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The epidemiology and control of primary amoebic meningoencephalitis with particular reference to South Australia

The epidemiology and control of primary amoebic meningoencephalitis with particular reference to... Abstract This paper reviews the history, epidemiology and control of primary amoebic meningoencephalitis (PAM), caused by Naegleria fowleri, with particular reference to South Australia. The intention has been to outline misconceptions and uncertainties pervading the earlier literature. Although PAM infections elsewhere have been attributed to cysts in air-borne dust, we believe that contact with water in the domestic environment was not adequately considered as a potential source of these infections. Several reports have cast doubt on the effectiveness of chlorine in controlling N. fowleri, although there is laboratory and South Australian field experience to the contrary. These reports can be traced to a misunderstanding of the circumstances surrounding cases of PAM reported by other workers. Provided that a continuous free chlorine residual of 0·5 mg/l can be maintained in water accessible to N. fowleri, the risk of disease should be negligible. The failure of amphotericin B therapy to save recent victims of the disease, despite relatively prompt intervention, is disappointing. Possible reasons for this, and the reports that rifampin or tetracycline combined with amphotericin might be more successful, are discussed. References Anderson and Jamieson, 1972 Anderson K. , Jamieson A. . Primary amoebic meningoencephalitis , Lancet , 1972 , vol. 1 (pg. 902 - 903 ) Google Scholar Crossref Search ADS PubMed WorldCat Apley et al., 1970 Apley J. , Clarke S.K.R. , Roome A.P.C.H. , Sandry S.A. , Saygi G. , Silk B. , Warhurst D.C. . Primary amoebic meningoencephalitis in Britain , British Medical Journal , 1970 , vol. i (pg. 596 - 599 ) Google Scholar Crossref Search ADS WorldCat Cain et al., 1981 Cain A.R.R. , Wiley P.F. , Brownell B. , Warhurst D.C. . Primary amoebic meningoencephalitis , Archives of Disease in Childhood , 1981 , vol. 56 (pg. 140 - 143 ) Google Scholar Crossref Search ADS PubMed WorldCat Carter, 1970 Carter R.F. . Description of a Naegleria sp. isolated from two cases of primary amoebic meningoencephalitis, and of the experimental pathological changes induced by it , Journal of Pathology , 1970 , vol. 10 (pg. 217 - 244 ) Google Scholar Crossref Search ADS WorldCat Carter, 1972 Carter R.F. . Primary amoebic meningoencephalitis: An appraisal of present knowledge , Transactions of the Royal Society of Tropical Medicine and Hygiene , 1972 , vol. 66 (pg. 193 - 213 ) Google Scholar Crossref Search ADS PubMed WorldCat Centers for Disease Control, 1978 Centers for Disease Control . Primary amebic meningoencephalitis California, Florida, New York , Morbidity and Mortality Weekly Report , 1978 , vol. 27 (pg. 343 - 344 ) OpenURL Placeholder Text WorldCat Cerva, 1971 Cerva L. . Studies of limax amoebae in a swimming pool , Hydrobiologia , 1971 , vol. 38 (pg. 141 - 161 ) Google Scholar Crossref Search ADS WorldCat Chang, 1978 Chang S.L. . Resistance of pathogenic Naegleria to some common physical and chemical agents , Applied and Environmental Microbiology , 1978 , vol. 35 (pg. 368 - 375 ) Google Scholar PubMed OpenURL Placeholder Text WorldCat Commonwealth Department of Health, 1980 Commonwealth Department of Health . Primary amoebic meningoencephalitis—Western Australian out-break , Communicable Diseases Intelligence, Bulletin No. 81/3 , 1980 Canberra OpenURL Placeholder Text WorldCat Commonwealth Department of Health, 1981 Commonwealth Department of Health . Primary amoebic meningoencephalitis—New South Wales , Communicable Diseases Intelligence, Bulletin No. 81/17 , 1981 Canberra OpenURL Placeholder Text WorldCat Cursons et al., 1977 Cursons R.T.M. , Brown T.J. , Keys E.A. . Immunity