Prevalence and Risk Management of N. fowleri in Louisiana’s Public Water Systems

Samendra Sherchan, Department of Global Environmental Health Sciences, Tulane University, , New Orleans, LA, 70115, sshercha@tulane.edu

Naegleria fowleri, also known as “the brain-eating amoeba”, is a free living amoebae found naturally in hot springs and warm surface waters. N. fowleri can cause primary meningoencephalitis (PAM), most often leading to death within 4 to 6 days if inhaled or forced into the nasal passages when swimming or diving (99% fatal). It is naturally found in soil and warm water and is fairly resistant to chlorine based disinfection. It has a three stage lifecycle. N. fowleri exists in soil in a cystic form and excysts to a flagellate stage when in contact with warm water and a source of food (bacteria). In 2011, two people died of Primary Amoebic Meningoencephalitis (PAM) caused by N. fowleri in DeSoto Parish and St. Bernard Parish, Louisiana. Both cases involved the use of a neti-pot. In 2013, there was second death in St. Bernard Parish (4-year old boy) caused by PAM and confirmed to be N. fowleri (Nf) infection. The child was playing on a backyard Slip’n Slide and about two days later, he was dead. Testing conducted in 2013 by Louisiana Department of Health and Hospitals (DHH)/CDC in both St. Bernard and DeSoto found this amoeba in the treated distribution system water supply. This presentation will cover the prevalence and risk management of N. fowleri in Louisiana’s public water systems.