Arkansas Infant Dies From ‘Brain-Eating Amoeba’ Infection

Naegleria fowleri, a brain-eating amoeba. Courtesy of Centers for Disease Control and Prevention

A toddler from Arkansas has died from getting infected by a “brain-eating amoeba” after likely being exposed to the organism while playing in a splash pad.

Michael Alexander Pollock III, a 16-month-old boy, died on the evening of Sept. 4 at the Arkansas Children’s Hospital in Little Rock from an infection caused by amoeba Naegleria fowleri, the Arkansas Democrat Gazette said, citing a coroner. Though the Arkansas Department of Health (ADH) did not confirm the victim’s name, a Sept. 14 press release said that a state resident had died from Naegleria fowleri infection.

“Through an investigation involving testing and inspection, [ADH] concluded that the individual was likely exposed at the Country Club of Little Rock splash pad,” the department stated.

“ADH sent multiple samples from the pool and splash pad to the CDC. The CDC has reported one splash pad sample as confirmed to have viable Naegleria fowleri. The remaining samples are still pending,” it said.

According to the U.S. Centers for Disease Control and Infection (CDC), Naegleria fowleri is an amoeba that lives in the soil and warm fresh water like rivers, lakes, and hot springs. The organism causes primary amebic meningoencephalitis (PAM), a disease of the central nervous system.

Naegleria fowleri “is commonly called the ‘brain-eating ameba’ because it can cause a brain infection when water containing the amoeba goes up the nose. Only about three people in the United States get infected each year, but these infections are usually fatal,” the agency states.

Between 1962 and 2022, the United States has seen 157 cases of Naegleria fowleri infection. Out of these, only four people have survived.

In March, a man from southwest Florida died due to Naegleria fowleri infection, forcing the Florida Department of Health in Charlotte County to issue an alert.

The infection “can only happen when water contaminated with amoebae enters the body through the nose … You cannot be infected by drinking tap water,” said Florida Department of Health spokesman Jae Williams, according to AP.

In July, a 2-year-old boy died from Naegleria fowleri after getting infected while swimming in a natural hot spring in Nevada.

Prevalence in US, Symptoms

Naegleria fowleri infections have primarily occurred in southern states. The states that have reported the highest number of cases between 1962 and 2022 are Texas with 39 and Florida with 37.

California has reported 10 cases, Arizona 9, and South Carolina 8. The remaining states have reported less than 8 infections each during the six-decade period.

In 2022, three infections were reported, one each in Iowa, Arizona, and Nebraska. The illnesses occurred after exposure to freshwater.

PAM “disproportionately affects males and children. The reason for this distribution pattern is unclear but may reflect the types of water activities (such as diving or watersports) that might be more common among young boys,” according to the CDC.

Symptoms of infection start one to 12 days after having nasal exposure to Naegleria fowleri, with infected individuals dying one to 18 days after symptoms begin. PAM is difficult to detect as the disease progresses so fast that diagnosis sometimes occurs only after the death of the patient.

During stage 1 of the infection, patients can experience severe frontal headache, vomiting, fever, and nausea. In stage 2, the individual experiences a stiff neck, seizures, hallucinations, altered mental status, and end up in a coma.

Treatment involves a combination of drugs like fluconazole, rifampin, amphotericin B, and azithromycin. “These drugs are used because they are thought to be effective against Naegleria fowleri and have been used to treat patients who survived.”

Survivors, Prevention

There are, in total, five survivors of Naegleria fowleri in North America, four in the United States and one in Mexico.

The first survivor in the United States dates back to 1978, whose condition gradually improved over a one-month period. It has been suggested that the strain of Naegleria fowleri which infected this individual was a less virulent one.

In 2013, two children who got infected by Naegleria fowleri survived. A 12-year-old girl was subjected to treatment and eventually made a full neurologic recovery. The child’s recovery is attributed in part to early diagnosis and treatment.

Though an 8-year-old child also survived the infection that year, the child likely ended up contracting permanent brain damage, according to the CDC.

The fourth American survivor was a 16-year-old boy in 2016 who was treated with the same protocol as used on the 12-year-old girl. The boy also made a full neurologic recovery.

As part of precautionary measures, when swimming in shallow bodies of warm water, it is advisable to avoid stirring up the sediment at the bottom, according to the American Academy of Pediatrics (AAP). Before rinsing sinuses, ensure that tap water is boiled for one minute and cooled down.