to pathogenic free-living amoebae , Lancet , 1977 , vol. ii (pg. 875 - 876 ) Google Scholar Crossref Search ADS WorldCat Cursons et al., 1980 Cursons R.T.M. , Brown T.J. , Keys E.A. . Effect of disinfection on pathogenic free-living amoebae in axenic conditions , Applied and Environmental Microbiology , 1980 , vol. 40 (pg. 62 - 66 ) Google Scholar PubMed OpenURL Placeholder Text WorldCat De Jonckheere and van de Voorde, 1976 De Jonckheere J. , van de Voorde H. . Differences in destruction of cysts of pathogenic and nonpathogenic Naegleria and Acanthamoeba by chlorine , Applied and Environmental Microbiology , 1976 , vol. 31 (pg. 294 - 297 ) Google Scholar PubMed OpenURL Placeholder Text WorldCat Derremaux et al., 1974 Derremaux A.L. , Jadin J.B. , Willaert E. , Moret R. . Action du chlore sur les amibes de l'eau , Annales de la Société Belge de Médecine Tropicale , 1974 , vol. 54 (pg. 415 - 428 ) Google Scholar PubMed OpenURL Placeholder Text WorldCat Dorsch, 1982 Dorsch M.M. . Primary Amoebic Meningoencephalitis: An Historical and Epidemiological Perspective with Particular Reference to South Australia , 1982 Adelaide South Australian Health Commission Fowler and Carter, 1965 Fowler M. , Carter R.F. . Acute pyogenic meningitis probably due to Acanthamoeba sp: a preliminary report , British Medical Journal , 1965 , vol. ii (pg. 740 - 742 ) OpenURL Placeholder Text WorldCat Griffin, 1972 Griffin J.L. . Temperature tolerance of pathogenic and nonpathogenic free-living amoebas , Science , 1972 , vol. 178 (pg. 869 - 870 ) Google Scholar Crossref Search ADS PubMed WorldCat Griffin, 1978 Griffin J.L. . Kreier J.P. . Pathogenic free-living amoebae , Parasitic Protozoa , 1978 , vol. Vol. 2 New York Academic Press (pg. 507 - 549 ) Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC Kadlec et al., 1980 Kadlec V. , Skvarova T. , Cerva L. , Nebazniva D. . Virulent Naegleria fowleri in indoor swimming pool , Folia Parasitologica , 1980 , vol. 27 (pg. 11 - 17 ) Google Scholar PubMed OpenURL Placeholder Text WorldCat Lawande et al., 1979 Lawande R.V. , John I. , Dobbs R.H. , Egler L.J. . A case of primary amebic meningoencephalitis in Zaria, Nigeria , American Journal of Clinical Pathology , 1979 , vol. 71 (pg. 591 - 594 ) Google Scholar Crossref Search ADS PubMed WorldCat Lee et al., 1979 Lee K.K. , Karr S.L. , Wong M.M. , Hoeprich P.D. . In vitro susceptibilities of Naegleria fowleri strain HB-1 to selected antimicrobial agents, singly and in combination , Antimicrobial Agents and Chemotherapy , 1979 , vol. 16 (pg. 217 - 220 ) Google Scholar Crossref Search ADS PubMed WorldCat Lyons and Kapur, 1977 Lyons T.B. , Kapur R. . Limax amoebae in public swimming pools of Albany, Schenectady and Rensselaer Counties, New York: their concentration, correlations and significance , Applied and Environmental Microbiology , 1977 , vol. 33 (pg. 551 - 555 ) Google Scholar PubMed OpenURL Placeholder Text WorldCat Miller et al., 1982 Miller G. , Cullity G. , Walpole I. , O'Connor J. , Masters P. . Primary amoebic meningoencephalitis in Western Australia , Medical Journal of Australia , 1982 , vol. i (pg. 352 - 357 ) OpenURL Placeholder Text WorldCat Robinson, 1977 Robinson B.S. . Effectiveness of chlorine in the control of Naegleria: laboratory and field studies in South Australia , Proceedings of the 7th Federal Convention of the Australian Water and Wastewater Association , 1977 (pg. 465 - 478 ) Canberra, 1977 Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC Robinson and Lake, 1981 Robinson B.S. , Lake J.A. . The influence of temperature on growth and distribution of Naegleria species , Proceedings of 9th Federal Convention of the Australian Water and Wastewater Association , 1981 (pg. 12 - 19 ) Section 3 Perth, 1981 Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC Saygi et al., 1973 Saygi G. , Warhurst D.C. , Roome A.P.C.H. . A study of amoebae isolated