Brain-Eating Amoeba Case Confirmed in South Carolina, Death Reported

The South Carolina Department of Public Health (SCDPH) has confirmed a case of Naegleria fowleri, commonly known as a “brain-eating amoeba,” in the state. While SCDPH initially reported the case earlier this month, Prisma Health Richland Children’s Hospital in Columbia later confirmed that a patient treated at their facility died as a result of the infection.

Health officials presume the infection occurred at Lake Murray. This marks South Carolina’s first confirmed case of Naegleria fowleri since 2016.

Naegleria fowleri is a microscopic, single-celled amoeba naturally found in warm freshwater bodies such as lakes, rivers, ponds, and hot springs, particularly during periods of high water temperatures and low water levels. Infection occurs when water containing the amoeba enters the body through the nose, typically during activities like swimming, diving, or putting one’s head under water. From the nose, the amoeba travels to the brain, where it causes a severe and nearly always fatal brain infection called Primary Amebic Meningoencephalitis (PAM). It is crucial to note that infection cannot occur from swallowing contaminated water.

Symptoms of PAM typically begin around five days after exposure, though they can manifest anywhere from one to twelve days. Early symptoms include severe headache, fever, nausea, and vomiting. As the infection progresses, more severe symptoms such as a stiff neck, confusion, loss of balance, seizures, and hallucinations can develop. The disease progresses rapidly, with death usually occurring within about five days after symptoms first appear.

While Naegleria fowleri is common in warm freshwaters across the globe, infection in humans is extremely rare. Nationwide, only 167 cases have been reported in the past 62 years, with fewer than 10 cases identified annually in the U.S. Despite its rarity, the infection has a fatality rate of over 97 percent.

To reduce the risk of infection, health officials recommend the following precautions:

• Avoid forceful entry of water into the nose: When swimming or engaging in water-related activities in warm freshwater, hold your nose shut, use nose clips, or keep your head above water.
• Avoid stirring up sediment: Naegleria fowleri can live in the sediment at the bottom of bodies of water. Avoid digging or stirring up the bottom in shallow, warm freshwater areas.
• Be cautious in hot conditions: The risk of infection may increase during periods of extremely hot temperatures and low water levels.
• Use safe water for nasal irrigation: If using neti pots or other devices for sinus rinsing, use only distilled, sterile, or previously boiled and cooled tap water. Do not use untreated tap water.

Anyone experiencing symptoms such as a severe headache, fever, stiff neck, or vomiting after recently swimming in warm freshwater should seek immediate medical attention and inform their healthcare provider about their water exposure history.