US toddler dies of rare brain-eating amoeba infection likely contracted at splash pad in Arkansas

Naegleria Fowleri
A handout photomicrograph provided by the Centers for Disease Control and Prevention (CDC) depicts the characteristics associated with a case of primary amebic meningoencephalitis, a rare brain infection. Photo credit: CDC via Reuters

By Christina Zdanowicz of CNN

A toddler in the US state of Arkansas died of a rare brain-eating amoeba infection, which was likely contracted at a splash pad at a country club, according to health officials and the county coroner.

The victim died from Naegleria fowleri infection, a condition which "destroys brain tissue, causing brain swelling and in certain cases, death," the Arkansas Department of Health said in a news release on Thursday (local time). 

Naegleria fowleri is an amoeba that lives in soil and warm freshwater lakes, rivers, ponds and hot springs. In rare instances, people have contracted Naegleria fowleri infections from recreational water that had an insufficient amount of chlorine in it, such as pools, splash pads or surf parks, according to the US Centers for Disease Control and Prevention. 

Naegleria fowleri infections are rare. Only about three people in the United States contract the infection per year, but the outcome is usually fatal, according to the CDC.

In the Arkansas case, a 16-month-old boy died on September 4 after spending a few days in the hospital, Pulaski County Coroner Gerone Hobbs told CNN on Friday.

The state health department conducted testing and inspection, finding that the victim was likely exposed at a splash pad at the Country Club of Little Rock. A splash pad or spray pool is a recreational area for water play, typically through an interactive fountain that sprays or jets water onto users. 

Multiple samples from the pool and splash pad were sent to the CDC for evaluation, the release said. The CDC found that one sample had viable Naegleria fowleri and the other samples are still pending. 

The Country Club of Little Rock closed its pool and splash pad voluntarily and there is no ongoing risk to the public, according to officials. CNN reached out to the country club but has not heard back.

The Arkansas Department of Health is not confirming additional information about the case, a spokesperson said in an email to CNN on Friday.

The last case of Naegleria fowleri in Arkansas was in 2013, the state health department said.

In 2021, a three-year-old died from a brain infection from Naegleria fowleri after spending time in a splash pad, according to the CDC. In that case, Texas public health officials discovered the splash pad's water was "recirculated and not adequately disinfected." 

What to know about Naegleria fowleri

This type of amoeba enters the body through the nose, most commonly when people go swimming, diving, or put their heads underwater in freshwater bodies, according to the CDC.

The amoeba travels up to the brain, destroying brain tissue and causing an almost-always fatal infection called primary amebic meningoencephalitis (PAM).

Naegleria fowleri infection cannot be spread from person to person. 

Symptoms of PAM, such as headache, fever, nausea or vomiting, typically begin five days after infection, but they can start within one to 12 days, according to the CDC.

Later symptoms can include confusion, stiff neck, lack of attention to surroundings and people, seizures, hallucinations and coma.

Once the disease starts, it rapidly progresses, usually causing death within about five days.

The CDC says the best way to prevent infection when swimming in fresh water is to keep water from going up the nose. It also suggests avoiding stirring up sediment, where amoebae are more likely to live, at the bottom of freshwater. 

According to Te Whatu Ora, primary meningoencephalitis was first recognised in New Zealand in 1968 among people who had been swimming in untreated thermal pools in the central North Island. There were eight fatal cases between 1968 and 1978, and a further death was reported in 2000.

As per the public health agency, Naegleria infection can be acquired by exposure of the nasal passages to contaminated, usually warm fresh or inadequately treated water, usually by diving or swimming.

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