Every summer, when the warm weather rolls around and the local ponds and lakes heat up enough for a tempting dip, remember that there may be something else lurking in those waters besides the people looking to cool off. Naegleria fowleri, the topic of today’s episode, makes its home in warm, fresh waters, and that’s mostly where it stays, until a chance encounter between human and amoeba introduces it to a new locale: the brain. In this episode, we explore the brutal biology of the so-called ‘brain-eating amoeba’, walk through its recent but global history, and discuss the possible future of this pathogen, both good (e.g. treatments, awareness) and bad (e.g. climate change, land-use change).
Even though this is a very rare disease, its deadly potential is deeply felt by those impacted by it. We are very grateful to Dr. Sandra Gompf, who shares her story of how her son Philip’s fatal encounter with Naegleria fowleri led her to create Amoeba Season, a Philip T Gompf Memorial Fund for Infectious Disease Research project. You can learn more about Dr. Gompf’s story on her website, amoeba-season.com, where you can also find many helpful links for raising awareness, fact sheets on amoebic meningitis, and a wonderful set of resources for healthcare professionals. As Dr. Gompf says, amoebic meningitis is 99% fatal but 100% preventable, and the best method of prevention is knowledge – Amoeba Season is a great place to start.
| History | Biology |
| Apley, J., et al. “Primary amoebic meningoencephalitis in Britain.” Br Med J 1.5696 (1970): 596-599. | John, D.T., 1982. Primary amebic meningoencephalitis and the biology of Naegleria fowleri. Annual Reviews in Microbiology, 36(1), pp.101-123. |
| Butt, Cecil G. “Primary amebic meningoencephalitis.” New England Journal of Medicine 274.26 (1966): 1473-1476. | Marciano-Cabral, F. and Cabral, G.A., 2007. The immune response to Naegleria fowleri amebae and pathogenesis of infection. FEMS Immunology & Medical Microbiology, 51(2), pp.243-259. |
| Cooper, Amanda Marie, et al. “Killer amoebas: Primary amoebic meningoencephalitis in a changing climate.” Journal of the American Academy of PAs 32.6 (2019): 30-35. | Siddiqui, R., Ali, I.K.M., Cope, J.R. and Khan, N.A., 2016. Biology and pathogenesis of Naegleria fowleri. Acta tropica, 164, pp.375-394. |
| Coupat-Goutaland, Bénédicte, et al. “Population structure in Naegleria fowleri as revealed by microsatellite markers.” Plos one 11.4 (2016): e0152434. | Maciver, S.K., Piñero, J.E. and Lorenzo-Morales, J., 2020. Is Naegleria fowleri an emerging parasite?. Trends in parasitology, 36(1), pp.19-28. |
| De Jonckheere, Johan F. “Origin and evolution of the worldwide distributed pathogenic amoeboflagellate Naegleria fowleri.” Infection, Genetics and Evolution 11.7 (2011): 1520-1528. | Matanock, A., Mehal, J. M., Liu, L., Blau, D. M., & Cope, J. R. (2018). Estimation of Undiagnosed Naegleria fowleri Primary Amebic Meningoencephalitis, United States. Emerging Infectious Diseases, 24(1), 162-164. https://doi.org/10.3201/eid2401.170545 |
| De Jonckheere, Johan F. “What do we know by now about the genus Naegleria?.” Experimental parasitology 145 (2014): S2-S9. | Ali, M., Jamal, S.B. and Farhat, S.M., 2020. Naegleria fowleri in Pakistan. The Lancet Infectious Diseases, 20(1), pp.27-28. |
| Delattre, J. M., and C. Oger. “Naegleria fowleri and heated aquatic environments: a possible mechanism.” Ann. Soc. Belg. Méd. Trop 61 (1981): 441-452. | Shakoor, S., Beg, M.A., Mahmood, S.F., Bandea, R., Sriram, R., Noman, F., Ali, F., Visvesvara, G.S. and Zafar, A., 2011. Primary amebic meningoencephalitis caused by Naegleria fowleri, Karachi, Pakistan. Emerging infectious diseases, 17(2), p.258. |
| Fowler, M., and R. F. Carter. “Acute pyogenic meningitis probably due to Acanthamoeba sp.: a preliminary report.” British Medical Journal 2.5464 (1965): 734-2. | Vargas-Zepeda, J., Gómez-Alcalá, A.V., Vázquez-Morales, J.A., Licea-Amaya, L., De Jonckheere, J.F. and Lares-Villa, F., 2005. Successful treatment of Naegleria fowleri meningoencephalitis by using intravenous amphotericin B, fluconazole and rifampicin. Archives of medical research, 36(1), pp.83-86. |
| Gompf, Sandra G., and Cristina Garcia. “Lethal encounters: The evolving spectrum of amoebic meningoencephalitis.” IDCases 15 (2019): e00524. | |
| Heggie, Travis W. “Swimming with death: Naegleria fowleri infections in recreational waters.” Travel Medicine and Infectious Disease 8.4 (2010): 201-206. | |
| Huizinga, H. W., and G. L. McLaughlin. “Thermal ecology of Naegleria fowleri from a power plant cooling reservoir.” Applied and environmental microbiology 56.7 (1990): 2200-2205. | |
| Jahangeer, Muhammad, et al. “Naegleria fowleri: Sources of infection, pathophysiology, diagnosis, and management; a review.” Clinical and Experimental Pharmacology and Physiology 47.2 (2020): 199-212. | |
| Liechti, Nicole, et al. “The genome of Naegleria lovaniensis, the basis for a comparative approach to unravel pathogenicity factors of the human pathogenic amoeba N. fowleri.” BMC genomics 19.1 (2018): 1-11. | |
| Maciver, Sutherland K., Jose E. Piñero, and Jacob Lorenzo-Morales. “Is Naegleria fowleri an emerging parasite?.” Trends in parasitology 36.1 (2020): 19-28. | |
| Martínez-Castillo, Moisés, et al. “Naegleria fowleri after 50 years: is it a neglected pathogen?.” Journal of medical microbiology 65.9 (2016): 885. | |
| Nicholls, Claire L., et al. “Primary amoebic meningoencephalitis in North Queensland: the paediatric experience.” Medical Journal of Australia 205.7 (2016): 325-328. | |
| Rodriguez-Anaya, Libia Zulema, et al. “Application of the omics sciences to the study of Naegleria fowleri, Acanthamoeba spp., and Balamuthia mandrillaris: current status and future projections.” Parasite 28 (2021). | |
| Saberi, Reza, et al. “A systematic literature review and meta‐analysis on the global prevalence of Naegleria spp. in water sources.” Transboundary and Emerging Diseases 67.6 (2020): 2389-2402. | |
| Siddiqui, Ruqaiyyah, and Naveed Ahmed Khan. “Primary amoebic meningoencephalitis caused by Naegleria fowleri: an old enemy presenting new challenges.” PLoS Negl Trop Dis 8.8 (2014): e3017. | |
| Stahl, Leigha M., and Julie B. Olson. “Environmental abiotic and biotic factors affecting the distribution and abundance of Naegleria fowleri.” FEMS Microbiology Ecology 97.1 (2021): fiaa238. | |
| Symmers, W. St C. “Primary amoebic meningoencephalitis in Britain.” Br Med J 4.5681 (1969): 449-454. |
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