] all over the place just eating brain cells. We didn't have any clue what was going on, but when we got the actual tissue we could see it was the amoeba."

She died a month later of an infection called granulomatous amoebic encephalitis (GAE), according to a recent case report published in the International Journal of Infectious Diseases. The disease is caused by a single-celled amoeba called Balamuthia mandrillaris, and it's extremely deadly. Of the 109 cases between 1974 and 2016, 90 percent were fatal.

According to the FDA, some bacteria and amoebae in tap water are safe to swallow because acid in the stomach kills them. However, when they enter the nasal cavity, they can stay alive for long periods of time and travel up to the brain, where they start eating their way through tissue and cells. Another brain-eating amoeba called Naegleria fowleri can cause a similar disease, except it acts faster and can cause death in just a few days. Although it's also rare, it's usually found in warm freshwater, and infections start by getting contaminated water up one's nose while swimming or by using a nose irrigation device filled with tap water.

Dr. Cynthia Maree, an infectious disease doctor at the Swedish Medical Center, said the changing environment could facilitate the spread of these infections. "I think we are going to see a lot more infections that we see south (move) north, as we have a warming of our environment," Maree says. Researchers say these amoebae are still little-understood. Future studies would need to be conducted to learn more about the risk factors involved.

[h/t The Seattle Times]

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