People who use disinfected tap water in neti pots -- small, tea pot-like containers used to treat sinuses -- can develop a serious infection that is often fatal, a new federal study warns.
The findings, published in the journal Clinical Infection Diseases, has tied the use of tap water-filled pots with infection by the Naegleria fowleri ameba, a single-celled organism, that can travel from the nose to the brain, causing primary amebic meningoencephalitis, a very rare, but life-threatening disease.
The study, by the Centers for Disease Control and Prevention, examined 32 N. fowleri infections from 2002 to 2011. Lead researcher Jonathan Yoder, coordinator of waterborne diseases and outbreak surveillance at CDC, noted clues to the connection came from two Louisiana patients, a 28-year-old man and a 51-year-old woman, who died within five days of being admitted to the hospital with meningitis-like symptoms.
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"N. fowleri was found in water samples from both homes," Yoder said, but "not found in the treatment plants or distribution systems of the municipal water systems servicing the patients' homes." Although it was never clear how N. fowleri were introduced into the plumbing of the patients' houses, once there, the organisms were able to colonize the hot water systems.
In addition, Yoder's team also tested commercially available reconstituted salt packets for use with neti pots and found that these were unable to reduce the number of N. fowleri organisms. That means simply adding salt to tap water does not inactivate the organisms fast enough.
Yoder advises that the simplest methods to avoid infection are to use water that is labeled as distilled or sterile, or use only water that was previously boiled for one minute (at elevations above 6,500 feet, boil for three minutes) that has been left to cool. Another option: Use water that has gone through a filter with a pore size of one micron or smaller.
Deaths from N. fowleri infection, which remain very rare, "are tragic for the families of those infected," Yoder said. "The CDC is working to understand this organism so that we can improve prevention recommendations, identify N. fowleri infections, and improve clinical treatment."
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