Introduction: Naegleria fowleri

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Introduction: Naegleria fowleri

Of the more than 47 species of Naegleria that have been described, only one species, N. fowleri, has been associated with human disease. The species was named after Malcolm Fowler who identified trophozoites of Naegleria in the olfactory bulbs and frontal lobes of the first reported human case in South Australia in 1965.
N. fowleri causes a disease called primary amoebic meningoencephalitis (PAM). From 1962 to 2022 there have been 157 documented cases of PAM in the United States with only three known survivors.2 While the majority of cases have primarily occurred in the Southern part of the United States (see map), cases have been reported as far north as Minnesota. N. fowleri is naturally found in warm (30° C - 46° C) freshwater such as ponds, lakes, and rivers, but has also been found in minimally chlorinated swimming pools, geothermally heated water such as hot springs, and discharge from industrial or power plants, plus tap water (contaminated unchlorinated drinking water, well water, and even treated water that has traveled long distances before reaching homes). People cannot become infected by drinking contaminated water since the amoebae are killed by stomach acids. Cases occurring from tap water resulted from its use in nasal cleansing. The organism is not found in seawater and is sensitive to freezing.
2. Centers for Disease Control and Prevention (CDC). Case reports by state of exposure - data table. Last updated May 3, 2023. Accessed November 18, 2023. https://www.cdc.gov/parasites/naegleria/state-map.html
3. Centers for Disease Control and Prevention (CDC). Image, "Number of case reports of PAM by state of exposure, United States, 1962-2022. Public domain. May 3, 2023. Accessed November 18, 2023. https://www.cdc.gov/parasites/naegleria/state-map.html
4. Centers for Disease Control and Prevention (CDC). Image, "Naegleria fowleri". CDC public domain. 2022. Accessed November 18, 2023. https://www.cdc.gov/meningitis/amebic.html

Naegleria case reports image CDC (3)
Computer-generated representation of N. fowleri in its amoeboid
trophozoite stage, its flagellated stage, and its cyst stage.
(4)