The CDC has issued a warning against using tap water to rinse the nose after investigating a spate of cases in which the practice led to fatal brain infections.
Agency officials looked at 10 patients who had contracted the deadly amoeba acanthamoeba – a single-celled organism that can spread to the brain and kill its victims.
Three of those people died from the infection linked to their use of tap water in nasal rinses such as neti pots. Another seven people suffered serious illness and were hospitalized.
Acanthamoeba lurks in lakes, swimming pools, tap water, and heating and air conditioning systems across the US, and has been found in more than half of US tap water samples.
Unsanitary tap water can reach the brain if it is rinsed into the nose. Researchers used the findings to urge people who rinse their noses to use boiled, sterile or distilled water.
At least half of the patients used tap water to rinse their nose. Although Acanthamoeba has been found in >50 percent of US tap water samples, 33 percent of adults believe tap water is sterile
For the latest study, ten patients aged 32 to 80 reported rinsing their nose before becoming infected with Acanthamoeba. Seven were male and three were female.
They all had weakened immune systems, a condition that puts them at increased risk of serious infection.
The CDC, which examined patient records from 1994 to 2022, blamed unsanitary tap water for harboring the amoeba and causing the problem.
The CDC said: ‘Education about using unboiled tap water for nasal rinses may be effective in preventing invasive Acanthamoeba infections, especially among immunocompromised hosts.
‘CDC recommendations for performing safe nasal rinses include using boiled, sterile, or distilled water. If tap water is used, it should be boiled for a minimum of one minute, or three minutes at altitudes > 1,980 meters, and allowed to cool before use.”
Nine patients were diagnosed with rhinosinusitis, or inflammation of the nasal cavity and sinuses, six patients with GAE, six patients with a skin disease, a type of skin infection, and three patients with osteomyelitis, an infection of the bone, which causes pain. , can cause swelling and swelling. limited mobility.
The fact that most infections involved the skin and sinuses likely contributed to the relatively high survival rate of the study population. Skin infections are usually not fatal.
Three people died, all of whom had the brain infection.
The survival rate of the brain infection is low – between seven and ten percent. It is also rare, with just a few reports of diseases per year.
The fact that most infections here involved the skin and sinuses likely contributed to the relatively high survival rate of the study population.
Acanthamoeba should not be confused with Naegleria fowleri, commonly called brain-eating amoeba, which kills about 97 percent of victims.
It causes a disease called primary amoebic meningoencephalitis, also known as PAM.
Once the brain-eating amoeba enters the nasal passages, it migrates along the olfactory nerve fibers to reach the brain. From there, it causes inflammation and destruction of brain tissue.
When Acanthamoeba is introduced into the nasopharynx at the back of the nasal passages, it can travel to the brain and into the bloodstream or directly into body tissues.
It activates the immune system to generalized masses of immune cells called granulomas that contribute to tissue destruction.
Some of the symptoms of GAE include headache, fever, confusion, seizures, and focal neurological deficits, depending on the brain areas affected.
The brain infection caused by this particular amoeba progresses slowly and a person may suffer from it for weeks or even months before dying.
At least half of the study participants participated in nasal irrigation with tap water, a risky endeavor considering that Acanthamoeba and other similar amoebae have been found in more than 50 percent of U.S. tap water samples.
But many Americans don’t know that. About 33 percent of American adults believe tap water is sterile, and 62 percent believe it is safe for sinus irrigation.
Acanthamoeba can cause another type of infection, Ancathoamoeba keratitis, which occurs when the amoeba contaminates contact lenses or lenses.