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CDC: Potentially deadly amoeba not detected in samples from Florida patient

Infectious disease physicians at Golisano Children’s Hospital believe he could still have it thus recommended to continue treating him for this infection.
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Posted at 6:36 PM, Jul 26, 2022

CHARLOTTE COUNTY, Fla. — The CDC has confirmed with Fox 4 that a Florida patient did not test positive for a potentially deadly amoeba.

In an e-mail sent to us late Tuesday night, Candice Hoffmann, press officer for the National Center for Emerging and Zoonotic Infectious Diseases at the CDC, said on July 10, the CDC provided consultation about a sick patient in Florida.

The CDC received two samples of cerebrospinal fluid from the patient and Naegleria fowleri was not detected in either sample.

We asked the CDC about the testing following a statement the Charlotte County Department of Health made during the County Board meeting on Tuesday morning. The spokesperson said they are notified when a test sample is submitted by a doctor.

"Regarding patients, CDC is available to perform testing for Naegleria fowleri on patient specimens at the request of the patient’s healthcare provider," Hoffman said in a statement. "CDC encourages any person with symptoms that might be consistent with primary amebic meningoencephalitis (PAM) to see their healthcare provider right away."

Though the test is negative, we asked why bodies of water are not tested for the amoeba. Hoffman said what the DOH echoed on Tuesday — that the amoeba is naturally occurring and there is no established relationship between detection or concentration of Naegleria fowleri and risk of infection.

"Environmental testing may be warranted for investigations in which Naegleria fowleri detection may be useful for establishing geographical distribution in new environments, survival in disinfected water bodies, or in household water systems," Hoffman said in a statement.

The CDC declined to discuss specific cases due to privacy reasons and told us to contact the state health department for questions about the patient.

Hoffman added that so far this year, only one person from Missouri has tested positive for the amoeba.

Here's a look at the CDC's full statement to us, answering our questions about the amoeba.

So far, this year, in the United States, there has been one confirmed case of Naegleria fowleri, in a patient who resided in Missouri.

On 7/10/22, CDC provided consultation about an ill patient in Florida. CDC’s free-living ameba laboratory performed testing on two samples of cerebrospinal fluid (CSF) from this patient and Naegleria fowleri was not detected in either sample. For more information about this patient, please contact the Florida Department of Health.

Regarding the third question, while CDC experts provide treatment information and advice to clinicians, the decision to treat a patient for Naegleria fowleri is always made by the doctor or team of doctors providing care for the patient.

Regarding the last question, I am unsure if you meant testing patients or testing bodies of water. Regarding patients, CDC is available to perform testing for Naegleria fowleri on patient specimens at the request of the patient’s healthcare provider. CDC encourages any person with symptoms that might be consistent with primary amebic meningoencephalitis (PAM) to see their healthcare provider right away.

If you are asking about testing bodies of water, in general, CDC does not recommend testing rivers and lakes for Naegleria fowleri because the ameba is naturally occurring and there is no established relationship between detection or concentration of Naegleria fowleri and risk of infection. Environmental testing may be warranted for investigations in which Naegleria fowleri detection may be useful for establishing geographical distribution in new environments, survival in disinfected water bodies, or in household water systems.
Candice Hoffmann, National Center for Emerging and Zoonotic Infectious Diseases at the CDC

Lee Health on Thursday, July 28, 2022, with the consent of the family, released the following statement on his condition and suspected case of primary amebic meningoencephalitis, which is caused by Naegleria fowleri.

On July 9, Caleb’s family brought him to Golisano Children’s Hospital of Southwest Florida with symptoms of hallucinations, a severe headache, and high fever. After ruling out the much more common condition of bacterial meningitis, which has very similar symptoms to primary amebic meningoencephalitis (PAM), and learning that he had been swimming in brackish water on July 1, doctors tested and began treating Caleb for PAM. This occurred on July 10, within 24 hours of his arrival to Golisano Children’s Hospital.

