Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
N. fowleri is a water-borne
disease. Exposure occurs when people come into contact with warm, fresh water
usually through swimming, diving, water skiing, or other recreational activity.
Although contact with infected water is common, symptomatic disease caused by N. fowleri is rare. It is common for people in the southern U.S. to have antibodies
showing evidence of past exposure even when they have no history of symptoms or
disease.
The danger of serious infection comes when water containing Naegleria
fowleri
is forced in into the nose and nasal mucosa. The parasite then migrates through
the olfactory nerves and enters the brain. The initial step of infection can
occur when diving or inadvertently aspirating water during swimming. Rarely,
under-chlorinated swimming pools have been implicated in transmission. Because
Naegleria fowleri can be present in untreated well water, there is a
small but real chance of transmission to young children during bathing.
Naegleria fowleri
has also caused disease in adults who inject water into the nose as part of
ritual ablutions related to religious practices.
What are risk factors for Naegleria fowleri
infection?
The major risk factor for infection is recreational exposure to warm fresh
water, especially if there is a history of aspiration of water into the nose. A
review of cases in the U.S. by Yoder, et al. showed that there were 111 reported
cases of primary amoebic encephalitis between 1962 and 2008. Living in the
southern States is a risk factor for infection, because the water is warmer and
more conducive to growth of the amoeba. A frequently asked question is when
infections most commonly occur. The answer is that the organism is most active
in summer months, even in the southern states. Most cases occur in previously
healthy young males (median age of 12 years).
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Encephalitis is a brain inflammation that causes sudden fever, vomiting, headache, light sensitivity, stiff neck and back, drowsiness, and irritability. Meningitis is an infection that causes inflammation of the meninges that surround the brain and spinal cord. Symptoms of meningitis include high fever, headache, nausea, vomiting, and stiff neck.
Recreational Water Illnesses (RWIs) are caused by germs spread by breathing in mists or aerosols, swimming, or having contact with contaminated water in hot tubs, water parks, water play areas, fountains, lakes, rivers, oceans, and swimming pools. Diarrhea is the most commonly reported recreational water illness. Diarrheal illnesses are caused by germs such as Crypto, Shigella, Norovirus, E. coli, and Giardia. Prevention of water born illnesses is key to avoid infection. Avoid swallowing water and practice good hygiene habits are a must.
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