Additional test results from the federal Centers for Disease Control and Prevention (CDC) confirm the presence of the rare ameba Naegleria fowleri in four locations of the St. Bernard Parish water system, the Louisiana Department of Health (DHH) announced Thursday.
LDH announced last week that the encephalitis death of a child that had visited St. Bernard Parish was connected to the rare ameba, which testing confirmed was present at the home. Because some water samples showed low residual levels of chlorine, LDH sent additional water samples to the CDC for testing last week and St. Bernard parish began flushing its water lines with additional chlorine last week, as a precautionary measure.
Assistant Secretary for Public Health J.T. Lane said, "We know that chlorine kills Naegleria fowleri, which is why it was critical that the parish proactively began flushing its water system with additional chlorine last week. The parish will continue this action until it raises chlorine residuals to recommended levels, and this process will continue for several weeks. LDH is working with parish officials to provide assistance and support to the parish's staff to ensure that chlorine levels are being monitored daily."
State Health Officer Jimmy Guidry said, "The water is safe to drink and there are basic precautions that families can take -- such as chlorinating their pools and avoiding getting water in their noses -- to protect themselves, though infection from this ameba is very rare."
Today's confirmation is from four sites located in Violet and Arabi. LDH scientists pulled samples from hydrants and faucets that connected directly to the water lines. Hundreds of liters of water were filtered in order to capture any amebas that might be present in the water.
Naegleria fowleri is a rare infection that has been associated with three deaths traced to water in Louisiana since 2011. Two people died in 2011, in addition to the death being announced last week. The CDC confirmed that Naegleria fowleri was the cause of the death after specialized testing was conducted.
PRECAUTIONARY MEASURES FOR FAMILIES
According to the CDC, personal actions to reduce the risk of Naegleria fowleri infection should focus on limiting the amount of water going up a person's nose and lowering the chances that Naegleria fowleri may be in the water. For information on preventative measures, please visit the CDC Website here: http://www.cdc.gov/parasites/naegleria/prevention.html
To prevent any risk when using drinking water, make sure water does not go up your nose. Some common sense suggestions from the CDC include:
- DO NOT allow water to go up your nose or sniff water into your nose when bathing, showering, washing your face, or swimming in small hard plastic/blow-up pools.
- DO NOT jump into or put your head under bathing water (bathtubs, small hard plastic/blow-up pools) - walk or lower yourself in.
- DO NOT allow children to play unsupervised with hoses or sprinklers, as they may accidentally squirt water up their nose. Avoid slip-n-slides or other activities where it is difficult to prevent water going up the nose.
- DO run bath and shower taps and hoses for 5 minutes before use to flush out the pipes. This is most important the first time you use the tap after the water utility raises the disinfectant level.
- DO keep small hard plastic/blow-up pools clean by emptying, scrubbing, and allowing them to dry after each use.
- DO use only boiled and cooled, distilled, or sterile water for making sinus rinse solutions for neti pots or performing ritual ablutions.
- DO keep your swimming pool adequately disinfected before and during use. Adequate disinfection means:
o Pools: free chlorine at 1-3 parts per million (ppm) and pH 7.2-7.8
o Hot tubs/spas: free chlorine 2-4 parts per million (ppm) or free bromine 4-6 ppm and pH 7.2-7.8
o If you need to top off the water in your swimming pool with tap water,
DO place the hose directly into the skimmer box and ensure that the filter is running.
DO NOT top off by placing the hose in the body of the pool.
Residents should continue these precautions until extensive testing no longer detects the ameba in the water system. Residents will be made aware when that occurs.
ABOUT NAEGLERIA FOWLERI
Exposure to Naegleria fowleri typically occurs when people go swimming or diving in warm freshwater lakes and rivers. In very rare instances, Naegleria fowleri infections may also occur when contaminated water from other sources (such as inadequately chlorinated swimming pool water or heated tap water less than 116.6 degrees Fahrenheit) enters the nose when people submerge their heads or when people irrigate their sinuses with devices such as a neti pot. People cannot be infected with Naegleria fowleri by drinking water.
Naegleria fowleri causes the disease primary amebic meningoencephalitis (PAM), a brain infection that leads to the destruction of brain tissue. In its early stages, symptoms of PAM may be similar to symptoms of bacterial meningitis.
Initial symptoms of PAM start one to seven days after infection. The initial symptoms include headache, fever, nausea, vomiting, and stiff neck. Later symptoms include confusion, lack of attention to people and surroundings, loss of balance, seizures, and hallucinations. After the start of symptoms, the disease progresses rapidly and usually causes death within one to 12 days.
Naegleria fowleri infections are very rare. In the 10 years from 2001 to 2010, 32 infections were reported in the U.S. Of those cases, 30 people were infected by contaminated recreational water and two people were infected by water from a geothermal drinking water supply.