Caleb’s care team at Golisano Children’s Hospital is and has been following the recommended protocol from the Centers for Disease Control and Prevention (CDC) for PAM since July 10. The team sent two samples taken from cerebrospinal fluid to the CDC for testing, and both resulted as negative for Naegleria fowleri.

According to the CDC, it is common for Naegleria fowleri not to be initially evaluated for or detected in patients with PAM.

Due to Caleb’s symptoms, his reported recent exposure to brackish water, and his clinical course, infectious disease physicians at Golisano Children’s Hospital believe he could still have PAM caused by Naegleria fowleri and thus recommended to continue treating him for this infection.

On July 10, as per the protocol for laboratory evaluation of PAM, communication with the local Department of Health occurred, and then subsequent communication with the CDC to facilitate testing of the sample. Even though there was not a confirmed result for PAM to report to the Department of Health (due to inconclusive tests), Caleb’s doctors believe this to be the cause of his illness and are treating him accordingly.

Caleb is currently in the pediatric intensive care unit and his family remains hopeful. Our thoughts and prayers are with Caleb and his family during this very difficult time.

Lee Health

Our original reporting continues below:

Fox 4 is working for you — pushing for answers surrounding what could be a public health concern you need to know about. We're talking about a potentially deadly infection caused by an amoeba.

It's turned up in Florida many times before and while a local family claims a young boy became infected at a Charlotte County beach, it's been difficult to get confirmation from state and local health officials about whether this freshwater amoeba is to blame.

Fox 4 learned about this two weeks ago, but we wanted to really make sure were accurate on this story before telling you at home about a public health risk in our area.

We first contacted the CDC, state and local health officials close to two weeks ago. State and local health officials told us there was no confirmed case of the amoeba called Naegleria fowleri. The CDC said they were looking into it.

Fast forward to July 26, the Department of Health in Charlotte County gave a last-minute educational presentation at the Charlotte County Board of Commissioners meeting, which had us asking more questions.

"We’ve been aware of this individual that’s been on social media for quite some time. I’m not at liberty to discuss out of respect for privacy for that family," said Joseph Pepe, the DOH Charlotte County presenter at the Board meeting.

That's all the DOH would say about whether a boy was infected with a potentially deadly amoeba in Charlotte County. This is despite a family's claims on GoFundMe and Facebook that a young boy likely became infected at a Charlotte County beach in early July and remains in the hospital.

Commissioner Joseph Tiseo said he knew the family.

"I know him and his family. Came up with my son, approximately the same age," Tiseo said.

We e-mailed and called every health agency today — CDC, state, and local health departments — asking whether any tests were conducted. None of them responded.

Here's why Fox 4 continues to ask questions:

In a post on Facebook from July 17, the boy's aunt claimed that samples were sent to the CDC, but those samples did not come back positive or negative. Six days later, a Charlotte County spokesperson stated there was no confirmed case of the amoeba in Charlotte County.

Minutes after our story aired, Charlotte County DOH returned our request. They reiterated the same thing as before: there are no confirmed cases of the amoeba in Charlotte County. However, their presenter offered this up to Charlotte County leaders on Tuesday about testing.

"We’re notified even when a physician moves to test and then from there we work with the CDC, our labs, those physicians, and really try to rule out any other possible case or definition," Pepe said.

Regardless of whether a test was conducted on the boy, we also learned a test would not be conducted on any bodies of water.

“Testing of the freshwater is not recommended by the CDC because amoeba is naturally occurring and there is no established relationship between detection or concentration of Naegleria fowleri and risk of infection," Pepe explained. "You can just assume that ngleria is in freshwater. That’s why the testing component isn’t in there as well."

Tiseo added that he doesn't know 100 percent if it's this amoeba, but certainly some of the symptoms point that way.

This infection is extremely rare. The CDC has only reported 154 cases since 1962 with only four survivors.

The only way to become infected is if the amoeba enters through the nose, such as when water splashes or goes up your nose from jumping in the water.

Fox 4 will continue to monitor this situation, so our viewers can get an accurate picture of whether this was truly an infection caused by an amoeba in our waterways.