
Rare brain-eating amoebas killed woman who rinsed her sinuses with tap water - prostoalex
https://www.seattletimes.com/seattle-news/health/rare-brain-eating-amoebas-kill-seattle-woman-leave-doctors-bracing-for-possible-repeats/
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capkutay
Sounds like she was using a neti-pot. I thought most of the neti-pot products
made it pretty clear that you're supposed to use previously boiled or
distilled bottled water. Maybe they need to make it more clear that the
consequences of using tap water can be pretty dangerous.

~~~
cortesoft
They do, but I am never sure how that is supposed to be practical. You need to
use warm water, which is easy with tap water, but hard to do quickly with
distilled or boiled water.

I know it has risks, but I still use normal tap water. From what I have read,
all of the cases are from people using well water, never from city provided,
chlorinated water. It actually says this in the article, too.

~~~
dom96
Can you explain why you use a neti-pot? I don't know anyone who uses one and I
don't really understand the reasons behind it.

~~~
QuantumGood
Reduces incidents of mild sleep apnea in conjunction with nasal strips and
sleeping on my side. (I determine occurrence of sleep apnea by checking if
waking happens between or during sleep cycles.)

Also helps with voice work (I am a voice coach), makes for clearer mask
resonance.

~~~
QuantumGood
(An in-hospital sleep study confirmed my self-diagnosis of mild sleep apnea.)

~~~
repolfx
What do you mean by mild? I did a study and had an AHI of 28, my doctors put
me on CPAP. I'm not overweight and the machine is set to give hardly any
pressure but it still seems to eliminate the issue, at least according to the
machine's own counts. If I could fix it with just some nose strips and a neti
pot, that would be amazing.

~~~
QuantumGood
"Mild" used by doc prescribing me Modafinil after study. There were insurance
cost concerns as well so I pursued other options.

I have to work at keeping my mouth closed, and some nights don't work out
well, but most do. I also use alternating combinations of sedatives, and take
them in stages (e.g. sometimes a partial pill embedded in a softgel taken
after 3 hours of sleep). I'm overweight, and it did start for me after I
gained weight

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Tharkun
I don't get the scare mongering in this discussion. People are saying to
always boil the water, to not cook with hot tap water, etc. Don't these people
bathe in hot tap water? Don't they drink cold tap water? Do they all live in
areas with super unsafe tap water?

Or is there a specific danger that comes from the water going up your
nostrils? (Which can easily happen while bathing)

What am I missing here?

~~~
novia
There is a specific danger associated with the water going up your nose.
Things that go up your nose have better access to the blood brain barrier.
Don't snort unboiled water kids.

~~~
Tharkun
Source? 'access to the blood brain barrier' sounds odd. You make it sound like
the BBB magically starts in the nostrils and is somehow weak there. That's not
how the BBB works. Sure, your nostrils are closer to your brain than, say,
your teeth, but not by much.

~~~
baddox
I’m fairly sure that different body parts do provide easier access to the
blood brain barrier. In this case, I would guess that it’s because of the
mucous membranes in the nasal cavity. There must be a reason people snort
cocaine rather then just rub it on their hands.

~~~
ec109685
Great comment. They don’t dissolve it into water and gargle either.

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angry_octet
I'm stunned at how many people are commenting that they will continue using
untreated water. You can end up having your brain eaten and die, I can't think
of a PSA any more convincing.

~~~
asynchronous13
There's been ~100 cases in 40 years. That's less than 3 people per year, so
it's very rare.

There's about 10 shark attacks per year in the U.S. Now that you know that,
will you stay out of the ocean forever? Or will you maybe take the risk and go
for a dip if you go on a beach vacation?

 _edit_ Plus, of those 40 cases the vast majority are from swimming in lakes.
So there's only a handful of cases where the infection was due to neti-pot
usage. I could only find 3 confirmed cases. That's extremely rare.

~~~
angry_octet
Also, it might be incredibly rare because most people follow the instructions,
and/or the people who follow instructions poorly live in areas with highly
treated water (essentially the entire urban population). In warmer rural
areas, using rainwater or borewater, it is likely to have significant growth
of Naegleria fowleri. Children are particularly susceptible.

