Essential Information on the Uncommon 'Brain-Eating' Amoeba Discovered in Australia's Tap Water

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A particularly dangerous microorganism found in water, often referred to as a “brain-eating amoeba,” has recently been discovered in two drinking water systems in south-west Queensland.

The two towns affected are located about 750 kilometers west of Brisbane: Augathella, with around 300 residents, and Charleville, with approximately 3,000 people.

Analysis commissioned by Queensland Health of water samples uncovered the presence of Naegleria fowleri in the water systems of medical facilities in both Charleville and Augathella, as well as the incoming town water supply.

The Murweh Shire Council, which encompasses the affected areas, issued a health notice on August 7, alerting locals and visitors about the presence of N. fowleri in the water supply.

But what exactly is this organism, and how substantial is the risk for these Queensland towns and others?

What is the brain-eating amoeba?

The N. fowleri amoeba is a microscopic organism found around the world. It only lives in warm freshwater, generally between 25 and 40°C. This can include ponds, lakes, rivers, streams and hot springs.

If someone is infected with N. fowleri, it causes what’s called primary amoebic meningoencephalitis, a serious infection of the brain.

Symptoms include a sore throat, headache, hallucinations, confusion, vomiting, fever, neck stiffness, changes to taste and smell, and seizures.

The incubation period of primary amoebic meningoencephalitis — the time between infection and symptoms appearing — typically ranges from three to seven days.

Tragically, this illness is nearly always fatal, even if someone receives medical attention quickly. Death typically occurs about five days after symptoms begin.

Fortunately though, cases are very rare. In the United States, there were 167 reported cases of primary amoebic meningoencephalitis between 1962 and 2024, according to the Centers for Disease Control and Prevention. Only four survived.

A comprehensive review of the disease up to 2018 found 381 recognized cases, with Australia reporting 22, ranking fifth worldwide after the US, Pakistan, Mexico, and India. A striking 92 percent of those infected died.

How do people get infected?

The means of infection is quite atypical. N. fowleri infects by entering the brain through the nose, navigating through a protective layer known as the nasal epithelium.

This is an important physical barrier and allows the amoeba to travel to the brain through the olfactory nerve, which is responsible for our sense of smell. The infection then kills brain tissue and causes swelling of the brain, termed cerebral oedema.

Infections occur in people when infected water travels up their nose. Most cases involve children and young people who have swum in infected waters. The majority of cases occur in males, with an average age of 14.

Even water sports in affected waterways can be dangerous. A person is currently in intensive care in Missouri after it’s believed they became infected while water skiing.

Concerning the recent findings in Queensland, the source of the contamination remains unidentified. A freshwater source or groundwater feeding the affected systems might have been tainted with N. fowleri, potentially allowing the amoeba to spread. Further investigations are anticipated to provide clarity.

Is it dangerous in drinking water?

First, it’s important to note you can’t get primary amoebic meningoencephalitis from drinking contaminated water.

But any activity that allows infected water to enter a person’s nose is potentially dangerous. This can happen during a bath or a shower.

Some people flush their nasal passages to clear congestion related to allergies or a viral infection. This has been linked to infections with N. fowleri. If you’re going to flush your nasal passages, you should use a sterile saline solution.

Younger children engaging in water-related activities like hose or sprinkler play may be vulnerable. A tragic case involved a 16-month-old who died in 2023 in the US after using a contaminated water “splash pad,” a recreational zone designed for kids to enjoy water play.

What is the risk in Queensland?

Regarding N. fowleri, Australian drinking water guidelines advise:

“If the organism is detected, advice should be sought from the relevant health authority or drinking water regulator.”

The guidelines also provide recommendations on how to disinfect water supplies and control N. fowleri, using chlorine and other chemical compounds.

All public town water supplies across Australia are regularly tested to ensure that water is safe to drink.

We don’t yet know the exact cause of the detection of the amoeba N. fowleri in these Queensland towns’ water supplies. But drinking or cooking with water contaminated with this amoeba will not cause an infection.

Any activity that allows potentially contaminated water to go up the nose should be navigated carefully for now in the affected areas.

Contamination of a town drinking water supply from this amoeba is very rare and is unlikely in other Australian town water supplies.

To reduce your risk in potentially infected warm, fresh waters you should keep your head above water while swimming. And don’t jump or dive in. You can use a nose-clip if you want to swim with your head under water.

The amoeba cannot survive in salt water, so there’s no risk swimming in the ocean. Also, properly maintained swimming pools should be safe from the organism.

New South Wales Health advises that the amoeba cannot survive in water that is clean, cool and adequately chlorinated.