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.

And, 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.

Photo by Centers for Disease Control and Prevention.