Amoeba in the brain, 10 cases in the USA: be careful when washing your nose with tap water

Amoeba in the brain, 10 cases in the USA: be careful when washing your nose with tap water

OfLaura Cuppini

Experts: Avoiding using boiled water for rinsing may help prevent invasive Acanthamoeba infections, particularly among immunosuppressed people

Ten cases of Acanthamoeba infection, an amoeba that can affect the central nervous system, often leading to death. The US CDC describes them (Centers for Disease Control and Prevention) in a report published onlinewhich takes stock of the situation between 1994 and 2022. The ten patients had undergone nasal washes before getting sick. Everybody was immunosuppressed (five had cancer and two had AIDS) and used tap water – therefore not sterile – for rinsing: a very risky habit due to the possible presence of amoebae in the water. Seven of them survived.

Tap water

«Most patients had been rinsing for months or even years and at least half were using tap water -. the CDC experts underline -. Avoiding using unboiled tap water for nasal washes may help prevent invasive Acanthamoeba infections, particularly among the immunosuppressed.” The infections occurred from 1994 to 2022, but nine are concentrated in the last decade. They provoked rhinosinusitis, skin diseases, amoebic granulomatous encephalitis, osteomyelitis. While specifying that the cause-effect relationship is not certain, i.e. “it has not been established with certainty that nasal washing is the route of transmission of all the cases analyzed”, the CDC reiterates that “especially immunosuppressed people should be informed about safe nasal washes to prevent amoeba infections». Rinsing with tap water has been associated with infections caused by amoebae such as Naegleria fowleri and, indeed, Acanthamoeba.

Immunosuppressed at risk

Acanthamoeba amoebae are present throughout the world soil, lakes, rivers and in tap water. They can cause keratitis (an eye infection), amoebic granulomatous encephalitis (an infection of the central nervous system), skin diseases, rhinosinusitis, lung diseases, osteomyelitis (bone infection), and disseminated infections. Amoebae can enter the body through the eyes, lesions and wounds or the respiratory tract. People at highest risk of infection are those who have suffered an organ or stem cell transplant, patients with cancer, HIV or diabetes mellitus. Acanthamoeba infections (excluding keratitis) are rare, affecting 3-12 people per year in the United States; however 82% of cases are fatal.

When to do nasal washes

Nasal washes with saline solution are useful for remove secretions, dust, allergens and pollution products, which obstruct the upper airways resulting in breathing difficulty. The goal is to keep the mucous membranes, and their functioning, in optimal conditions. Washing should be done at least once a dayparticularly in the presence of rhinopathy (inflammation of the nasal mucosa), sinusitis, pharyngitis, otitis media, cough. It’s about a simple and minimally invasive practice: for it to be effective, however, it is necessary to observe some rules and choose the most suitable tool.

Gentle pressure

It should be borne in mind that: the temperature of the physiological solution – i.e. 0.9% sodium chloride solution in purified water – must be lukewarm (in the nasopharynx, i.e. the cavity that connects the nose and throat, it is 34° C); when washing, the position of the head must be tilted forward and slightly rotated to the side; the irrigation pressure must be gentle because high pressure could damage the lining of the nose or push secretions into the middle ear. If you use the syringecontinuous and slow pressure must be exerted on the piston (the 10 ml syringe should be emptied in 10 seconds).

Nasal aspirators

However, there is no evidence of the effectiveness of the nasal aspirators. In exceptional cases, the “mouth” ones can be useful as they allow you to remove the mucus that cannot come out of the nostril after washing because it is particularly thick or abundant. But the practice should not be considered a routine and cannot replace the washing described above. The aspirator can irritate the nasal mucosa and also fails to remove secretions from the nasopharynx, but only from the front of the nose. Finally, the use of electric vacuum cleaners it is strongly discouraged.

March 18, 2024


Source link