[https://healthywa.wa.gov.au/Articles/A_E/Amoebic-
meningitis](https://healthywa.wa.gov.au/Articles/A_E/Amoebic-meningitis)
[https://www.cdc.gov/parasites/naegleria/pathogen.html](https://www.cdc.gov/parasites/naegleria/pathogen.html)
[https://www.abc.net.au/news/2018-03-20/professor-
encouraging...](https://www.abc.net.au/news/2018-03-20/professor-encouraging-
rural-communities-to-treat-their-water/9567366)

There is a similar problem where cleaning contact lenses with untreated water
leaks to Acanthamoeba infection, leading to possible blindness of loss of an
eye.

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code_duck
I wash my nose in such a way frequently because I have an extreme sensitivity
to airborne chemicals and fragrances. It’s so uncomfortable to be doused with
air freshener, diesel exhaust, cleaner fumes, laundry fragrance, plastic odor
or perfume that I rinse my nose out with whatever water is available, which
includes taps and drinking fountains. I’ve worried about such an illness
happening to me, evidently with good reason.

~~~
chipperyman573
You can safely use bottled water, that would probably be a easy alternative :)

~~~
anotheryou
how is bottle water better? where I live the tap water is usually of higher
quality than the bottled water, just a bit harder.

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michaelbuckbee
I still don't quite understand how tap water in a neti-pot is significantly
more dangerous than swimming in local lakes, swimming pool or the ocean.
Certainly, you get water in your sinuses from that, right?

~~~
da_chicken
Yes, and people get from it from swimming [0] [1] [2]. That's typically how
people get infected. It doesn't affect that many people because people
typically don't intend to fill their nose while swimming.

The issue is that a neti pot is that you're intentionally putting water deep
into the sinus cavities. This amoeba is exactly why they tell you to only use
sterilized water in a neti pot and to clean and sterilize your neti pot
regularly.

[0]: [https://www.theepochtimes.com/surfer-dies-from-brain-
eating-...](https://www.theepochtimes.com/surfer-dies-from-brain-eating-
amoeba-after-swimming-in-texas_2675565.html)

[1]: [https://www.dailymail.co.uk/news/article-2392917/Hope-
Kali-H...](https://www.dailymail.co.uk/news/article-2392917/Hope-Kali-
Hardig-12-contracted-deadly-brain-eating-amoeba-Arkansas-water-park.html)

[2]: [https://www.nbcnews.com/health/health-news/brain-eating-
amoe...](https://www.nbcnews.com/health/health-news/brain-eating-amoeba-lurks-
warm-summer-water-n156551)

~~~
nscalf
Beyond just that, I have to question how many non-lethal non-brain-eating
infections come from injecting untreated water into your face that don't make
the news.

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mch82
FDA: “Is Rinsing Your Sinuses With Neti Pots Safe?”
[https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm316375.h...](https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm316375.htm)

Highlights:

* “...usually safe and effective products when used and cleaned properly”

* “Tap water isn’t safe for use as a nasal rinse because it’s not adequately filtered or treated.”

* Neti Pots are FDA regulated medical devices

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dhimes
I'm a little confused. Was the tap-water untreated (that is, well water)? Can
these damn things survive chlorination? They're a known danger swimming in
southern (US)- meaning warm- fresh-water lakes and ponds. But- damn, this is
scary. Probably because I also use a neti-pot.

Neti-pots are often used to help alleviate the symptoms of sinusitis. My neti-
pot came with packets of salts that you dissolve in the water, which I use.
But I didn't think that was required to kill stuff in treated water. I thought
it was to reduce irritation when using it- and maybe help kill the bacteria
you are trying to rinse away.

~~~
cowpewter
The salts _are_ to reduce irritation. Plain water is extremely uncomfortable
in your sinuses, but saline is fine. As far as I know they do nothing to
reduce contaminants in your water or harm bacteria.

~~~
ergothus
And yet the article mentions distilled OR saline, which definitely raises the
question.

