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The Brain-Eating “Amoeba” Strikes Again

The views expressed are those of the author and are not necessarily those of Scientific American.

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Just when you thought the U.S. was safe from amoebas . . . it turns out it’s not.

This summer saw a micro-burst of brain-eating amoeba attacks (well, only three, but that was plenty for the press to get its panties in a bunch over it. How could you not about “brain-eating amoebas”?) in people who swam in U.S. freshwater lakes, ponds, etc. You’d think the commencement of North American winter would preclude further possibility of attack. Alas, it does not. For this is the “amoeba’s” new secret weapon: the neti pot.

The notorious neti pot. Creative Commons image by Kurt Yoder, 2004. Click image for license and link.

Yes, the Neti pot. For those of you unfamiliar with this contraption, the idea is that instead of honking your way to kingdom come into a scratchy paper tissue, you can gracefully irrigate your way to an obstruction-free breathing by pouring the contents of a Neti pot into one nostril and out the other. Exhibit A:

A neti pot in action. Creative Commons image by Aikhan. Click for license and link.

Although I’ve never tried this, I’d say it’s probably easier said than done, at least to start. But it does seem to be effective, once mastered, based on what I’ve read.

Unless, that is, the tap water you use to fill the pot is home to some wayward “amoebas” called Naegleria fowleri. Somehow they can slip through the microbial Fort Knox of some U.S. water treatment plants and make it into tap water (at least in Louisiana).

This is not a problem if you drink the water and they end up in your stomach, where they are digested. This is very much is a problem if you dribble them through your sinus system, where they seem to occasionally find their way brainward with the same efficacy they display in unlucky swimmers who accidentally inhale some protist-infested pond water while swimming. Once they wander into your brain, death is almost certain.

There’s an easy solution, though. Just boil your neti pot water first, or use store-bought distilled water. And in any event, only two people in Louisiana have died from infested neti pots this year. So don’t panic. This rates nowhere near the level of concern that should be inspired by, say, getting in your car and driving it down the street. These amoebas don’t seek out humans. They just go sightseeing when they happen to be in the neighborhood. Unfortunately, the sight they’re seeing is your gray matter.

For those of you who missed it and are curious exactly what Naegleria fowleri is (it’s not actually a true amoeba), I’m reprinting my post from August on this very subject below:

Cyst, trophozoite ("amoeba"), and flagellate forms of the protist Naegleria fowleri. Photos by CDC.

In the press this week were reports (see here and here and here) that the brain-eating amoeba Naegleria fowleri has killed three people this summer, as it does in a typical year. The only trouble is, Naegleria isn’t a true amoeba.

So why are they called amoebas if they are not? The organisms in question — which, like true amoebas are microbes called protists — do alternate between cysts, flagellate (swimming) forms, and amoeba-like (blobby, crawling) forms that are more properly called “trophozoites”. When times are good, these trophozoites crawl through the mud in search of bacteria to eat. When times are bad, they sprout tails and swim off like guided missiles in search of happier hunting grounds. Either of these forms can rarely, accidentally infect humans, typically in warm, shallow water in the southern U.S. in summertime. When times get *really* bad, they encyst. Click here for a CDC graphic of their life cycle (on the left). But the trophozoite forms only superficially resemble amoebas; their DNA tells us they are something much different indeed.

Naegleria, it turns out, is only a distant relative of the Amoebozoa, the true amoebae, which generally lack flagella. In fact, the true amoebae seem to be more closely related to fungi and animals than it they are to Heterolobosea, the phylum that includes Naegleria. Naegleria, in turn, seem to be much more closely related to Euglena — the flagellated (tailed) photosynthetic single-celled organisms from high school and college biology lab — and Trypanosoma, the causal organisms of sleeping sickness and Chagas disease. Take a look at this family tree of eukaryotes (nucleated organisms – everything except bacteria and archaea) for the groups Amoebozoa and Heterolobosea to see what I mean.

Heterolobosea are difficult to define in a sentence, since they have evolved into so many niches. What tells us they are related is their DNA. But generally speaking, the phylum that includes Naegleria is made up of organisms that alternate between amoeboid and swimming forms, and that, like the Euglenozoa, have “discoid” cristae, or folds, in their energy-producing mitochondria. In contrast, most animals, I believe, have sheet-like or laminar cristae. How exactly discoid is different from laminar I have not been able to discover. For extra randomness, the Heterolobosea also includes a group of slime molds that’s completely unrelated to the big showy ones most people (if they ever think of them) think of as slime molds.

The proposed kingdom to which the Heterolobosea belong — the Excavata — are even more of a mixed bag, although again one might say they are almost exclusively protists with either no or unusual mitochondria, two or more flagella for swimming, and a characteristic underside feeding groove supported by fibers called microtubules.

