Public health officials with the North Carolina Department of Health and Human Services are reporting a child died Friday after developing an illness caused by an amoeba that is naturally present in freshwater. The child became ill after swimming in a private pond on their residence in central North Carolina in early August. To protect the family’s privacy, no other identifying information will be released.
"Our heart-felt condolences and sympathies are with the family and friends of this child," said State Epidemiologist Zack Moore, M.D. "Although these infections are very rare, this is an important reminder that this amoeba is present in North Carolina and that there are actions people can take to reduce their risk of infection when swimming in the summer."
Laboratory testing at the federal Centers for Disease Control and Prevention confirmed the child’s illness was caused by Naegleria fowleri, an amoeba (one-celled living organism) commonly found in freshwater. Naegleria fowleri, does not cause illness if swallowed but can be fatal if forced up the nose, as can occur during jumping into water, diving, water-skiing or other water activities.
Symptoms of Naegleria fowleri infection — an infection of the brain called primary amebic meningoencephalitis (PAM) — start with severe headache, fever, nausea and vomiting and progress to stiff neck, seizures and coma and can lead to death. These rare infections usually occur when it is hot for prolonged periods of time, which results in higher water temperatures and lower water levels. Naegleria fowleri grows best at higher temperatures up to 115°F.
As there is no means to eliminate this amoeba from fresh water bodies of water, in warmer areas where this infection has been more common, recommended precautions include:
- Limit the amount of water going up your nose. Hold your nose shut, use nose clips or keep your head above water when taking part in warm freshwater-related activities.
- Avoid water-related activities in warm freshwater during periods of high water temperature and low water levels.
- Avoid digging in or stirring up the sediment while taking part in water-related activities in shallow, warm freshwater areas.
Naegleria fowleri infections are rare, with only 147 known infected individuals in the U.S. (between zero and eight cases annually) from 1962 through 2019. North Carolina had six cases during that time period. This amoeba can cause severe illness up to nine days after exposure. A person cannot be infected with Naegleria fowleri by drinking water, the amoeba is not found in salt water, or in properly maintained and chlorinated pools.