Brain-eating amoeba forces school board to declare state of emergency

Monday, September 15, 2014, 12:41 PM - It's been two weeks now since the brain-eating amoeba, Naegleria fowleri, was discovered in the water supply that serves over 12,500 residents of St. John the Baptist Parish, just to the west of New Orleans, Louisiana. As efforts to eradicate the potentially fatal pest from the water supply continue, the local school board has been forced to declare a state of emergency so that they can spend the money needed to secure bottled water for schools in the affected area.

Naegleria fowleri is a single-celled organism that lives in warm, fresh waters throughout the world - rivers, ponds and lakes, but it thrives in hot waters, such as hot springs and near water discharges from industrial plants. It can be perfectly at home in any fresh water supply though, and has been found in non-chlorinated swimming pools and municipal water supplies.

The life cycle of Naegleria fowleri. Credit: CDC

If a person comes into contact with Naegleria fowleri, typically by the organism entering their body through the nose, it makes its way to the brain and causes a severe and often fatal infection known as Primary Amebic Meningoencephalitis (PAM). The symptoms of PAM - severe frontal headache, fever, nausea and vomiting, followed by stiff neck, seizures, altered mental state, hallucinations, and coma - can progress very quickly. Some people have been known to show symptoms and die within just a few days of exposure, while in others it can take a full three weeks for the infection to run its course. In addition to its swiftness, the illness is quite deadly, with less than 5 per cent of those infected making a recovery. Fortunately, infections are quite rare. Since the early 1960s, there have been over 200 cases reported worldwide, with the majority in the United States. Diagnosis is difficult, given the similarity of the symptoms to other illnesses, like bacterial meningitis, and given the rapid progression of symptoms, diagnosis is usually made after death.

The amoeba has three different life stages. Two of its stages - the cyst stage that it usually takes when confronted by low food supplies or low temperatures, and the flagellate stage - aren't found in human tissues. Inside our bodies is the perfect conditions for it to take on the third stage - the trophozoite stage. This is not only its reproductive stage, but also its feeding stage. In this form, the amoeba reproduces by splitting in two (binary fission) and they engulf and consume both red and white blood cells and kill other tissues. Entering through the nose, the nerves that govern the sense of smell are attacked first, resulting in a loss of that sense and the sense of taste. Then the growing population of amoebas spread into the brain where they consume tissues there, causing the onset of the other common symptoms. Coma is usually the end result of all of this, and then death.

Naegleria fowleri has a rather notorious history in the United States, where it's claimed the lives of 129 of the total 132 people who have become infected over the years. It's very common in waterways in the U.S. Southeast, and communities - especially those in Central Florida - often have warnings that advise against swimming in non-chlorinated water.

The school board in St. John the Baptist Parish is securing bottled drinking water for six schools in the area, at a cost of around $17,500, as a precaution. It's important to note that there's no threat of infection from drinking water contaminated with this amoeba. The organism simply cannot make it's way to the brain from the digestive system. It's only when contaminated water goes up the nose that infection becomes possible. The supply of bottled water will prevent any accidental exposure, such as water being splashed from a faucet or spraying from a drinking fountain.

The state of emergency called by the parish school board is simply a measure that will allow them to secure the supply of bottled drinking water for the students quickly. Normally, they are required to go through a 'public bid' procedure, however that may take longer than the two months required for the 'chlorine burn' the parish is performing to clear the water supply of the Naegleria fowleri.