Headlines about brain-eating amoeba and flesh-eating bacteria often raise public concern. Medical experts at AdventHealth Orlando are sharing information on how to prevent these rare but dangerous infections.
Naegleria fowleri, known as the brain-eating amoeba, is a single-celled organism that lives in warm freshwater environments such as lakes, rivers, hot springs, and poorly maintained pools. According to Jose Alexander, MD, medical and technical director of the microbiology, virology and immunology laboratories at AdventHealth Orlando: “This isn’t just a summer issue anymore. When temperatures rise above 80 degrees — even in winter — amoebas can remain active.”
Dr. Alexander explained that infection occurs only when contaminated water enters the body through the nose. He said: “When they enter the human body, we become what we call an accidental host. They’re not looking to infect us. They were just in the water that got into the nose.” To reduce risk, Dr. Alexander recommends avoiding submerging your head in freshwater or using a nose clip: “The amoeba is probably in every lake. As an expert, I always assume that, because it’s part of nature,” he said. “I would avoid getting into a lake. If I must get into a lake, I avoid putting my head in the water. And even with all of that, if I get into a lake, I use a nose clip to reduce the chance of getting water in my nose, because that’s the amoeba’s portal of entry into the body.”
Vibrio vulnificus is another organism of concern found in warm coastal waters between May and October. This bacterium can cause necrotizing fasciitis — commonly referred to as flesh-eating disease — when it enters through open wounds exposed to saltwater or brackish water.
Symptoms for brain-eating amoeba infection include fever, severe headache, stiff neck, confusion, nausea, vomiting and seizures; it progresses rapidly and has a high fatality rate. The Centers for Disease Control and Prevention (CDC) notes only 164 cases have been reported in the United States over 60 years but with a mortality rate of 97%. In 2016 AdventHealth successfully treated one of just four known survivors.
Most cases occur among males under age 14; reasons for this trend are unclear but may relate to exposure patterns.
Flesh-eating bacteria cause between 150 and 200 cases annually in the U.S., about one-fifth resulting in death according to CDC data. Symptoms include fever, redness at wound site, pain or swelling and rapid tissue destruction requiring urgent care.
Dr. Alexander noted that early intervention improves outcomes: “The immune system can limit the infection,” he said. “The treatment can be effective.” He added that those with underlying health conditions face higher risks: “Any condition that causes some level of immunosuppression decreases the chance for the immune system to fight back,” Dr. Alexander said. “This organism will spread quickly.”
Rapid diagnosis is key for both diseases: “Time is critical,” Dr. Alexander said. “A key factor in the treatment for these cases is a rapid diagnostic.” His team developed a PCR test now used nationwide which shortens result times from days to hours.
He also highlighted future advances: “At AdventHealth, we believe there is always a reason for hope,” he said. “Through innovation and whole-person care, we strive to give patients every possible option for healing so that they can return to the activities that make them feel whole.”
AdventHealth Orlando has been serving patients since its founding in 1908 and operates as both a pediatric hospital and training facility under president Terry Shaw.
