Primary amoebic meningoencephalitis epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hardik Patel, M.D.
Overview
Primary amoebic meningoencephalitis is both exceptionally rare and highly lethal. In the 10 years from 2002 to 2011, 32 infections were reported in the U.S. Of those cases, 28 people were infected by contaminated recreational water, two people were infected by water from a contaminated, geothermal (naturally hot), untreated drinking water supply, and two people were infected after performing nasal irrigation using contaminated tap water.
Epidemiology and Demographics
Primary amoebic meningoencephalitis is both exceptionally rare and highly lethal. There had been fewer than 200 confirmed cases recorded in medical history as of 2004,[1] 300 cases as of 2008,[2] with an in-hospital case fatality rate of ~97% (3% patient survival rate).[3]
Age
Primary amoebic meningoencephalitis have occurred in all age groups, but 107 cases have occurred in children under 18 years of age (median age of 12 years; range 8 months to 66 years) out of 123 infections documented in the U.S. from 1962 through 2011.
Gender
Over three-quarters (>75%) of infections have been in males.
Number of case-reports of primary amebic meningoencephalitis by age group and gender: United States, 1962-2011.
Copyleft image obtained courtesy of http://www.cdc.gov/parasites/naegleria/graphs.html#gender
Developed Countries
Although most cases of primary amebic meningoencephalitis (PAM) caused by Naegleria fowleri infection in the United States have been fatal (122/123 in the U.S.,[4]), there have been two well-documented survivors in North America: one in California[5] and one in Mexico.[6] It has been suggested that the survivor’s strain of Naegleria fowleri was less virulent, which contributed to the patient’s recovery. In laboratory experiments, the California PAM survivor’s strain did not cause damage to cells as rapidly, suggesting that it was less virulent than strains recovered from other fatal infections.[7] Multiple other patients have received treatments similar to the California PAM survivor, including amphotericin B, miconazole/fluconazole/ketoconazole, and/or rifampin. They did not survive, making it difficult to determine the efficacy of the treatment regimen. Infections are more likely to occur in southern-tier states, but can also occur in other locations. Over half of all reported infections have occurred in Florida and Texas.
Number of case-reports of primary amebic meningoencephalitis by state of exposure: United States, 1962-2011.
Copyleft image obtained courtesy of http://www.cdc.gov/parasites/naegleria/state-map.html
Season
While infections with Naegleria fowleri are very rare, they occur mainly during the summer months of July, August, and September. Infections usually occur when it is hot for prolonged periods of time, which results in higher water temperatures and lower water levels. Infections can increase during heat wave years as water temperatures increase.
Number of case-reports of primary amebic meningoencephalitis by month of illness onset and probable water exposure: United States, 1962-2011.
Copyleft image obtained courtesy of http://www.cdc.gov/parasites/naegleria/graphs.html#exposure
References
- ↑ Wiwanitkit V (2004). "Review of clinical presentations in Thai patients with primary amoebic meningoencephalitis". MedGenMed. 6 (1): 2. PMC 1140726. PMID 15208515.
- ↑ Caruzo G, Cardozo J (2008). "Primary amoebic meningoencephalitis: a new case from Venezuela". Trop Doct. 38 (4): 256–7. doi:10.1258/td.2008.070426. PMID 18820207. Unknown parameter
|month=ignored (help) - ↑ "Amebic Meningoencephalitis". Retrieved 16 July 2010.
- ↑ Yoder JS, Eddy BA, Visvesvara GS, Capewell L, Beach MJ (2010). "The epidemiology of primary amoebic meningoencephalitis in the USA, 1962-2008". Epidemiol Infect. 138 (7): 968–75. doi:10.1017/S0950268809991014. PMID 19845995.
- ↑ Seidel JS, Harmatz P, Visvesvara GS, Cohen A, Edwards J, Turner J (1982). "Successful treatment of primary amebic meningoencephalitis". N Engl J Med. 306 (6): 346–8. doi:10.1056/NEJM198202113060607. PMID 7054710.
- ↑ Vargas-Zepeda J, Gómez-Alcalá AV, Vásquez-Morales JA, Licea-Amaya L, De Jonckheere JF, Lares-Villa F (2005). "Successful treatment of Naegleria fowleri meningoencephalitis by using intravenous amphotericin B, fluconazole and rifampicin". Arch Med Res. 36 (1): 83–6. PMID 15900627.
- ↑ John DT, John RA (1989). "Cytopathogenicity of Naegleria fowleri in mammalian cell cultures". Parasitol Res. 76 (1): 20–5. PMID 2622894.