There are true amoebas that infect humans. Entamoeba histolytica comes to mind, the cause of the vastly more prevalent disease amoebic dysentary, which infects some 50 million worldwide. Naegleria, on the other hand, are not parasites of humans; they prefer bacteria and don’t seek out people. They only infect us when we swim into their habitat and happen to bump into them nose-first. Hungry and far from home, they crawl into our brains and start eating like crazy, killing the unfortunate host 95% of the time.

But as a result of its accidental nature, Naeglaria infection is quite rare in the United States — happening perhaps 2-3 times a year — especially compared to organisms that do seek us out in water. As a blog post at the L.A. Times points out:

According to the Centers for Disease Control and Prevention, the most commonly reported recreational water illness (RWI) is diarrhea, which can be caused by germs such as Cryptosporidium, Giardia, Shigella, norovirus and E. coli. These can be introduced into the water through trace amounts of fecal matter that cling to people’s bodies. The agency reports:

Swimmers share the water — and the germs in it — with every person who enters the pool. On average, people have about 0.14 grams of feces on their bottoms which, when rinsed off, can contaminate recreational water. In addition, when someone is ill with diarrhea, their stool can contain millions of germs. This means that just one person with diarrhea can easily contaminate the water in a large pool or water park.

I think I could have gone my whole life without knowing each and every bottom in the pool contains 0.14 grams of feces. It certainly makes a hard sell for the bidet. This fact alone should be *much* more frightening than the chance that a little, lost, hungry protist might somehow find its way into your brain, no matter how food-crazed it might be once it gets there. And if you’re still worried, there’s always nose clips.

Jennifer Frazer About the Author: Jennifer Frazer is a AAAS Science Journalism Award-winning science writer. She has degrees in biology, plant pathology/mycology, and science writing, and has spent many happy hours studying life in situ. Follow on Twitter @JenniferFrazer.

The views expressed are those of the author and are not necessarily those of Scientific American.

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  1. 1. BlondMaggie 11:27 am 12/21/2011

    Jennifer – a friend of mine asks, what about the salt that you’re supposed to add to the water in a neti pot? I assume that the Naegleria fowleri from the summer were found in freshwater ponds. I would further assume that means they like fresh water.

    Shouldn’t the salinity of a net pot inhibit or kill the beasties? Or would it have not effect at all?

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  2. 2. Jennifer Frazer in reply to Jennifer Frazer 12:51 pm 12/21/2011

    It may or it may not, but would you want to take a chance when all you have to do is boil the water or buy a 99c jug of distilled water to be absolutely certain? : )

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  3. 3. kdimoff 5:22 pm 12/21/2011

    you know, ’cause neti pots needed one more reason to freak people out about them :)

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  4. 4. davidwogan 7:03 pm 12/21/2011

    Whew, good thing I boil water before neti potting! Great article :)

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  5. 5. Jennifer Frazer in reply to Jennifer Frazer 11:21 pm 12/21/2011

    Kati — Yeah, no kidding. : ) It’s gonna be a while before I take the, er, plunge.
    Thanks David!

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  6. 6. Gedas 12:11 am 12/22/2011

    water boarding should be the best medicine…

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  7. 7. Bonnie Nordby 2:55 am 12/22/2011

    The salt is to create normal saline or the correct salinity level to match the human mucosa,tears, and blood. Better than plain water because it won’t pull fluid out of your tissues and end up drying your nose out more. One of the most important things is to keep nasal passages moist. Dry nasal passages bleed and open you up to infection including colds and influenza. Especially important in winter when heating dries the air of humidity. This is where neti pots and inhaling steam, saline nasal sprays and use of nasal lubricants like aquaphor may help. I occasionally use a net pot when allergy season strikes too. I also ran into information that humming and chanting resonant tones can keep sinuses clearer. I tried and it does seem to work. I will now be sure to inwardly chant when swimming in potentially contaminated water. “oh, no you little invaders, my brain is not yours to eat”.

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  8. 8. EyesWideOpen 2:58 pm 12/22/2011

    Wow, “a little, lost, hungry protist.” Now you frame it that way, poor thing! Makes me realize these are lean and hungry times. Why not donate some of our brain tissue to these creatures? I think I’ll dive to the bottom of our pool now and take a deep breath.

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  9. 9. eyobedw 4:12 am 01/21/2012

    jennifer….i read ur post on “Naegleria Fowleri”…i was wondering if it’s safe to use steam of a warm shower(it comes from tap water, but its heated) to rinse the nose?…u see i got cats and i don’t want asma.

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  10. 10. maryallen 3:30 pm 03/2/2012

    This shouldn’t let anyone’s summer swimming excursions be ruined. This amoeba has always been around. Just because you are hearing about it in the news doesn’t mean your chances of picking it up have increased. People should worry more about all the goobers and spit that you walk through on the sidewalks and parking lots every darn day!! Then you walk those shoes right into your home and let your infants crawl through. And then you let your dogs jump up on your furniture and bed!! Now that’s a disease just waiting to happen!!

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