Naegleria risks, preventive measures?

[SeanWilson]

Curious if anyone knows of any steps you can take to prevent naegleria fowleri above and beyond the typical suggestions? I'm especially interested as it relates to recovery diving in freshwater and stirring up bottom mud/muck on purpose regularly. CDC info suggests it only is concern if entering through nasal passage, but I'm curious about whether or not it could enter through ear canals or open cuts/scratches (would assume they would let you know if it could...but it's the govt...you know?)?

IF it's just the nasal passage to worry about, I wonder if others might know of some sort of method for keeping water out of the nasal passage while wearing a mask (in reference to the occasional small leakage into the mask, or should one's mask accidentally get knocked loose while in the middle of physical activity). I'm not paranoid, but if I'm stirring the bottom and digging through mud on purpose with my face often inches off the bottom, I consider it a reasonable working environment threat/situation to guard against. If I were just engaged in normal diving for enjoyment, I wouldn't be worried.

If anyone knows of any research involving divers and naegleria, I would appreciate a link or reference. Any suggestions and ideas (could you, for instance, insert petroleum jelly in nostrils to aid blocking water, but still allow clearing mask & equalization if need be?). Thanks!

 

[DocVikingo]

Hi Sean,

The good news is Naegleria fowleri is so rare in humans that even a recovery diver working in mud/muck should take precautions against many other pathogenic organisms and dangers before being concerned about it. The bad news is that if one contacts it and a correct snap diagnosis isn't arrived at, they very likely will die within a week.

As you probably know, it favors still, stagnant and very warm fresh water. Obviously dry, hot weather contributes to the risk.

The protozoa changes to its amoebic form in the nasal passages and then makes its way up the olfactory nerve and infects the brain and sometimes the spinal cord. BTW, entry through the external ear canal or open cuts/scratches with subsequent proliferation does not seem possible. However, some cases appear to be the result in inhalation either of ambient air or water droplets containing the pathogen.

As for preventative measures, a well-fitting full face mask would seem to be the place to start. The insertion of petroleum jelly into the nostrils likely would be of very limited effectiveness.

Helpful?

Best of luck,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.

 

[SeanWilson]

Great info and very helpful. A full face mask would definitely be a good idea and I'll look into them. I appreciate the info on how the protozoa changes to amoebic form in the nasal passage. The bit about some apparent cases being the result of inhaling ambient air or water particles is what concerns me most.

I am not typically worried about illness/diseases, but naegleria cases seem on the rise and it's particularly nasty in its mortality rate. I know that a lot of its presence and concentration depends on the type/amount of organic matter present on the bottom to a degree as well. Here in Oklahoma, the water is always warm, muddy and usually has a lot of organic matter. Every clump of mud and silt that drifts up past my mask makes me wish I had a full mask and dry suit these days. A rather large group of tri-athletes swimming in the river near OKC just recently all came down with e-coli, and it's getting so that you can't even eat fish anymore due to the lead and pesticides. Last I checked, all but perhaps three bodies of water in the state were considered contaminated/polluted by EPA & DEQ standards.

I would rather be overly cautious than regretful, and intend to continue researching possible measures such as irrigating the nasal passages with something as a form of pre-treatment/prevention that would hinder or kill naegleria if possible.Probably nothing to be done for it, but if something like flushing the nostrils with a solution of some sort would reduce the odds even the tiniest bit, I wouldn't mind taking the trouble/time to do it. As an aside, sometimes I snorkel in the same environments and a snorkel full of water contaminated with e-coli, naegleria and other things just sounds more and more like a good reason to give up free diving and stick to scuba.

Again, thanks for the information. It does put me somewhat at ease; the full mask is probably where I'm headed. Certainly can't hurt. Have a great day!