A teenager in central North Carolina is in critical condition after contracting a rare and often fatal brain infection caused by a waterborne amoeba, state health officials announced this week.
The North Carolina Department of Health and Human Services said Aug. 27 that the teen has primary amebic meningoencephalitis, or PAM, a brain infection caused by Naegleria fowleri, an amoeba commonly found in warm freshwater such as lakes and ponds. The department did not release the teen’s name, age or hometown, citing the family’s privacy, and said the source of the infection remains under investigation.
“Our hearts go out to this teen’s family, friends and loved ones as they navigate this difficult time,” State Epidemiologist Dr. Zack Moore said in a statement. “While these infections are very rare, this is an important reminder that this amoeba is present in our state and across the U.S.”
The North Carolina case comes days after an 8-year-old Louisiana girl, Lillian Smart, died from a Naegleria fowleri infection that health officials said she most likely contracted while swimming in Lake Claiborne in the northern part of the state. It was Louisiana’s first confirmed case of the infection since 2013.
PAM is exceedingly rare but almost always fatal once symptoms appear. According to the CDC, fewer than 10 people a year in the United States are diagnosed with the infection, and more than 97 percent of known cases have been fatal. The agency has recorded 167 cases nationwide between 1962 and 2024, with only four survivors.
The amoeba infects people when contaminated water enters through the nose and travels to the brain, most often during swimming or diving in warm lakes, rivers or hot springs during summer months. It cannot be contracted by swallowing water and does not spread from person to person.
Early symptoms of PAM include headache, fever, nausea and vomiting. The illness often progresses rapidly to coma and death, typically within about five days, though the CDC notes fatalities have occurred anywhere from one to 18 days after symptoms begin.
The CDC recommends several precautions to reduce the risk of infection: holding the nose or wearing a nose clip when jumping or diving into freshwater, keeping the head above water in hot springs, avoiding digging in shallow water where the amoeba is more likely to live, and using distilled or boiled water — rather than tap water — when rinsing sinuses.
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