Rare Disease Report

Improper Use of Neti Pot Can Increase Risk of Naegleria Fowleri and Other Bacteria

FEBRUARY 15, 2017
Andrew Black
Neti Pots are used as in home devices that a saline solution to treat congested sinuses, colds and allergies by flushing out clogged nasal passages.  
According the FDA and CDC, improper use of a neti pot can increase your risk of an infection of Naegleria fowleri, also known as the brain-eating amoeba and other bacterial infections.
Follow these steps recommended by both organizations to ensure proper safety:

Use filtered water

Using tap water isn’t safe to use for a nasal rinse because it’s not filtered or treated. Some tap water contains low levels of organisms, such as bacteria and protozoa, including amoebas, that may be safe to swallow because stomach acid kills them. But when in your nose, these organisms can stay alive in nasal passages and cause potentially serious infections.
To prevent infections, distilled, filtered, and boiled and cooled tap water is recommended for use.

Safely use nasal irrigation systems

Information included with the irrigation device might give more specific instructions about its use and care. These devices all work in basically the same way:
  • Leaning over a sink, tilt your head sideways with your forehead and chin roughly level to avoid liquid flowing into your mouth.
  • Breathing through your open mouth, insert the spout of the saline-filled container into your upper nostril so that the liquid drains through the lower nostril.
  • Clear your nostrils. Then repeat the procedure, tilting your head sideways, on the other side.
  • Sinus rinsing can remove dust, pollen and other debris, as well as help to loosen thick mucus. It can also help relieve nasal symptoms of sinus infections, allergies, colds and flu. Plain water can irritate your nose. The saline allows the water to pass through delicate nasal membranes with little or no burning or irritation.

Use and care of device

  • Wash and dry your hands.
  • Check that the device is clean and completely dry.
  • Prepare the saline rinse, either with the prepared mixture supplied with the device, or one you make yourself.
  • Follow the manufacturer’s directions for use.
  • Wash the device, and dry the inside with a paper towel or let it air dry between uses

About Naegleria fowleri

Naegleria fowleri is a free-living microscopic amoeba that can cause a rareand devastating infection of the brain called primary amebic meningoencephalitis (PAM). The amoeba is commonly found in warm freshwater (e.g. lakes, rivers, and hot springs) and soil.
The infection usually occurs when the person is in contaminated water and the amoeba enters through the nose and travels to the brain where it causes PAM.
Symptoms of PAM can be mild at first, but worsen quickly. Usually, initial symptoms appear about 5 days after the infection and can headache, fever, nausea, or vomiting. These are followed quickly by confusion , loss of balance, seizures, and hallucinations. 
Death usually occurs about 5 days (range of 1 -12 days) after initial symptoms appear.

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