Public Health Messaging After the First Case of Primary Amebic Meningoencephalitis in Kansas

Background: Naegleria fowleri is a small, free-living ameba that can cause a very rare, but severe, infection of the brain. This organism infects people by entering the body through the nose. This typically occurs when people swim or dive in warm freshwater.

Case history: A 14-year-old male was admitted to a local hospital through the emergency room in August 2011 with a one-day history of complications with headache, neck stiffness and fever of 101 Fahrenheit. Prior to this headache, the patient had been completely healthy. Death occurred 4 days later.

The case swam at a lake near Wichita, Kansas the weekend before illness onset. At this time, the region had been experiencing an unusually hot summer and the lake's temperature was higher than normal.

Autopsy findings confirmed the polymerase chain reaction (PCR) test was positive for Naegleria and brain tissue samples were sent to the CDC for further testing.

Implications/conclusions: The ensuing response was unique in that local health officials and spokespersons remained cognizant of and adhered to medical privacy boundaries pertaining to public information dissemination; however, the victim's family used social websites and other media outlets to provide information about the child's death.

Also, an event at the lake that draws 16,000 attendees was scheduled to take place one week after the death, so local health department officials issued educational materials and precautionary statements on measures to limit the amount of water that enters the nose while swimming, as well as awareness of symptoms of Primary Amebic Meningoencephalitis.