DSHS Offers PAM Precautions
July 14, 2016
The Texas Department of State Health Services is reminding swimmers and water skiers to take precautions to avoid infection from Naegleria fowleri, an ameba present in nearly all rivers, lakes, ponds and streams. The ameba can cause primary amebic meningoencephalitis, or PAM, an infection of the brain. Although infection is extremely rare, it is almost always fatal.
Nine cases of PAM have been reported in Texas since 2005 resulting in eight deaths, including a recent case of a teen from Harris County.
DSHS offers these precautions to reduce the already low risk of infection:
•Do not swim, ski, dive or jump into stagnant water.
•Hold your nose or use nose clips when jumping, skiing, diving or wakeboarding in any fresh water.
•Avoid putting your head underwater in hot springs and other warm fresh water bodies.
•If you use a Neti-Pot or syringe for nasal irrigation or participate in ritual nasal rinsing be sure to use only sterile, distilled, or lukewarm previously boiled water.
•Avoid digging in, or stirring up mud and scum while taking part in water-related activities in shallow, warm freshwater areas.
The ameba thrives in warm, stagnant water but may be present in any body of fresh water. A combination of lower water levels, high temperatures and stagnant or slow-moving water may produce higher concentrations of the ameba.
Infection can occur when water containing the ameba is forced up the nose when participating in water-related activities. The organism has also been found in tap water and can be introduced to the brain when tap water is used for nasal irrigation or sinus flushes. Symptoms may include severe headache, high fever, stiff neck, nausea and vomiting.
The ameba does not live in salt water or in swimming pools and hot tubs that are properly cleaned, maintained and treated with chlorine.
Closing lakes or other bodies of water is not a standard public health protection measure against PAM given that the amebas are ubiquitous, naturally occurring microorganisms and infections are extremely rare.