After two reported deaths in Louisiana last year from “brain-eating amoebas” after using neti pots, health authorities and the manufacturer of nasal wash device are warning the public not to use unsterilized tap water when using the neti pot.
The Louisiana Department of Health and Hospitals announced earlier in the month that a 51-year-old DeSoto Parish woman died recently after using tap water in a neti pot to irrigate her sinuses. In June, a 20-year-old St. Bernard Parish man also died, both because of infections with the nearly 100% deadly amoeba,Naegleria fowleri.
What is a Neti Pot?
According to Mayo Clinic asthma and allergy specialist, James T C Li, M.D., Ph.D., a neti pot is a container designed to rinse the nasal cavity. You might use a neti pot to treat nasal allergies, sinus problems or colds.
In addition to Louisiana health officials, Dr. Ketan C. Mehta, MD, CEO of NeilMed Pharmaceuticals Inc., the manufacturer of the NasoFlo Neti Pot issued a release Thursday emphasizing the safe use of the Neti Pot.
Dr. Mehta says in the release:
As a physician, I feel that nasal irrigation is safe and very effective for nasal and sinus symptoms as long as directions are followed as described in our product brochure.
NeilMed has learned about recent news and internet articles concerning the improper use of unfiltered or contaminated tap water with neti pots. We emphasize when used as directed, NeilMed’s nasal wash devices are safe, affordable and effective. From the beginning, NeilMed’s directions of use have always stressed the importance of using clean and previously boiled, distilled or filtered water through a 0.2 micron filter for nasal irrigation. Our product brochure clearly notes that using tap water is not recommended. Please do not use tap or faucet water when using NeilMed’s nasal wash devices unless it has been previously boiled and cooled down. NeilMed brochures also provide clear instructions for disinfecting our nasal irrigation devices. The neti pot devices are designed to allow for microwave disinfection as they do not contain any metal parts.
Can I use the tap water for nasal rinsing if it is labeled safe to drink?
No, we do not recommend using drinking tap water for nasal rinsing unless you boil it or run through a filter of 0.2 micron size. Tap water is not always safe depending on its environmental source, and it is impossible to designate all areas as water safe for nasal irrigation.
Naegleria fowleri is a relatively rare, pathogenic amoeba found in warm or hot freshwater like lakes, rivers and hot springs. It is also possible to get it from dirty unchlorinated or under-chlorinated swimming pools. This parasite is found worldwide and in the United States, it is found mainly in the southern-tier states.
People typically get it by swimming, jumping or playing in freshwater and get the water up their nose. From there the parasite travels to the brain and spinal cord and necrotizes or basically eats brain tissue. The disease is known as primary amoebic meningoencephalitis (PAM) and it has a very rapid progression. Typical symptoms may start after a day or two; headache, fever, nausea and vomiting. Later symptoms may include seizures, irrational behavior, hallucinations and finally coma and death. The course of the disease typically last about a week. Because the symptoms are very similar to bacterial meningitis, PAM may not even be considered in the diagnosis.
Fortunately, it’s a pretty rare disease, with only approximately 30 cases in the past decade. Unfortunately, treatment is usually unsuccessful with only a handful of people surviving infection.
You should always assume there is some risk when swimming in freshwater. The location and number of amoeba present in a body of water varies from time to time. The Centers of Disease Control and Prevention recommends these four steps to reduce your risk of infection:
• Avoid water-related activities in bodies of warm freshwater, hot springs, and thermally-polluted water such as water around power plants.
• Avoid water-related activities in warm freshwater during periods of high water temperature and low water levels.
• Hold the nose shut or use nose clips when taking part in water-related activities in bodies of warm freshwater such as lakes, rivers, or hot springs.
• Avoid digging in or stirring up the sediment while taking part in water-related activities in shallow, warm freshwater areas.