Frequently Asked Questions about PAM

What is Naegleria fowleri?

A free-living microscopic amoeba that can cause a devastating and fatal infection in the brain called Primary Amebic Meningoencephalitis.

Who can be infected?

Anyone with freshwater exposure or who has had improperly chlorinated water up the nose is at risk for Primary Amebic Meningoencephalitis. Cases have been reported in individuals as young as eight months up to individuals in their 60’s. The median age of infection is 12, with over 75% of infections occurring in males.

When do infections occur?

Infections are more prevalent in the summertime when water temperatures are warmer. The amoeba loves warm water. It grows best at higher temperatures up to 115 degrees Fahrenheit and can survive for short periods of time at even higher temperatures.

Where is Naegleria fowleri found?

In all bodies of freshwater, including but not limited to ponds, lakes, rivers, and hot springs. It is also found in improperly chlorinated swimming pools, hot tubs, and splash pads. Cases have also been linked to contaminated water systems when tap water is used for nasal irrigation and other religious purposes.

How does the infection occur?

The infection occurs when water containing the amoeba enters the body via the nose. The amoeba travels up the nose to the brain, where it causes the infection. You can not get infected with the amoeba from drinking contaminated water. The amoeba can not be passed from one person to another. The amoeba causes swelling in the brain, which ultimately causes death if untreated.

Where do infections occur?

Infections have been reported around the world. In the United States, the majority of infections have occurred in Southern-tier states, however, there have been documented cases as far north as Minnesota.

What are the symptoms of an infection caused by Naegleria fowleri?

Symptoms often begin mild but worsen very quickly. Symptoms usually start within 1-9 days with an average of 5 days after exposure. Symptoms may include fever, nausea, vomiting, and headache and often mimic the flu or Meningitis. As the infection progresses, symptoms may include confusion, seizures, hallucinations, stiff neck, altered mental status, and coma. Death typically occurs within five days of the onset of symptoms.

How is an infection caused by Naegleria fowleri diagnosed?

There is currently no early detection test. It is vitally important to rule out an infection caused by Naegleria fowleri when a patient presents with symptoms and to ask about freshwater exposure. Naegleria fowleri infections must be diagnosed in a laboratory setting. Naegleria fowleri organisms, Naegleria Fowleri nucleic acid, or Naegleria fowleri antigens will be seen in Cerebrospinal fluid (CSP), biopsy, or tissue specimen.

What is the treatment for Primary Amebic Meningoencephalitis?

If you suspect PAM or have a confirmed diagnosis of PAM, please consult the CDC for treatment protocols at 770-488-7110.