If I wake up feeling like crap, it is far easier to use a salt packet than to
go to the store for distilled water. The article implies that is fine (but the
article may be misleading)

~~~
jimktrains2
Perhaps they meant premixed , sterile saline solutions ?

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sctb
Here's the paper:
[https://www.ijidonline.com/article/S1201-9712(18)34525-9/pdf](https://www.ijidonline.com/article/S1201-9712\(18\)34525-9/pdf).

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happycube
Ouch. I've taken to using the Arm&Hammer spray cans, even though they're quite
a bit more expensive.

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PaulAJ
A more common problem is eye infection. This is an issue for contact lens
wearers, and amoebas can also get in your eyes when you go swimming.

[https://www.allaboutvision.com/contacts/acanthamoeba-
keratit...](https://www.allaboutvision.com/contacts/acanthamoeba-
keratitis.htm)

------
BjoernKW
Distilled water certainly is the safest way but tap water mixed with salt in
countries where it's safe to drink tap water in most cases should cause no
harm either.

Salt works as a disinfectant when dissolved in water. When rinsing your
sinuses you'll want to use saline water anyway because fresh water will hurt
the mucous membranes in your nose.

~~~
gilgoomesh
That's bad advice. Common saline solutions are around 9g/L and won't kill most
protozoa.

[http://www1.nencki.gov.pl/pdf/ap/ap574.pdf](http://www1.nencki.gov.pl/pdf/ap/ap574.pdf)

Even at seawater-like concentrations of over 30g/L, it can take over 72 hours
to sterilize water containing fresh-water protozoa.

Boiling is the only practical way to sterilize water.

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prewett
I wonder if it’s things like this that make people feel like their tap water
isn’t safe and then they buy bottled water or “natural” or “raw” water,
instead of understanding that tap water is pretty safe. By historical
standards we have superior water, compared to most of history.

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hughdbrown
So, these medical people did not consult House?
[https://house.fandom.com/wiki/Henry_(patient)](https://house.fandom.com/wiki/Henry_\(patient\))

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roryisok
Well great, I just did this last night. Goodbye HN.

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2bitencryption
I use a product like this, and I'm paranoid enough to buy distilled water,
boil it, and then add a saline mixture before doing the deed.

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User23
How hard would it be to design a microwave water still? I steam things in my
microwave all the time. It's not really my area of expertise, but I imagine it
wouldn't be super difficult to design a glass (or similar) vessel that would
collect condensate after the microwave shuts off.

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Dowwie
It's not clear after reading this article the source of the victim's tap
water. Was it from a well? I suspect the tap wasn't using filtered, and
possibly chemically treated water.

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sjg007
This happens every ten years.

~~~
rv-de
And millions of people every day suck in tap water through their noses to
clean them - and still this infection happens virtually never.

But it seems that even the rational and sophisticated HN crowd isn't immune to
overresponding towards news that is basically just gross on a visual level
while completely irrelevant from a statistical perspective.

Having said that I once while tripping immersed my head in water and got some
of it quite far up my head through the nose. That water was in a warm, lenitic
and rather dirty pond - the optimal breeding conditions for this terrible
little creature. I was worried for at least a week about having my brain eaten
:D

But that was in middle Germany and it seems these amoebas don't really like it
here so much.

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sargun
Does UV-C irradiation work to kill these little buggers?

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balls187
Don't swim with contacts either.

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ianai
I’m seriously shocked by how much push back rational thought is getting in
this thread.

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aldoushuxley001
Rough.

~~~
rv-de
I think this is one of the most on spot and reasonable comments in this
thread. The rest is writing about how worried they are or convincing others
how unlikely it is.

Some folks here down vote faster than they can think it seems.

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ams6110
Person dies under unusual, rare circumstances. Happens every day, there are
nearly 8 billion of us. Why is this news?

~~~
glassesman
Neti pots and nasal rinse methods in general have become fairly popular. If
reporting on this could save other people from becoming victims, it's worth
covering.

~~~
jacquesm
Sounds like the easiest way to avoid becoming a victim is not to use the
product.

~~~
tempestn
Yes, except then you would be forgoing the benefits, which are significant for
situations like sinus infections or colds. Instead, you could simply avoid
using it with untreated well water.

