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View Full Version : Another ameoba death-this time on the westcoast...


KJAECKIN
09-27-2007, 02:02 PM
Same ameoba that caused the deaths of a couple of kids in Florida has now been found in Lake Havasu...

http://www.kpho.com/news/14214579/detail.html

beatle78
09-27-2007, 02:40 PM
Man, that's scary. Hopefully they can develop a immunization shot to give kids in the future!

corey
09-27-2007, 02:49 PM
Man, thats crazy.It makes the cool cool weather we are having right now seem like a pretty good deal.

jsc0324
09-27-2007, 03:07 PM
Seems like nose plugs are a pretty simple preventative measure. Anyone ski with nose plugs? Even though the odds are in our favor, something to consider.

KJAECKIN
09-27-2007, 03:32 PM
The Orlando Watersprts Complex(OWC) started handing out free nose plugs to anyone that wanted one.

jsc0324
09-27-2007, 03:39 PM
I am skiing in a private ski lake near Barstow CA and it is not particularly deep. An overreaction, I am sure, but I worry about the kids skiing and having the boat stir up something (amoeba.) I think I am going to have the kids wear nose plugs while skiing until this seems to go away. My oldest is just learning to slalom and I expect there is a fair amount of water going up the nose. I know it won't eliminate the possibility, but surely it lowers the chances.

Has anyone here used nose plugs? Do they stay on? Are they unreasonably uncomfortable?

rodltg2
09-27-2007, 03:42 PM
I am skiing in a private ski lake near Barstow CA and it is not particularly deep. An overreaction, I am sure, but I worry about the kids skiing and having the boat stir up something (amoeba.) I think I am going to have the kids wear nose plugs while skiing until this seems to go away. My oldest is just learning to slalom and I expect there is a fair amount of water going up the nose. I know it won't eliminate the possibility, but surely it lowers the chances.

Has anyone here used nose plugs? Do they stay on? Are they unreasonably uncomfortable?


is your water above 80? ive been wondering if this has ever come up in a private ski lake. our water only see's 80 for a small period of time. we are in the clear now. looking at low 70's now.

jsc0324
09-27-2007, 04:08 PM
is your water above 80? ive been wondering if this has ever come up in a private ski lake. our water only see's 80 for a small period of time. we are in the clear now. looking at low 70's now.


That's a great question. Two things, because the lake I am skiing is shallow, 5-6 feet, the temperature changes pretty fast with the weather. I think it is common that in the summer months it drops into the mid 70's at night and warms to well over 80 by noon or so. (Barstow is really hot, last summer I skied there when the air temp was 118, whew!) I think that this week, the average water temp will be in the mid 70's.

I work at a research company in Los Angeles and one of my co-workers is a neuro-physicist and his take on it from his biology training that simply using 80 degrees as a measure of risk was too simple. He summed it up by saying he would stay out of the water and until he knew more, nose plugs made sense. I appreciate that the risk is really small, but it just seems like nose plugs are a pretty easy precaution until this blows over or is well defined. Additionally, for those of you shaking your heads, I recognize that I tend to error on the side of precaution.

Sodar
09-27-2007, 04:11 PM
(Barstow is really hot, last summer I skied there when the air temp was 118, whew!) I think that this week, the average water temp will be in the mid 70's.

Where in Newberry?

rodltg2
09-27-2007, 04:32 PM
its not a new thing and it wont just go away. i think the risk has always been there. i wonder if ski lakes are less likely. from what i read , the amoeba lives in warm, shallow, stagnent water. although ski lakes are shallow between 4-8ft, they change in temp very fast. they also loose alot of water so new water is constantly being pumped in. the boat is going up and down constantly moving the water around.

mccobmd
09-28-2007, 01:12 PM
Waiting for it to pass won't work since it will always be there. To me the safest thing is if you kids have any of the "clinical Symptoms" below in lake season get them on amphotericin immeadiately. From my research it is false to assume the kids couldn't get it from swimming, just less likely. Stagnant and warm water increase the concetration and the inoculum that could be recieved but don't statitistically change the likelihood of the disease. That being said nose plugs certainly won't make it more likely.



NAEGLERIA: PRIMARY AMEBIC MENINGOENCEPHALITIS — The only species of the Naegleria genus that has been confirmed to be pathogenic to humans is N. fowleri, which can cause an acute, fulminant disease known as primary amebic meningoencephalitis (PAM).

Epidemiology — N. fowleri is found worldwide, particularly in warm bodies of water such as man-made lakes and ponds, hot springs, and thermally polluted streams and rivers. They cannot survive in seawater [1]. The organism has been isolated from nasal passages and throats of healthy individuals and seroprevalence studies have shown that many individuals from endemic areas for PAM have positive antibody titers [2,3]. Disease typically occurs in previously healthy children and young adults. Affected individuals characteristically have a recent history of water-sports activities in lakes, ponds, or inadequately chlorinated swimming pools. The reason that disease occurs in only a small proportion of exposed individuals is unclear.

N. fowleri exists in the environment in three forms:

Trophozoite, which is the reproductive stage that feeds on bacteria
Resistant cyst
Transient flagellate form
N. fowleri is believed to gain access to the central nervous system (CNS) via the olfactory epithelium. The organisms can traverse the cribriform plate to reach the brain. Although infection is typically associated with swimming or fresh water contact, it is believed that infection via inhalation of contaminated dust is also possible [4]. The incubation period between exposure and clinical manifestations can be as short as one day and is usually within two weeks.

Clinical presentation — The typical presentation of PAM resembles bacterial meningitis, with the acute onset of headache, fever, neck stiffness, nausea, and vomiting. Alterations in taste and smell may be noted initially, perhaps because of involvement of the olfactory nerve. Patients do not respond to routine antibiotics, and progressive deterioration occurs. Seizures, ataxia, cranial nerve palsies, confusion, and coma frequently develop.

