While people suffering from sinus infections are reaching for their neti pots, hoping for unobstructed nasal passageways, the Louisiana Department of Health reminds residents to sterilize the water first.

Last week the state reported it’s second death due to Naegleria fowleri infection: a 51-year-old woman who had used N. fowleri infected tap water in her neti pot. The first death was recorded in June of this year, from the same conditions.

Neti pots are used to flush out blocked nasal passages. N. fowleri is a free-living amoeba often found in warm freshwater ponds, rivers and lakes, and sometimes pools with minimal chlorination. Infection can only occur when the amoeba enters the nose. Once in the nose, the amoeba accesses the brain through the olfactory nerve and causes swelling, necrosis and hemorrhaging in brain tissue, hence its nick name: “brain-eating” amoeba. N. fowleri infection causes primary amebic meningoencephalitis, or PAM, a rare but nearly always fatal disease. Symptoms may present any time between one and 15 days after infection and include headache, fever, nausea, vomiting, seizures and coma.

Louisiana State Epidemiologist, Dr. Raoult Ratard reminds people that, when irrigating the nose, previously boiled, distilled or sterilized water should be used; “Tap water is safe for drinking, but not for irrigating your nose,” he says.

Currently, human beings are nearly defenseless against the amoeba. Because what makes N. fowleri pathogenic is still unknown, there is no effective treatment. Certain antifungals and antiprotozoan compounds are used to treat infection but are not 100 percent effective.

Fortunately, infections are rare. According to the Louisiana Department of Health, between 2001 and 2010, only 32 cases were reported in the United States. Further, there are ways to reduce the risk of infection. The CDC recommends avoiding activities in warm freshwater, avoiding the disturbance of dirt or soil when playing in shallow water and using a nose clip (or holding your nose) when swimming. You may also want to ensure that your pool is properly chlorinated before diving in.

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