An amoeba that killed a New Jersey man is common in warm, freshwater bodies, but the chances of people getting sick from it, much less dying, is very low.

Fabrizio Stabile's main symptom before he died last month after contracting Naegleria floweri was a headache, which state epidemiologist Tina Tan is a common symptom for someone who has contracted the amoeba. Tan said in a given year, authorities might get eight reports of infections by the amoeba, or they might get none at all.

She said it is important to remember that "hundreds of millions of people" swim in waters that might have the amoeba present.

"It's important to recognize the route of transmission," she said. "The way people get infected is when water that contains Naegleria floweri goes up the nose."

What that means, Tan said, is that people don't get sick from it from swallowing water with the amoeba in it, and it is not spread from person to person. People who do contract the amoeba will typically experience symptoms within nine days, Tan said.

The CDC reports that Naegleria floweri thrives in warm environments, growing best at temperatures of up to 115 degrees.

"It is less likely to be found in the water as temperatures decline," the CDC says on its website. "The amoeba can be found in lake or river sediment at temperatures well below where one would find the amoeba in the water."

From 2008 to 2017 a total of 34 infections were reported in the U.S., according to the CDC. Three of those infections came from recreational waters, while three came during nasal irrigation using contaminated tap water and one came from someone using a slip-n-slide using contaminated tap water.


The most common symptoms include headache, fever, nausea or vomiting. From there, the symptoms can develop to confusion, loss of balance, seizures or even hallucinations. Tan said disease progression depends on the person's health and other factors.


Testing for the amoeba involves obtaining spinal fluid and testing it, Tan said. One of the problems doctors face with diagnosis is the disease progresses so quickly, and can ultimately be fatal if not caught and treated in time.


Treatment can be difficult because of the limited window to make the diagnosis and no sure drugs to treat the infection. The CDC reports that while several drugs have proven effective in the laboratory "their effectiveness is unclear since almost all infections have been fatal, even when people were treated with similar drug combinations."

The CDC reported two people survived recent infections after being treated with a new drug called miltefosine, along with other drugs and treatment of brain swelling.


Because the amoeba is contracted through the nose, there are a few simple steps people can take to keep themselves safe. Just wearing nose clips or simply holding your nose closed when going under water can be an effective method of prevention, Tan said. People swimming in warm, freshwater bodies may simply choose to not put their heads under water at all.

Tan said these bodies of water are typically not regulated for the amoeba, but since it is so rare, and the causes can be variable there really is no way to effectively regulate it.

"Testing is not routinely performed on these recreational waters," she said. "the fact is that these amoeba are pretty common and infections are rare. The relationship between finding the amoeba in the water and the occurrence of infection is unclear because of the issue of how rare this is."

Tan said Stabile's death is the first documented case of the amoeba in a New Jersey resident. His family has started a foundation to raise awareness about the dangers of the amoeba. A GoFundMe established to help start the foundation has raised more than $23,000 in the past week, with a goal of $50,000.

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