Brain-Eating Ameba

Primary Amebic Meningoencephalitis

Jennifer Cope, MD

May 28, 2013

Editorial Collaboration

Medscape &

In This Article

Preventing Naegleria fowleri Infection

The only certain way to prevent PAM due to swimming is to refrain from water-related activities in warm freshwater. Additional recommendations that may reduce risk include:

Hold your nose shut, use nose clips, or keep your head above water when taking part in water-related activities in bodies of warm freshwater;

Avoid putting your head under the water in hot springs and other untreated thermal waters;

Avoid water-related activities in warm freshwater during periods of high water temperature and low water levels;

Avoid digging in, or stirring up, the sediment while taking part in water-related activities in shallow, warm freshwater areas.

To prevent PAM related to nasal and sinus irrigation for medical or religious purposes, it is important for your patients to understand that tap water from any source is not sterile. When making a solution for irrigating, flushing, or rinsing your nose or sinuses with a neti pot or other device, use water that has been:

Previously boiled for 1 minute, or boiled for 3 minutes at elevations above 6500 feet, and then left to cool; or

Filtered, using a filter with an absolute pore size of 1 micron or smaller; or

Purchased with a label specifying that it contains distilled or sterile water.

Rinse the irrigation device after each use with water that has been previously boiled, filtered, distilled, or sterilized and leave the device open to air dry completely.

Thank you for taking the time to learn about this rare and devastating infection and what you can do to help prevent it in your patients.