Texas Department of State Health Services, Infectious Disease Control Unit

Primary Amebic Meningoencephalitis

(PAM, Naegleriasis and Acanthamebia

ICD-9 136.2; ICD-10 B60.2 and B60.1

FAQs

Data

Investigation

Reporting

Resources

Organism

Naegleria fowleri

Transmission

Naegleria fowleri (amoeba) is found in warm fresh water such as rivers, lakes and ponds. The amoeba is introduced to the brain by forced entry of water up the nose during recreational fresh water activity. The organism has also been found in tap water and can be introduced to the brain when tap water is used for nasal irrigation or sinus flushes.

Symptoms

Infections with Naegleria fowleri cause the rare disease PAM, a brain infection that leads to the destruction of brain tissue. In its early stages, Naegleria fowleri infection may be similar to bacterial meningitis. Initial symptoms of PAM start 1 to 7 days after infection. Symptoms may include headache, fever, nausea, vomiting, and/or stiff neck. Later symptoms may include confusion, lack of attention to people and surroundings, a loss of balance, seizures, and/or hallucinations. After the start of symptoms, the disease progresses rapidly and death occurs within 10 days, usually on the 5th or 6th day.

Prevention & Treatment

Only sterile, distilled, or lukewarm previously boiled water should be used for nasal irrigaton or sinus flushes.

Avoid water-related activities in bodies of warm freshwater during periods of high water temperature and low water levels

Hold the nose shut or use nose clips when taking part in water-related activities in bodies of warm freshwater such as lakes, rivers, or hot springs.

Avoid digging in or stirring up the sediment while taking part in water-related activities in shallow, warm freshwater areas.

Several drugs are effective against Naegleria fowleri in the laboratory however, their effectiveness is unclear since almost all infections have been fatal even when people were treated.

Recent Texas Trends

No PAM cases have occurred in Texas in 2011. From 1983 - 2010 there were 28 cases of PAM reported to the Texas Department of State Health Services. Most of these cases occurred in young males ages 9-12 with exposure to warm fresh water lakes, ponds and rivers during the warm summer months. No Texas cases have resulted from nasal irrigation or sinus flushes.

	(PAM, Naegleriasis and Acanthamebia ICD-9 136.2; ICD-10 B60.2 and B60.1	FAQs Data Investigation Reporting Resources
	Organism Naegleria fowleri
	Transmission Naegleria fowleri (amoeba) is found in warm fresh water such as rivers, lakes and ponds. The amoeba is introduced to the brain by forced entry of water up the nose during recreational fresh water activity. The organism has also been found in tap water and can be introduced to the brain when tap water is used for nasal irrigation or sinus flushes. Symptoms Infections with Naegleria fowleri cause the rare disease PAM, a brain infection that leads to the destruction of brain tissue. In its early stages, Naegleria fowleri infection may be similar to bacterial meningitis. Initial symptoms of PAM start 1 to 7 days after infection. Symptoms may include headache, fever, nausea, vomiting, and/or stiff neck. Later symptoms may include confusion, lack of attention to people and surroundings, a loss of balance, seizures, and/or hallucinations. After the start of symptoms, the disease progresses rapidly and death occurs within 10 days, usually on the 5th or 6th day. Prevention & Treatment Only sterile, distilled, or lukewarm previously boiled water should be used for nasal irrigaton or sinus flushes. Avoid water-related activities in bodies of warm freshwater during periods of high water temperature and low water levels Hold the nose shut or use nose clips when taking part in water-related activities in bodies of warm freshwater such as lakes, rivers, or hot springs. Avoid digging in or stirring up the sediment while taking part in water-related activities in shallow, warm freshwater areas. Several drugs are effective against Naegleria fowleri in the laboratory however, their effectiveness is unclear since almost all infections have been fatal even when people were treated. Recent Texas Trends No PAM cases have occurred in Texas in 2011. From 1983 - 2010 there were 28 cases of PAM reported to the Texas Department of State Health Services. Most of these cases occurred in young males ages 9-12 with exposure to warm fresh water lakes, ponds and rivers during the warm summer months. No Texas cases have resulted from nasal irrigation or sinus flushes.