Summary
- Primary amoebic meningoencephalitis (PAM) is a rare and fatal disease caused by Naegleria fowleri, a single-cell ameba found in natural waters and sometimes in poorly disinfected recreational waters.
- A case of PAM was reported in a 30-year-old woman who visited an indoor surfing center in Taiwan in July 2023. She experienced neurologic symptoms and died shortly after.
- The Taiwan Centers for Disease Control (TCDC) detected N. fowleri as the causative agent using multiplex quantitative reverse transcription PCR.
- Water quality testing revealed insufficient chlorine levels in the facility, prompting a comprehensive cleanup and disinfection. The investigation did not conclusively determine the source of N. fowleri.
- Activities that increase the risk of N. fowleri infection, such as diving, jumping into water, or surfing, should be done cautiously to prevent water from entering the nasal cavity. Indoor water facilities should prioritize water quality and sanitation to prevent PAM cases.
Primary amoebic meningoencephalitis (PAM) is a rare but deadly disease caused by a tiny single-cell organism called Naegleria fowleri. This organism usually lives in natural water sources but can also be found in swimming pools and recreational waters that have not been properly disinfected. A recent case of PAM in Taiwan has brought attention to the importance of water safety in indoor recreational facilities.
The Case – Primary amoebic meningoencephalitis:
A 30-year-old woman visited an indoor surfing center in northern Taiwan and tragically passed away just a few days later. She experienced symptoms such as headache, stiffness in the neck and shoulders, fever, and seizures before her condition rapidly deteriorated. After her death, it was discovered that Naegleria fowleri was the only pathogen detected in her system.
Investigation:
Officials from the Taiwan Centers for Disease Control (TCDC) visited the surfing center to conduct an environmental investigation. Water and biofilm samples were taken from various areas of the facility to test for Naegleria fowleri. It was found that one sample from stagnant water beneath the basement ladder tested positive for the organism. Further investigation revealed design deficiencies in the facility that may have contributed to contamination.
Prevention of Primary amoebic meningoencephalitis:
Following the tragic incident, the surfing center suspended operations for a thorough cleanup and disinfection. The facility made necessary renovations, including adding footbaths for swimmers, drainage ditches around the pool, and ensuring proper chlorine levels in the water. The staff members were trained to maintain chlorine levels at 1-3 parts per million and a pH of 7.2-7.8 to prevent future incidents.
Lessons Learned
Naegleria fowleri infections are rare but can be fatal. It is essential for recreational facilities to prioritize water quality and sanitation to prevent such incidents. Activities that involve water entering the nasal cavity, such as diving and surfing, pose a higher risk for infection. Visitors to recreational waters should be cautious and avoid letting water enter their noses to reduce the risk of infection.
Conclusion
The case of primary amoebic meningoencephalitis in Taiwan serves as a reminder of the importance of water safety in indoor recreational facilities. Maintaining proper disinfection practices and ensuring water quality is crucial to prevent infections caused by pathogens like Naegleria fowleri. Public health authorities should conduct regular inspections of recreational facilities to ensure compliance with safety guidelines.
In summary, the tragic case of primary amoebic meningoencephalitis in Taiwan highlights the need for vigilance in maintaining water quality and sanitation in indoor recreational facilities to prevent infections and ensure the safety of visitors.
Infectious Diseases,Nephrology,Neurology,Urology