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A&M experts discuss rare infection that led to death of Texas native

Texan+Parasite
Graphic by Nic Tan
Texan Parasite

10-year-old Texas native Lily Mae Avant passed away Sept. 9 after contracting a rare infection from a brain-eating amoeba called Naegleria fowleri.
Avant contracted this infection after swimming in the Brazos River with her family over Labor Day weekend. The amoeba is thought to have been ingested through her nose, and she was taken to the hospital after showing symptoms of headache and fever.
Although getting infected by this amoeba is rare, Naegleria fowleri is a very common microorganism in the fresh waters of Texas. Thriving in warm, stagnant water, when the hot summer months roll around, the Naegleria multiply.
According to Dr. Jason McKnight, assistant clinical professor of primary care and population health with the A&M college of medicine, there are many other amoebas similar to Naegleria Fowleri in the state’s bodies of fresh water. However, this particular amoeba is one of the most deadly.
“The fatality rate is very high — 99 percent actually,” McKnight said. “Only about 11 people have been documented to survive this infection. Those that are still alive probably have fairly significant brain and central nervous system damage from the infection.”
McKnight said the amoeba attacks the brain, thus affecting cognitive processes and reducing a person’s ability to breathe, as well as causing seizures, blindness and more. However, the initial symptoms tend to imitate bacterial meningitis, causing misdiagnosis in some cases.
“The reason [the infection] is so rapidly fatal is because it progresses very quickly,” McKnight said. “But you also have to have a very high suspicion that this is the issue. The average symptom onset to death is only a little over five days. Once you figure out what it is, you are usually too far gone at that point. For the people that did survive, they caught it very early.”
Although not much can be done to anticipate the infection, it is still very rare to contract.
“Just because you are swimming where this amoeba is does not mean you will get infected,” McKnight said. “When you look at the research, they think there has only ever been 300 cases worldwide.”
Dr. Tiffany Skaggs, chief of medical staff at Beutel Health Center, said the number of cases of this infection is on the rise due to climate change and warmer water.
“This is still a rare condition, but it may be on the rise because of rising temperatures,” Skaggs said. “There is concern about global warming and increasing temperatures in water that is untreated [like] non-chlorinated pools. The amoeba like to live between the temperature of 86 to 115 Fahrenheit. The warmer the water gets, the more favorable the conditions of the amoeba.”
Dr. Garret Sansom, assistant professor in the A&M school of public health, said one can only contract this infection through the nostrils and not through the mouth. This is why he believes a good preventative measure is to use nose clips or nose plugs.
However tempting it may be to jump in a lake or pond, the summer months exacerbate one’s chance of contraction.
“Virtually every case happens in July, August and September,” Sansom said. “It’s tragic, but the young girl was right in the hot spot time for it. [In summer], there is warmer water which increases our chances of going swimming.”
Sansom said this amoeba can also be contracted in pools and water parks that are not well maintained or do not use the recommended amount of chlorine.
“If you were at a water park that you know was not well maintained, water shot up your nose, and then 12 hours later you have a headache or a fever, you should go in and say you are suspicious of this condition,” Sansom said.
Another unlikely culprit can be tap water. Although one cannot contract the infection through the mouth, there are other uses that could cause infection, such as the use of nostril rinses.
“The risk of you getting it from tap water is very rare, but if you live in a hot climate like Texas and your pipes get warm, it is possible for them to colonize,” Sansom said.
Sansom said he hopes that spreading awareness on how to prevent this condition will prevent similar cases in the future.
“I really want to encourage individuals, parents and caregivers that if, after a short time in swimming in fresh stale stagnant water or a water park, that it is okay to seek medical care immediately if you are suspicious,” Sansom said.
In memory of Lily Mae Avant, the Valley Mills Independent School District of Whitney, Texas, is selling t-shirts that read “Faith over Everything” and “#lilystrong.” All proceeds will go to the Avant Family.

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