Overview

• A 71-year-old Texas woman developed fever, headache and altered mental status within four days of using unboiled RV tap water in a nasal irrigation device and died eight days after symptom onset from primary amebic meningoencephalitis.
• Laboratory analysis confirmed Naegleria fowleri, a free-living amoeba that causes a rare and often fatal brain infection, in the patient’s cerebrospinal fluid.
• The CDC investigation identified two possible contamination sources: the RV’s prefilled potable water tank and the municipal water system connected at the campground.
• Naegleria fowleri infections are exceedingly rare but deadly, with a mortality rate above 97% and only four survivors among 164 US cases reported from 1962 to 2023.
• The CDC now advises using only distilled, sterilized or boiled then cooled water for nasal irrigation to eliminate the risk of amoebic infection.