Two Boys in U.S. Die From Brain Eating Amoeba

Two boys in the U.S. have died from a brain eating amoeba. Six year old Josiah McIntyre, from Texas, died around a week after falling ill, while 13-year-old Tanner Lake Wall, from Florida, died days after swimming in a lake where he is thought to have contracted the amoeba.

The two cases follow a report in the NEJM of a 44-year-old dying from a brain eating amoeba after swimming in an indoor pool in India. The case report was published by physicians at the Santa Clara Valley Medical Center, although it is unclear where the man was diagnosed and treated.

All three were found to have been infected with the amoeba Naegleria fowleri.

N. fowleri is a single-celled organism commonly found in freshwater sources, such as lakes, rivers and hot springs. It can also be found in swimming pools if the water is inadequately chlorinated or in contaminated tap water. It normally infects people by entering the body via the nose. From there, it travels to the brain where it causes primary amebic meningoencephalitis. This is a disease of the central nervous system and causes inflammation and destruction of the brain and its linings. On average, people die five days after infection.

Cases of primary amebic meningoencephalitis are rare. A CDC report in 2018 estimated 16 people die from N. fowleri infection in the U.S. every year, with many of these going undiagnosed.

In the case of the 44-year-old man, he had arrived at an emergency department suffering from a cough and confusion. His symptoms had come on the day before. It emerged he had been swimming five days before the symptoms started. His temperature was 39.8 degrees Celsius and his heart rate was 120 beats per minute. "He did not respond to questions or blink to visual threat; however, brainstem reflexes were intact, and he withdrew both arms and both legs from painful stimuli," the report said.

He was initially given antibiotics for bacterial meningitis and while his fever was reduced, his mental condition did not improve. Further tests revealed N. fowleri. This, the researchers wrote, is "almost universally fatal, although rare cases of survival have been described." The man died five days after arriving at hospital.

In Florida, Tanner's parents told News4Jax that their son had been swimming in a lake in a North Florida campground a few days before he fell ill. He was suffering from nausea, vomiting and headaches, as well as a stiff neck. Doctors initially diagnosed him with strep throat. His parents disagreed with the diagnosis and took him to another healthcare facility where he was placed on a ventilator. He was then diagnosed with the brain eating amoeba N. fowleri.

"They said, 'We're sorry to tell you this, but your son does not have bacterial meningitis. He has a parasitic amoeba, and there is no cure,'" his father Travis Wall told News4Jax.

Tanner was taken off life support after showing no sign of brain activity.

Josiah, from Houston, became ill at the start of September, suffering from sickness and a fever. His mother Maria said doctors initially thought it was a viral infection but she was later told he was suffering from a brain eating amoeba. "There was a very slim to none chance for him and I wish he would've gotten that slim chance, but I understand," she told abc13. "But it was hard."

According to the U.S. Centers for Disease Control and Prevention, infection with N. fowleri is generally fatal, with just five known survivors in North America. The most recent survival was in the U.S. in 2016. In this case, the patient—a 16-year-old boy—was diagnosed within hours of presenting at the hospital.

Earlier this year it was reported that the presence of N. fowleri in the U.S. was increasing. Speaking to Insider in June, CDC epidemiologist Jonathan Yoder said that in the first few decades where the amoeba was being tracked, it was only found in the southern tier of the U.S. "But in the last 10 years we have identified cases in additional northern states, like Indiana, Minnesota, Missouri, where we had not previously seen cases," he said.

"There is concern if waters continue to warm in northern states there may be more of a risk to people who go in water in those states."

brain eating amoeba
Stock image representing the brain eating amoeba Naegleria fowleri. Two boys in the U.S. recently died as a result of the amoeba. iStock