from the Bristol cases of primary amoebic encephalitis , Proceedings of the Royal Society of Medicine , 1973 , vol. 66 (pg. 277 - 282 ) Google Scholar PubMed OpenURL Placeholder Text Google Scholar Google Preview WorldCat COPAC Seidel, 1982 Seidel J. . Chemotherapy for primary amebic meningoencephalitis (Letter) , New England Journal of Medicine , 1982 , vol. 306 pg. 1296 Google Scholar Crossref Search ADS WorldCat Seidel et al., 1982 Seidel J.S. , Harmatz P. , Visvesvara G.S. , Cohen A. , Edwards J. , Turner J. . Successful treatment of primary amoebic meningoencephalitis , New England Journal of Medicine , 1982 , vol. 306 (pg. 346 - 348 ) Google Scholar Crossref Search ADS PubMed WorldCat Stevens et al., 1980 Stevens A.R. , De Jonckheere J. , Willaert E. . Naegleria lovaniensis new species: isolation and identification of six thermophilic strains of a new species found in association with Naegleria fowleri , International Journal for Parasitology , 1980 , vol. 10 (pg. 51 - 64 ) Google Scholar Crossref Search ADS PubMed WorldCat Stevens et al., 1981 Stevens A.R. , Shulman S.T. , Lansen T.A. , Cichon M.J. , Willaert E. . Primary amoebic meningoencephalitis: a report of two cases and antibiotic and immunological studies , Journal of Infectious Diseases , 1981 , vol. 143 (pg. 193 - 199 ) Google Scholar Crossref Search ADS PubMed WorldCat Thong, 1982 Thong Y.H. . Chemotherapy for primary amebic meningoencephalitis (Letter) , New England Journal of Medicine , 1982 , vol. 306 (pg. 1295 - 1296 ) Google Scholar Crossref Search ADS PubMed WorldCat Thong et al., 1979a Thong Y.H. , Rowan-Kelly B. , Ferrante A. . Delayed treatment of experimental amoebic meningoencephalitis with amphotericin B and tetracycline , Transactions of the Royal Society of Tropical Medicine and Hygiene , 1979 , vol. 73 (pg. 336 - 337 ) Google Scholar Crossref Search ADS PubMed WorldCat Thong et al., 1979b Thong Y.H. , Rowan-Kelly B. , Ferrante A. . Treatment of experimental Naegleria meningoencephalitis with a combination of amphotericin B and rifamycin , Scandinavian Journal of Infectious Diseases , 1979 , vol. 11 (pg. 151 - 153 ) Google Scholar Crossref Search ADS PubMed WorldCat Walters et al., 1981 Walters R.P. , Robinson B.S. , Lake J.A. . Experiences in the control of Naegleria in public water supplies in South Australia , Proceedings of the 9th Federal Convention of the Australian Water and Wastewater Association , 1981 (pg. 1 - 11 ) Section 3 Perth, 1981 Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC Warren and Ridgway, 1978 Warren I.C. , Ridgway J. . Swimming pool disinfection , Water Research Centre Technical Report TR90 , 1978 United Kingdom OpenURL Placeholder Text WorldCat This content is only available as a PDF. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Transactions of The Royal Society of Tropical Medicine and Hygiene Oxford University Press

The epidemiology and control of primary amoebic meningoencephalitis with particular reference to South Australia

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References (39)

Publisher
Oxford University Press
ISSN
0035-9203
eISSN
1878-3503
DOI
10.1016/0035-9203(83)90167-0
Publisher site
See Article on Publisher Site

Abstract

Abstract This paper reviews the history, epidemiology and control of primary amoebic meningoencephalitis (PAM), caused by Naegleria fowleri, with particular reference to South Australia. The intention has been to outline misconceptions and uncertainties pervading the earlier literature. Although PAM infections elsewhere have been attributed to cysts in air-borne dust, we believe that contact with water in the domestic environment was not adequately considered as a potential source of these infections. Several reports have cast doubt on the effectiveness of chlorine in controlling N. fowleri, although there is laboratory and South Australian field experience to the contrary. These