A Tarrant County child died this month from a rare infection caused by an amoeba that thrives in warm water.
Commonly called a brain-eating amoeba, Naegleria fowleri typically enters the body through the nose and travels to the brain, where it causes primary amebic meningoencephalitis.
In this case, the child likely contracted the amoeba from an Arlington splash pad, city and public health officials said Monday. The child, who has not been identified, died Sept. 11.
Here’s what we know about the amoeba.
How rare is an infection?
The risk of N. fowleri infection is extremely low, with only 34 reported infections in the United States between 2010 and 2019, according to the Centers for Disease Control and Protection.
Millions of people are exposed to the amoeba every year, but only a handful get sick from it, the Mayo Clinic says. Health officials don’t know why some people develop an infection while others do not.
In his 40-year career, Russ Jones, chief epidemiologist for the Tarrant County Public Health Department, said he has seen only four cases.
“It’s a very, very rare disease,” he said. “Unfortunately, its rarity also makes it difficult to diagnose.”
Where is the amoeba found?
Typically, N. fowleri lives in soil and warm freshwater, likes lakes, rivers and hot springs, particularly in southern states in the summer, according to the CDC.
In very rare cases, an infection can occur after contact with inadequately chlorinated swimming pool water or contaminated tap water, the CDC says. Very rarely, infections have occurred in people who used contaminated tap water to irrigate their sinuses.
On Sept. 24, the CDC confirmed the presence of N. fowleri from water samples taken from the Don Misenhimer Park splash pad, where the child had played, according to a joint news release from the city and the Tarrant County Public Health Department. In recent weeks, the city said, an internal review has revealed issues with water quality, incomplete records and gaps in inspections at the city’s splash pads.
Should parents be worried if their children played at an Arlington splash pad?
Not at this time.
Initial symptoms of primary amebic meningoencephalitis typically occur within nine days of infection and include fever, severe headache, nausea and vomiting, according to the CDC. Later symptoms may include a stiff neck, confusion, loss of balance, seizures and hallucinations.
Arlington closed the splash pad at Don Misenhimer Park on Sept. 5, immediately after it was notified of the child’s illness. It then closed all public splash pads for the remainder of the year.
No additional cases of the infection have been reported in Tarrant County, the news release said.
How might the amoeba have been present at the splash pad?
Most likely, the amoeba was living in nearby dirt or soil and entered the splash pad through someone’s feet or bottom of shoes, Jones said. Once in the water, it would be able to quickly multiply and thrive in the heat.
What if you drink contaminated water?
You cannot get infected from swallowing water contaminated with N. fowleri, according to the CDC. It must enter through your nose to cause an infection.
Is Arlington’s drinking water safe?
Arlington’s drinking water is not affected, the news release said. The splash pad is equipped with a backflow prevention device designed to isolate the facility’s water system from the city’s water distribution system.
Is the disease always fatal?
Almost always. According to the CDC, there are only five known survivors in North America: one from the U.S. in 1978, one from Mexico in 2003, two from the U.S. in 2013 and one from the U.S. in 2016.
What can be done to prevent an infection?
Diving or jumping into water or submerging your head under freshwater can increase the risk of contracting N. fowleri, but the risk is still very small. Holding your nose while underwater can decrease that risk, Jones said.
If you visit a splash pad, he said, it’s a good idea to rinse off before entering.