Brain-eating amoeba death in South Carolina confirmed by hospital

COLUMBIA, S.C. — A South Carolina children’s hospital has confirmed a death from a brain-eating amoeba in South Carolina. 

The Department of Public Health sent an email out Tuesday evening saying that the “organism is presumed to have occurred at Lake Murray.”

Prisma Heath Richland Children’s Hospital in Columbia confirmed Tuesday that a patient treated at their facility died from the organism. This announcement came a day after the South Carolina Department of Public Health (SCDPH) confirmed that there was a case of someone contracting the illness, but did not confirm a death. 

We send our condolences to the family,” said Dr. Anna Kathryn Burch, a pediatric infectious disease physician at Prisma Health Children’s Hospital. “The people here at Prisma Health Children’s Hospital care, and just want you to know that we’re thinking of your family.”

Prisma Health did not give any additional details regarding the patient, including the person’s age and where that person may have come into contact with the amoeba. 

The amoeba–whose scientific name is Naegleria fowleri–can be found in warm freshwater but occasionally has been detected in tap water. The Centers for Disease Control stresses that infections are extremely rare, with fewer than 10 cases a year in the U.S. However, those cases are usually deadly.

DPH says there have been 167 cases reported nationwide in the past 62 years. 

Dr. Burch held a media briefing Tuesday where she addressed questions about the amoeba. Here is a summary of some of those response and questions some people may be answering in the wake of this news. 

“Naegleria fowleri is an amoeba that is ubiquitous to any fresh water in the state of South Carolina and honestly in the Southeast in general, Burch said. “So any lake, river, pond, or hot spring that you could come into contact with in South Carolina will have this amoeba in it. It typically lives in the silt at the bottom of lakes and rivers.”

“The interesting thing is that for most people who come in contact with this type of amoeba, it causes no harm whatsoever. Most of us have been exposed to this amoeba who have been in lakes and rivers and those kind of things. The problem is, is that it’s not an issue when we come in contact with it.  Where it becomes a problem is if water with the amoeba forcefully enters the nose is able to cross from the nose into the brain. It cause a syndrome called primary amoeba meningoencephalitis…. which causes the brain to swell. More than 97% of reported U.S. cases have been fatal.”

Burch adds the amoeba does not exist in salt water, so there is no risk if you’re at the beach near the ocean. 

“In my career as a pediatric infectious disease physician in South Carolina, I’ve now seen two cases,” Burch said “There has only been one reported case in the state this year, and this is that case.”

“You can reduce risk by:

• Avoiding forceful entry of water into the nose during activities like diving, tubing, or skiing

• Teaching kids to blow out their nose or hold their nose when jumping into water.

• Using nose clips during freshwater activities.

• Avoiding digging in shallow, sandy or silty areas, where the amoeba lives.

Also, never use untreated tap water for nasal irrigation devices like neti pots. Tap water must be boiled and cooled, or use sterile or distilled water instead.”

“This is a tough question, especially for those of us raised in the South where freshwater swimming is a summer tradition. The risk increases during extremely hot temperatures. Families should weigh the risks and take precautions like nose clips, avoiding dunking, or choosing to float instead of diving. Pools and splash pads are typically safe because they are chlorinated.”

“The risk definitely is increased when it’s hotter temperatures, such as when we get these 100 degree days. So if you do happen to go into the water during those times, I think having a discussion with your children about why it’s so important to learn how to not get water up the nose, have things like the nose clips out there. Maybe decide not to go on the tube and just float around with floats and those kind of things.”

“This is a rare infection—fewer than 10 cases are reported per year in the U.S. But knowing how it spreads and how to reduce risk is the best thing you can do. We shouldn’t be afraid of our lakes and rivers, but we should be informed and cautious. Educate your kids, use nose protection, and make the decision that’s right for your family.”

“Symptoms usually begin around five days after exposure, but it can range from one to twelve days. It starts with a severe headache, fever, stiff neck, vomiting, and diarrhea. If your child has recently been in freshwater and shows any of those symptoms, it’s critical to tell your healthcare provider.”

“It’s rare, but there have been isolated cases where Naegleria fowleri was found in tap water. Chlorinated water should not carry risk, but again, never use tap water for nasal rinsing unless it’s been properly boiled or sterilized.”

“Yes, because it’s so rare, it’s not always top-of-mind for providers. That’s why it’s vital to mention any recent freshwater exposure to your doctor. Knowing that can help guide proper testing and quicker diagnosis.”