reports can be traced to a misunderstanding of the circumstances surrounding cases of PAM reported by other workers. Provided that a continuous free chlorine residual of 0·5 mg/l can be maintained in water accessible to N. fowleri, the risk of disease should be negligible. The failure of amphotericin B therapy to save recent victims of the disease, despite relatively prompt intervention, is disappointing. Possible reasons for this, and the reports that rifampin or tetracycline combined with amphotericin might be more successful, are discussed. References Anderson and Jamieson, 1972 Anderson K. , Jamieson A. . Primary amoebic meningoencephalitis , Lancet , 1972 , vol. 1 (pg. 902 - 903 ) Google Scholar Crossref Search ADS PubMed WorldCat Apley et al., 1970 Apley J. , Clarke S.K.R. , Roome A.P.C.H. , Sandry S.A. , Saygi G. , Silk B. , Warhurst D.C. . Primary amoebic meningoencephalitis in Britain , British Medical Journal , 1970 , vol. i (pg. 596 - 599 ) Google Scholar Crossref Search ADS WorldCat Cain et al., 1981 Cain A.R.R. , Wiley P.F. , Brownell B. , Warhurst D.C. . Primary amoebic meningoencephalitis , Archives of Disease in Childhood , 1981 , vol. 56 (pg. 140 - 143 ) Google Scholar Crossref Search ADS PubMed WorldCat Carter, 1970 Carter R.F. . Description of a Naegleria sp. isolated from two cases of primary amoebic meningoencephalitis, and of the experimental pathological changes induced by it , Journal of Pathology , 1970 , vol. 10 (pg. 217 - 244 ) Google Scholar Crossref Search ADS WorldCat Carter, 1972 Carter R.F. . Primary amoebic meningoencephalitis: An appraisal of present knowledge , Transactions of the Royal Society of Tropical Medicine and Hygiene , 1972 , vol. 66 (pg. 193 - 213 ) Google Scholar Crossref Search ADS PubMed WorldCat Centers for Disease Control, 1978 Centers for Disease Control . Primary amebic meningoencephalitis California, Florida, New York , Morbidity and Mortality Weekly Report , 1978 , vol. 27 (pg. 343 - 344 ) OpenURL Placeholder Text WorldCat Cerva, 1971 Cerva L. . Studies of limax amoebae in a swimming pool , Hydrobiologia , 1971 , vol. 38 (pg. 141 - 161 ) Google Scholar Crossref Search ADS WorldCat Chang, 1978 Chang S.L. . Resistance of pathogenic Naegleria to some common physical and chemical agents , Applied and Environmental Microbiology , 1978 , vol. 35 (pg. 368 - 375 ) Google Scholar PubMed OpenURL Placeholder Text WorldCat Commonwealth Department of Health, 1980 Commonwealth Department of Health . Primary amoebic meningoencephalitis—Western Australian out-break , Communicable Diseases Intelligence, Bulletin No. 81/3 , 1980 Canberra OpenURL Placeholder Text WorldCat Commonwealth Department of Health, 1981 Commonwealth Department of Health . Primary amoebic meningoencephalitis—New South Wales , Communicable Diseases Intelligence, Bulletin No. 81/17 , 1981 Canberra OpenURL Placeholder Text WorldCat Cursons et al., 1977 Cursons R.T.M. , Brown T.J. , Keys E.A. . Immunity to pathogenic free-living amoebae , Lancet , 1977 , vol. ii (pg. 875 - 876 ) Google Scholar Crossref Search ADS WorldCat Cursons et al., 1980 Cursons R.T.M. , Brown T.J. , Keys E.A. . Effect of disinfection on pathogenic free-living amoebae in axenic conditions , Applied and Environmental Microbiology , 1980 , vol. 40 (pg. 62 - 66 ) Google Scholar PubMed OpenURL Placeholder Text WorldCat De Jonckheere and van de Voorde, 1976 De Jonckheere J. , van de Voorde H. . Differences in destruction of cysts of pathogenic and nonpathogenic Naegleria and Acanthamoeba by chlorine , Applied and Environmental Microbiology , 1976 , vol. 31 (pg. 294 - 297 ) Google Scholar PubMed OpenURL Placeholder Text WorldCat Derremaux et al., 1974 Derremaux A.L. , Jadin J.B. , Willaert E. , Moret R. . Action du chlore sur les amibes de l'eau , Annales de la Société Belge de Médecine Tropicale , 1974 , vol. 54 (pg. 415 - 428 ) Google Scholar PubMed OpenURL