Is a Neti Pot Safe?

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How to Avoid a Brain-Eating Amoeba. (Is Nasal Irrigation Safe?)

Microscopic image of brain tissue infected by the amoeba Naegleria fowleri. Places it’s found include fresh water, heated swimming pools, and hydrotherapy pools, according to the CDC.

by James Hubbard, MD, MPH

I’ve long recommended nasal irrigation as prevention and treatment for colds and allergies.

Then came the report of brain-eating amoeba.

Two people died from the amoeba Naegleria fowleri after irrigating with contaminated tap water using a simple irrigation device called a neti pot. They developed meningitis with severe headaches and neck pain. There’s really no effective treatment.

Now everyone wonders, is irrigating with a neti pot safe? Is any sinus irrigation considered safe?

The answer is a resounding yes, if you follow the FDA suggestions by:

  1. Using distilled or sterile water you buy at a store.
  2. Boiling tap water for three to five minutes.
  3. Using a water filter with a pore size of 1 micron or smaller.

Before I read the FDA recommendations, I thought salt would kill the ameboae, but the FDA doesn’t mention it, so I no longer deem that a safe way to go. I’d still use a half-teaspoon of salt per cup of warm water but just because it seems to work better and not irritate the nasal lining as much. Just don’t depend on it alone to kill the amoebae.

Books adAnd, of course, whether you use a neti pot, bulb syringe, cup, glass, or commercial irrigator, rinse and clean it after every use, and let it air dry.

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Biology 101

In case you’ve forgotten your high school science, an amoeba (alternate spelling is ameba) is this microscopic, one-cell organism that lives in water. Its way of travel has always reminded me of the colored oil that moves around in those lava lamps.

One other thing.

The Naegleria fowleri amoeba is nothing new. It lives in warm, fresh water such as lakes, rivers, and hot springs. And just like with the neti pot, people have died from getting contaminated water up their nose. Of course, like the nasal-irrigation route, getting it this way is very rare, but deadly.

To avoid it, don’t go underwater if you can help it, and hold your nose if you do. Also, don’t sit around in the shallow water and stir up sediment, where it likes to reside.

What about you? Have you stopped sinus irrigation or changed your way of doing it since this report came out?

P.S. Quick update: You can now take my survival-medicine supplies list to the store with you. Just click the PDF link on this page for a simple, organized checklist.

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Photo by Centers for Disease Control and Prevention.

  • John

    Dr. Hubbard, any idea as to whether the amoeba can survive in a nasal spray medication that is refrigerated? Would the cold temperature or Hydrochloride kill it or prevent infection? I’m hoping there’s not much to worry about here.. :-)

    Thanks very much!

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      John, the only completely safe way is to boil the water, use bought bottled water, or buy commercial nose spray or irritant. Any of those should not have a risk of an amoeba whether you refrigerate it or not.

  • Amoeba Avoider

    I use a NielMed Nasal irrigation bottle. I use treated (and fairly well regulated) tap water and am always sure to boil the water for at least five minuets before cooling it. In addition to the salt (from NielMed) my doctor prescribed some soluble antibiotics for the nasal irrigation (unrelated to this), so that would also harm any amoebae that may inhabit the water.

    • Amoeba Avoider

      I also wash and microwave the bottle on the per use basis (I use it three times a day) as per the instructions.

      • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

        Thanks for sharing.

  • Carrie

    I went swimming today in a pool which I later learned had not been chlorinated properly. I got water up my nose 3 different times, my husband got water up his as well. I am very anxious about this as we live in the Southern states. Someone please tell me if I have cause to worry about this or not. I am very upset and worried about this.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      1. It’s extremely rare–in the U.S. a handful of cases per year compared to millions who get water up their nose. 2. There’s nothing to do unless you have symptoms. Then, all you can do is check with a doctor. 3. Here’s a good link to more info http://www.cdc.gov/meningitis/parasitic.html

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  • Brenna H.

    But then again our water is treated…does that help MD?

  • Brenna H.

    Docter.. MD, please help me..

  • Brenna H.

    help…..

  • Brenna H.

    PLEASE ANSWER ME SOMEONE I have anxiety and im worried to death about this whole amoeba thing….please answer me ASAP!!

  • Brenna H.

    I just took a shower and got a little water up my nose…. now im extremely worried……. do you think ill get it?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Brenna, #1 people get a little water up their nose all the time, including me. There’s been a handful of people who have ever gotten the amoeba. #2 Your chances of getting it are so small, I’d say you should be more worried about getting a heart attack from worrying so much about such things. #3 If you start having severe neck pain or headaches, see your doctor. Otherwise, don’t worry.

  • http://Amworriedabouttheambea Randall Keesling

    I got water in my nose on march 3rd 2013 in the shower. And I really need your help…

    I have a son to worry about also….

    Please contact me soon ASAP ..

    The city says it doesn’t have the ambea in the water tap. And Ioww park Texas gets there water from Wichita Falls texas. So please help me ..
    Contact me at keesling_randall52@yahoo.com

    • AMEBA KILLER

      woa! chill you dont have to be so worried, tap water is treated,also peaple get swimming pool water up their nose and down their throat all the time and they are okay and swimming pool water is outdoors and warm, in other words swimming pool water is more dangerous than shower water but it cant really hurt peaple.I think you have a case of germphobe (so do I) YOU DONT HAVE TO WORRY!!!

      • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

        Randall, I thought I had responded to this comment, but I don’t see it now.Ameba Killer, I agree with you, except there have been cases (very very rare) of people getting the amoeba who used tap water to irrigate. That’s why it’s prudent to use tap water. However, like I said, this has happened to a handful of people who were irrigating. I don’t know of any cases where someone just got water up their nose in the shower.