ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
Primary Amebic Meningoencephalitis Associated With Rafting on an Artificial Whitewater River: Case Report and Environmental Investigation.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Systematic Review of Brain-Eating Amoeba: A Decade Update.International journal of environmental research and public health · 2023Pooled it
- Neuroinvasive Free-Living Amoebae Pathogenesis, Neuroinflammation and Therapeutic Challenges.International journal of molecular sciences · 2026Review
- Global Review onInfectious disease reports · 2026Review
- Virulence ofbioRxiv : the preprint server for biology · 2025Article
- The role of plasma metagenomic sequencing in identification of Balamuthia mandrillaris encephalitis.Acta neuropathologica communications · 2025Article
- Review
- Primary amebic meningoencephalitis: a review of Naegleria fowleri and analysis of successfully treated cases.Parasitology research · 2024Review
- A Case of Primary Amebic Meningoencephalitis Associated with Surfing at an Artificial Surf Venue: Environmental Investigation.ACS ES&T water · 2023Article
- Clinical manifestations and outcome of patients with primary amoebic meningoencephalitis in Pakistan. A single-center experience.PloS one · 2023Article
- Article
- Case Report and Literature Review: Bacterial Meningoencephalitis or Not?Frontiers in pediatrics · 2022Article
- Attribution of Illnesses Transmitted by Food and Water to Comprehensive Transmission Pathways Using Structured Expert Judgment, United States.Emerging infectious diseases · 2021Article
- Inhibition of Fatty Acid Oxidation as a New Target To Treat Primary Amoebic Meningoencephalitis.Antimicrobial agents and chemotherapy · 2020Article
- Isolation of N. philippinensis and N. americana strains from irrigation waters of farmland soils in Iran.Environmental science and pollution research international · 2020Article
- A Fatal Case of Primary Amoebic Meningoencephalitis (PAM) Complicated with Diabetes Insipidus (DI): A Case Report and Review of the Literature.Case reports in infectious diseases · 2020Article
- Free-living amoebic encephalitis - Case series.Tropical parasitologyArticle
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
Abstract
Background: Naegleria fowleri is a thermophilic ameba found in freshwater that causes primary amebic meningoencephalitis (PAM) when it enters the nose and migrates to the brain. Patient exposure to water containing the ameba typically occurs in warm freshwater lakes and ponds during recreational water activities. In June 2016, an 18-year-old woman died of PAM after traveling to North Carolina, where she participated in rafting on an artificial whitewater river. Methods: We conducted an epidemiologic and environmental investigation to determine the water exposure that led to the death of this patient. Results: The case patient's most probable water exposure occurred while rafting on an artificial whitewater river during which she was thrown out of the raft and submerged underwater. The approximately 11.5 million gallons of water in the whitewater facility were partially filtered, subjected to ultraviolet light treatment, and occasionally chlorinated. Heavy algal growth was noted. Eleven water-related samples were collected from the facility; all were positive for N. fowleri. Of 5 samples collected from the nearby natural river, 1 sediment sample was positive for N. fowleri. Conclusions: This investigation documents a novel exposure to an artificial whitewater river as the likely exposure causing PAM in this case. Conditions in the whitewater facility (warm, turbid water with little chlorine and heavy algal growth) rendered the water treatment ineffective and provided an ideal environment for N. fowleri to thrive. The combination of natural and engineered elements at the whitewater facility created a challenging environment to control the growth of N. fowleri.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.