A Douglas County child died this week from a suspected infection with the amoeba Naegleria fowleri, which may have been contracted while swimming in the Elkhorn River on Sunday, according to the Douglas County Health Department.
The federal Centers for Disease Control and Prevention are conducting further tests to confirm the infection, according to the health department. Health officials declined to provide additional information about the child, such as age or gender.
The microscopic unicellular organism is commonly referred to as the “brain-eating amoeba.” It can cause a rare but almost always fatal brain infection called primary amebic meningoencephalitis, or PAM, when water containing the amoeba flows through the nose and reaches the brain, the CDC said.
If confirmed, the child’s death would be the first known death of Naegleria fowleri in state history, according to the Nebraska Department of Health and Human Services.
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Naegleria fowleri is present in many freshwater sources such as rivers, lakes and streams and is identified further north as previously cooler areas become warmer and drier.
While millions of people are exposed to freshwater sources for recreation each year, fewer than eight infections are diagnosed in the U.S. each year, said Dr. Matthew Donahue, state epidemiologist.
Infections usually occur later in the summer in warmer waters with a slower flow, especially in July, August and September, he said.
A Missouri resident died after being infected with the organism while swimming in Southwest Iowa’s Lake of Three Fires State Park in late June. Iowa health officials, working with the CDC, later confirmed the organism’s presence in the lake. Iowa officials closed a beach in the park for a while, but reopened it in late July after testing was completed.
Douglas County health officials urged residents to take precautions when exposed to freshwater sources.
Donahue said limiting the possibilities for fresh water to get into the nose is the best way to reduce the risk of infection. Behaviors associated with infection include diving or jumping into the water, submerging the head, or other activities such as water skiing or high-speed tubing that can cause water to forcibly rise up the nose.
Swimmers can reduce their risk by keeping their heads out of the water, using nose clips, or stuffing their noses when submerged, including in hot springs and other untreated warm water. Swimmers should also avoid digging or stirring up sediment at the bottom of lakes or rivers.
People cannot become infected by drinking contaminated water or by swimming in a swimming pool that has been properly cleaned, maintained and disinfected.
According to state health officials, the CDC generally does not recommend testing untreated rivers and lakes for the organism because it occurs naturally and there is no established link between detection and concentration of the amoeba and risk of infection.
Symptoms of an infection usually appear one to 12 days afterward, according to Douglas County health officials. They may include headache, fever, and nausea or vomiting. Those symptoms can develop into a stiff neck, confusion, seizures, and other neurological disorders.
“We can only imagine the devastation this family must feel,” Douglas County health director Lindsay Huse said in a statement. “And our deepest condolences are with them. We can honor the memory of this child by being educated about the risk and then taking steps to prevent infection.”
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