girl jumps from a dock into a lake

What Lurks in Still Waters

When the weather is hot, a quick dip in the local swimming hole may sound like just the thing to cool you down. However, before you dive in, take steps to protect yourself and your loved ones from microscopic dangers lurking beneath the surface.

Standing water is a breeding ground for bacteria, insects such as mosquitoes that can carry diseases and a nasty single-celled organism called naegleria fowleri — more commonly known as the brain-eating amoeba.

This troublesome amoeba thrives in still, dirty water — whether it’s a pool, pond or puddle — and can be life-threatening if it enters the nose of an unwary swimmer. From there, the amoeba makes its way to the brain where it can cause a serious infection known as primary amebic meningoencephalitis (PAM) that is usually fatal.

“Swimming in murky water is risky,” says An Thien Nguyen, M.D., an emergency medicine physician on the medical staff at Texas Health Presbyterian Hospital Denton. “PAM is probably one of the scariest problems related to swimming. Thankfully, it is rare and can largely be prevented.”

Putting a Stop to PAM

To prevent PAM, Dr. Nguyen recommends only swimming in clear water. Choose clean, moving water in nature or pools that are properly chlorinated. You cannot get PAM from drinking contaminated water, unless it goes up your nose.

If you do swim in dark or still water, avoid jumping in. The pressure of a dive or cannonball can force water up the nose, making it more likely that the amoeba will wind up there. Use a nose clip or your fingers to close your nostrils if you do jump or dive in.

Early detection plays an important role in the recovery of those who survive PAM. Symptoms usually begin within nine days of swimming and include fever, vomiting, nausea and headache. Once the disease progresses, it may also cause hallucinations, seizures, coma and other complications, including loss of life.

Take anyone experiencing these symptoms to the ER immediately, especially if they have been swimming in the last few weeks. Treatment with the medication miltefosine — a drug used to treat parasites and breast cancer — and cooling the body with therapeutic hypothermia may help beat PAM.

PAM is considered a medical emergency and requires immediate intervention for the best possible chance of survival. In an emergency, dial 911 to be connected with emergency medicine technicians in your area.

Physicians on the medical staff practice independently and are not employees or agents of the hospital or Texas Health Resources.

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