The epidemiology of primary amoebic meningoencephalitis in the USA, 1962–2008

• Published in: Epidemiology and infection Vol. 138; no. 7; pp. 968 - 975
• Main Authors: YODER, J. S., EDDY, B. A., VISVESVARA, G. S., CAPEWELL, L., BEACH, M. J.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.07.2010
• Subjects: Adolescent; Adult; Amebiasis - epidemiology; Amibiasis; Amoeba; Autopsies; Biological and medical sciences; Case reports; Central Nervous System Protozoal Infections - epidemiology; Child; Child, Preschool; Climate change; Disease; Drinking water; Epidemiology; Ethnicity; Female; Fresh water; Fundamental and applied biological sciences. Psychology; Groundwater; Human protozoal diseases; Humans; Infant; Infant, Newborn; Infections; Infectious disease epidemiology; Infectious diseases; Male; Males; Medical laboratories; Medical sciences; Meningitis; Meningoencephalitis; Meningoencephalitis - epidemiology; Microbiology; Naegleria fowleri; parasitic disease epidemiology and control; Parasitic diseases; Patients; Potable water; Protozoal diseases; Public health; River water; Rivers; United States - epidemiology; water-borne infections; Young Adult; United States; Florida; United States > US; Texas; water-borne infections; Infectious disease epidemiology; parasitic disease epidemiology and control; Infection; Nervous system diseases; Protozoal disease; Central nervous system disease; Amebiasis; Parasitosis; Epidemiology; Meningoencephalitis
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268809991014

Naegleria fowleri, a free-living, thermophilic amoeba ubiquitous in the environment, causes primary amoebic meningoencephalitis (PAM), a rare but nearly always fatal disease of the central nervous system. While case reports of PAM have been documented worldwide, very few individuals have been diagnosed with PAM despite the vast number of people who have contact with fresh water where N. fowleri may be present. In the USA, 111 PAM case-patients have been prospectively diagnosed, reported, and verified by state health officials since 1962. Consistent with the literature, case reports reveal that N. fowleri infections occur primarily in previously healthy young males exposed to warm recreational waters, especially lakes and ponds, in warm-weather locations during summer months. The annual number of PAM case reports varied, but does not appear to be increasing over time. Because PAM is a rare disease, it is challenging to understand the environmental and host-specific factors associated with infection in order to develop science-based, risk reduction messages for swimmers.