Neti pot danger? Two die from amoeba infection

Last week, Louisiana’s Department of Health and Hospitals issued a warning to residents: Don’t use tap water to rinse your nasal passages.

The warning came after a 51-year-old woman in the state died after she was infected with the “brain-eating” amoeba Naegleria fowleri, which enters the body through the nose and sometimes causes devastating meningitis. Apparently, the amoeba lurked in tap water the woman used in her neti pot, a pitcher-like device used to rinse nasal passages.

“Tap water is safe for drinking, but not for irrigating your nose,” Louisiana’s state epidemiologist, Dr. Raoult Ratard, said in a statement. He urged those who want to rinse their sinuses to use distilled, sterile or previously boiled water, and to rinse their neti pot (or other irrigation device) after each use and allow it to air dry.

If you’re anything like me and have always used tap water to rinse your sinuses, the warning is a bit scary. Naegleria fowleri infection is very rare -- only 32 people in the U.S. were affected between 2000 and 2010, the Louisiana warning noted -- but it’s also very deadly, causing the destruction of brain tissue and usually death within a couple of weeks. (Earlier this year, Booster Shots reported on a young woman in Florida who contracted the amoeba infection after swimming in a river.)

We spoke to Dr. Otto Yang, associate chief of the division of infectious diseases at UCLA’s Geffen School of Medicine, for more information on the amoeba.

People can get meningitis from Naegleria -- which lives in freshwater in warm places, such as the southern U.S. -- when the organism manages to get past a thin part of the skull behind the nose called the cribiform plate, and thus is able to enter the fluid behind the brain. Most of the time, this happens when people go swimming in lakes and ponds and get water up their noses.

Naegleria “is generally harmless when ingested by mouth, so [the Louisianans] got it because it was pushed directly into the area behind the nose close to the brain,” Yang said of the woman and a 20-year-old man who apparently died the same way in June. Yang said he believed that these to be the first reported cases of transmission through tap water.

Like the Louisiana health officials, Yang said it’s probably “best to use distilled or boiled water to play it safe,” when rinsing the sinuses. But, he emphasized, Naegleria fowleri “is generally a very rare infection.”

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