(1/6) A 6-year-old boy died from infection due to Naegleria fowleri in Lake Jackson, Texas, in early September 2020.

3/11 environmental water samples tested positive for Naegleria, including from a fire hydrant, a civic center play fountain, and a home water hose. https://twitter.com/TCEQ/status/1309888620791238656

(2/6) The public health investigation is ongoing.

A water advisory is currently in place for Lake Jackson pending further testing/investigation. https://abc13.com/brain-eating-amoeba-bad-water-supply-warning-tceq/6574686/

(3/6) Naegleria infection is very rare, with only ~300 cases having been reported worldwide from the 1960s until now, despite exposures to freshwater environments such as lakes, rivers, ponds, and streams.

It is unclear why infection is so rare even with frequent exposures.

(4/6) There are usually 0-8 cases/year in the United States:

https://www.cdc.gov/parasites/naegleria/graphs.html

If infection does occur, it is usually fatal >90-95% of the time. It presents similarly to bacterial meningitis and has a very fulminant course which is rapidly progressive over several days.

(5/6) The mechanism of inoculation is thought to be via inhalation with passage through the cribriform plate.

In 2013-2014, Naegleria was detected in some areas of the Louisiana public water system:

https://www.cdc.gov/parasites/naegleria/public-water-systems-louisiana.html

(6/6) More information about Naegleria in general:

https://www.cdc.gov/parasites/naegleria/index.html

@mmPharmD It is a really unfortunate story. I describe it briefly in this thread...