Sanitation essential —deadly amoeba cannot survive in pools with adequate chlorine levels

On the day that six-year-old Josiah Christopher McIntyre died from an infection caused by a brain eating amoeba, eight Texas cities were alerted to a possible contamination of their water supply, but all were cleared except the city of Lake Jackson which issued a disaster declaration.

The city traced the boy’s infection to two possible sources: a splash pad near the Lake Jackson Civic Center, or water from the hose at his home.

Josiah died on September 8, 2020, just five days after preliminary symptoms of the infection began. On September 3, the boy began complaining of a headache and then quickly developed a fever and started vomiting. He was taken to the emergency room the following day and tested for Covid-19, flu and strep but all tests came back negative. On September 6, he was admitted to the neurological care unit at Texas Children’s Hospital in Houston, where a number of CT scans showed swelling in the brain. The following day, doctors said they believed his infection was caused by single-celled amoeba Naegleria fowleri, commonly called the brain eating amoeba.

According to his mother, Maria Castillo, the doctors “explained the rarity of this amoeba and that out of the few cases that there have been very little survivors and that there was no treatment.”

N aegleria is a form of amoeba found in warm freshwater bodies — such as lakes, rivers and ponds — and sometimes soil. Only one form, Naegleria fowleri, can infect people, and lead to a deadlyinfectionofthebraincalledprimaryamebicmeningoencephalitis(PAM).Creditto:CDC.gov. PHTA Certified Inspector Program Amoeba

After Josiah was taken off various medical machines, he died.

That day, residents within the Houston area were alerted to a possible contamination of their water supply.

The boy’s illness and death prompted testing of the splash pad and the city’s water supply. On September 14, results at the splash pad came back negative for the organism so the Centers for Disease Control were contacted for further testing. The Texas Department of Health Services collected water samples for testing by the CDC. On September 25, three of the 11 water samples tested positive for Naegleria fowleri, including a city fire hydrant, the splash pad storage tank and Josiah’s home water hose faucet.

That day, officials issued a “Do Not Use” water advisory for the cities of Lake Jackson, Freeport, Angleton, Brazoria, Richwood, Oyster Creek, Clute, Rosenberg, Dow Chemical, TDCJ Clemens and TDCJ Wayne Scott. The Texas Commission on Environmental Quality told the cities not to use the water for any reason except to flush the toilets.

The advisory was lifted for all areas except for Lake Jackson the following morning, where residents were advised to boil water for cooking and drinking.

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The city’s water source is the Brazos River, and the organism is known to exist in warm freshwater places such as lakes and rivers.

The following is a September 27 press release from Governor Abbott’s Office: Governor Greg Abbott today issued a disaster declaration for Brazoria County in response to Naeglera Fowleri, a deadly amoeba, found in the City of Lake Jackson’s water supply. A Boil Water Notice has been issued for Lake Jackson as authorities continue to flush and disinfect the water system back to normal. The Texas Commission on Environmental Quality is working alongside the City of Lake Jackson, the Texas Division of Emergency Management, the Texas Department of State Health Services, the Centers for Disease Control, and the Environmental Protection Agency to resolve the ongoing water issue.

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“The state of Texas is taking swift action to respond to the situation and support the communities whose water systems have been impacted by this amoeba,” said Governor Abbott. “I urge Texans in Lake Jackson to follow the guidance of local officials and take the appropriate precautions to protect their health and safety as we work to restore safe tap water in the community.”

According to Modesto Mundo, City Manager of Lake Jackson, purging the city’s water system will take at least 60 days. Purging the system involves converting the water disinfectant from chloramine to chlorine, along with extensive flushing. Once the flushing and disinfecting process is complete, and the system’s chlorine residuals meet state and federal regulations, the boil water notice will be lifted for residents of Lake Jackson.

Until the purging process is complete, authorities advised Lake Jackson residents (who number over 27,000) to avoid activities that could cause water to go up the nose, such as sniffing water up the nose while bathing or in the shower, submerging the head in bathing water or playing with hoses and sprinklers.

Information from the Centers for Disease Control states that these Naegleria fowleri infections are rare, but almost always fatal. From 1962 to 2018, 145 people were infected and only four survived.

The typical number of U.S. infections range from zero to eight per year. This year, in addition to Josiah’s case, at least two other fatal cases of Naegleria fowleri have been reported, including a 13-yearold boy who contracted the illness after swimming in a lake in North Florida.

Infections occur after contaminated water travels up the sinuses and into the brain. It cannot be contracted by drinking water contaminated by the organism. Most infections occur after submersion in a natural water source, such as a lake or river. Infections contracted from municipal water sources are extremely rare, but not unheard of. In 2013, a 4-year-old child died from contaminated municipal water in St. Bernard Parish, Louisiana.

Naegleria fowleri cannot live in salt water and cannot survive in properly treated swimming pools.