When news broke that a teenager in North Carolina had died from a brain-eating amoeba, many families across the U.S. and Latin America started rethinking their summer swim plans. The infection, known as primary amebic meningoencephalitis (PAM), is caused by Naegleria fowleri, a heat-loving microorganism found in warm freshwater. While the risk remains extremely low, the recent case in Durham has prompted health officials to close a local aquatic facility and step up water testing.
What many people don't realize is that the danger isn't in swallowing water. According to the Centers for Disease Control and Prevention (CDC), the amoeba cannot infect the digestive tract. The only route into the body is through the nose. When water containing the amoeba is forced up the nasal cavity—during a dive, a jump, or even a splash—it can travel along the olfactory nerve to the brain, where it causes rapid and almost always fatal destruction of brain tissue.
"The key is to avoid water going up your nose," says Dr. María Fernanda Gutiérrez, an infectious disease specialist in Bogotá. "That's why we stress nose clips or keeping your head above water in warm, untreated lakes and rivers."
Understanding the biology of Naegleria fowleri
Naegleria fowleri thrives in warm freshwater environments—lakes, rivers, ponds, and hot springs—especially during the summer months when water temperatures rise. It does not survive in saltwater or in properly chlorinated pools. The CDC has recorded only 167 confirmed cases in the U.S. between 1962 and 2024, but the fatality rate is over 97%, with just four survivors in six decades.
Symptoms typically appear within five days of exposure and include severe headache, fever, nausea, and vomiting. As the infection progresses, it can cause neck stiffness, confusion, hallucinations, seizures, and coma. Because the disease moves so quickly, early recognition is critical. Doctors are urged to consider PAM in any patient who has recently submerged their head in warm freshwater and presents with these symptoms.
For Latino families, many of whom enjoy outdoor water activities during the summer, the message is not to panic but to be informed. "We don't want to scare people away from enjoying nature," says Dr. Gutiérrez. "We want them to take simple precautions."
Where the amoeba lives—and where it doesn't
Chlorinated pools and saline marine environments are safe because the amoeba cannot survive in those conditions. The North Carolina Department of Health and Human Services (NCDHHS) confirmed that the Durham facility where the amoeba was found has been closed and will remain so until rigorous disinfection is completed. Public water managers across the region are increasing testing protocols, especially during heatwaves, when the amoeba multiplies faster in slow-moving natural basins.
For those who use neti pots or perform nasal rinses for sinus relief, the CDC is clear: only use distilled, sterile, or previously boiled water. Tap water, even if treated, can contain the amoeba in rare cases. This is a particular concern in areas with aging infrastructure, like parts of Texas and Louisiana, where recent water safety warnings have been issued.
Prevention: simple steps, big impact
Health authorities recommend the following to minimize risk during warm freshwater activities:
- Avoid jumping or diving into warm lakes, ponds, and rivers during extreme heatwaves.
- Wear nose clips or keep your head above water when swimming in untreated natural basins.
- Refrain from stirring up sediment in shallow, warm water, as the amoeba can be present in the mud.
- Use only distilled, sterile, or boiled water for nasal rinses.
These habits drastically reduce the chance of nasal exposure. "It's about being smart, not scared," says Dr. Gutiérrez. "With a few precautions, you can still enjoy a day at the lake with your family."
As the North Carolina investigation continues, local health teams are monitoring water quality across the state. The CDC and NCDHHS are working together to ensure that any remaining risk is eliminated. For now, the best defense is awareness—knowing that the amoeba is rare, but that nasal water entry is the one thing to avoid.
For more on water safety and related health risks, check out our coverage on flesh-eating bacteria in Florida and Louisiana and Texas's efforts to stop the screwworm. And for a lighter note, see how Lake Jackson becomes a hummingbird haven each September.