PAM is fatal in more than 95 percent of cases, usually within four to six days. Death usually results from raised intracranial pressure leading to brain herniation. The diagnosis is infrequently made premortem, although a few survivors have been reported [5,6].

Diagnosis — Patients with PAM often have an elevated peripheral white blood cell (WBC) count, usually with a predominant increase in polymorphonuclear leukocytes (PMNs). However, these findings are nonspecific.

CSF examination — The cerebrospinal fluid (CSF) will have features resembling bacterial meningitis including elevated opening pressure, PMN pleocytosis, increased protein, and low glucose.

Imaging — Imaging of the brain may show cerebral edema, leptomeningeal enhancement (particularly in the basal meninges), and areas of hemorrhage and necrosis.

Organism identification and pathology — The organism can be visualized by microscopy and cultured. Newer molecular tools are in development.

Microscopy — Microscopy can be performed either directly on CSF or on histologic sections of brain. N. fowleri is found in humans in the trophozoite form only; the cyst form is not seen.
The motile trophozoite can often be seen on CSF wet mount examination or can be stained with Wright's or Giemsa stains. The organism is not visible on Gram stain. A wet mount examination should be performed in untreated patients who present with a purulent meningitis and no bacteria visible on Gram stain in order to exclude the diagnosis of PAM.

N. fowleri trophozoites may also be found in histologic tissues. The amebae measure 10 by 30 µm and have a single nucleus, which contains a central, dense nucleolus. Trophozoites are typically found around blood vessels. Pathologic specimens (usually at autopsy) will show cerebral edema, acute leptomeningitis and multifocal areas of hemorrhagic necrosis in the brain.

Culture — N. fowleri can be grown on agar plates coated with Gram negative bacteria.
Other techniques — Recent methods for the diagnosis of Naegleria include monoclonal antibodies, isoenzyme profile analysis, polymerase chain reaction (PCR), and DNA probes; however, these tests are available only as research tools [7-12]. Serologic tests have been developed but are not useful for making the diagnosis because patients usually die before mounting a detectable immune response [3,13,14].
Treatment — N. fowleri is highly sensitive to amphotericin B in vitro, but delays in diagnosis and the fulminant nature of the disease has led to the description of few survivors [5,15]. Successful therapy has been reported in a handful of cases, most of whom received amphotericin B as part of their therapy [1,5]. It is recommended that treatment be attempted with intravenous and/or intrathecal amphotericin B plus oral or intravenous rifampin. Amphotericin B plus oral ketoconazole or intravenous fluconazole are alternatives.

In vitro testing has demonstrated that amebae are more resistant to fluconazole and itraconazole than to amphotericin B and ketoconazole [16]. Miconazole, chloramphenicol, and sulfonamide antibiotics have also been used [15].

jsc0324
09-28-2007, 01:45 PM
This is helpful information. Thank you.

Funny no replies on skiing with nose plugs. I am just wondering if those things are going to be tolerable. I did speak with the owner of the lake where we ski and he said that while not common, he has had several (many) people that use nose plugs or some sort of tape.

Thanks again.

mpm32
09-28-2007, 02:00 PM
My ski partner skis with nose plugs. We're in the northeast so I don't think we have to worry about the ameobas up here in the NE. He wears them because he gets all stuffed up from the algae in the lake.

I think he pulls them off after he's up though, he gets the major blast on the start up. I'll ask him if they stay on in a fall.

I do bust his *** for looking dorky though, but if I were in southern waters I'd do the same.

Leroy
10-04-2007, 11:17 PM
One on Texas.

http://www.cnn.com/2007/HEALTH/10/04/amoeba.lake/index.html

uawaterskier
10-05-2007, 03:29 AM
sounds like you have to be stirring up the bottom to get this. good think our practice lake is 70+ feet deep and our tournament site is clay bottom

jsc0324
08-07-2008, 02:32 PM
http://www.latimes.com/news/local/la-me-amoeba6-2008aug06,0,5401452.story

We still aren't wearing nose plugs in my family when we ski, but maybe I'll give it another shot. There is a lot of resistance from the kids and the other parties in the group. In the middle of the day, our ski lake is well above 80.

TX.X-30 fan
08-07-2008, 07:02 PM
Only a very few are susceptible to the amoeba, millions in the water each year and a few kids die each year, very sad. I believe most anything we or kids do is much more dangerous. How many kids each year die from the bath tub, pool, cars and on and on.

Likely it will never get any research money with the low mortality rates and more pressing concerns like AIDS and global warming. :rolleyes:

jsc0324
08-07-2008, 07:32 PM
X-30 fan:

You make a good point....another point would be how many of these deaths are water sports related? I am not so worried about my trip to Lake Powell with the kids. (It's a DEEP lake with constant water movement.) I am worried about the time I spend on a private lake that is 4-8 feet deep and the silt is constantly being stirred by the prop. I am not such a great skier and I get more than my share of water up the old nose. I worry about my kids. That's why I may be reading more into this than I should. I am also the guy with the full tool kit on the water ready to replace the impeller/prop and other odd occurrences should the need arise. It's my nature. (geek)

Found another interesting link for those with private lakes and how we might be able to address this issue. Wonder if it works?

http://www.clean-flo.com/naegleria-fowleri-brain-eating-amoeba.html

Finally, X-30 fan, I love the quotes on the bottom of your posts. Thanks.

TX.X-30 fan
08-07-2008, 08:19 PM
All the deaths in Tx. last year were in shallow water near shore, in the muck. Not meaning to belittle the problem at all. We do not play in muck on our lake after it warms up. Board and swim in deep water. I can understand your concerns in a shallow ski lake.