Placeholder Text WorldCat Dorsch, 1982 Dorsch M.M. . Primary Amoebic Meningoencephalitis: An Historical and Epidemiological Perspective with Particular Reference to South Australia , 1982 Adelaide South Australian Health Commission Fowler and Carter, 1965 Fowler M. , Carter R.F. . Acute pyogenic meningitis probably due to Acanthamoeba sp: a preliminary report , British Medical Journal , 1965 , vol. ii (pg. 740 - 742 ) OpenURL Placeholder Text WorldCat Griffin, 1972 Griffin J.L. . Temperature tolerance of pathogenic and nonpathogenic free-living amoebas , Science , 1972 , vol. 178 (pg. 869 - 870 ) Google Scholar Crossref Search ADS PubMed WorldCat Griffin, 1978 Griffin J.L. . Kreier J.P. . Pathogenic free-living amoebae , Parasitic Protozoa , 1978 , vol. Vol. 2 New York Academic Press (pg. 507 - 549 ) Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC Kadlec et al., 1980 Kadlec V. , Skvarova T. , Cerva L. , Nebazniva D. . Virulent Naegleria fowleri in indoor swimming pool , Folia Parasitologica , 1980 , vol. 27 (pg. 11 - 17 ) Google Scholar PubMed OpenURL Placeholder Text WorldCat Lawande et al., 1979 Lawande R.V. , John I. , Dobbs R.H. , Egler L.J. . A case of primary amebic meningoencephalitis in Zaria, Nigeria , American Journal of Clinical Pathology , 1979 , vol. 71 (pg. 591 - 594 ) Google Scholar Crossref Search ADS PubMed WorldCat Lee et al., 1979 Lee K.K. , Karr S.L. , Wong M.M. , Hoeprich P.D. . In vitro susceptibilities of Naegleria fowleri strain HB-1 to selected antimicrobial agents, singly and in combination , Antimicrobial Agents and Chemotherapy , 1979 , vol. 16 (pg. 217 - 220 ) Google Scholar Crossref Search ADS PubMed WorldCat Lyons and Kapur, 1977 Lyons T.B. , Kapur R. . Limax amoebae in public swimming pools of Albany, Schenectady and Rensselaer Counties, New York: their concentration, correlations and significance , Applied and Environmental Microbiology , 1977 , vol. 33 (pg. 551 - 555 ) Google Scholar PubMed OpenURL Placeholder Text WorldCat Miller et al., 1982 Miller G. , Cullity G. , Walpole I. , O'Connor J. , Masters P. . Primary amoebic meningoencephalitis in Western Australia , Medical Journal of Australia , 1982 , vol. i (pg. 352 - 357 ) OpenURL Placeholder Text WorldCat Robinson, 1977 Robinson B.S. . Effectiveness of chlorine in the control of Naegleria: laboratory and field studies in South Australia , Proceedings of the 7th Federal Convention of the Australian Water and Wastewater Association , 1977 (pg. 465 - 478 ) Canberra, 1977 Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC Robinson and Lake, 1981 Robinson B.S. , Lake J.A. . The influence of temperature on growth and distribution of Naegleria species , Proceedings of 9th Federal Convention of the Australian Water and Wastewater Association , 1981 (pg. 12 - 19 ) Section 3 Perth, 1981 Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC Saygi et al., 1973 Saygi G. , Warhurst D.C. , Roome A.P.C.H. . A study of amoebae isolated from the Bristol cases of primary amoebic encephalitis , Proceedings of the Royal Society of Medicine , 1973 , vol. 66 (pg. 277 - 282 ) Google Scholar PubMed OpenURL Placeholder Text Google Scholar Google Preview WorldCat COPAC Seidel, 1982 Seidel J. . Chemotherapy for primary amebic meningoencephalitis (Letter) , New England Journal of Medicine , 1982 , vol. 306 pg. 1296 Google Scholar Crossref Search ADS WorldCat Seidel et al., 1982 Seidel J.S. , Harmatz P. , Visvesvara G.S. , Cohen A. , Edwards J. , Turner J. . Successful treatment of primary amoebic meningoencephalitis , New England Journal of Medicine , 1982 , vol. 306 (pg. 346 - 348 ) Google Scholar Crossref Search ADS PubMed WorldCat Stevens et al., 1980 Stevens A.R. , De Jonckheere J. , Willaert E. . Naegleria lovaniensis new species: isolation and identification of six thermophilic strains of a new species found in association with Naegleria fowleri , International Journal for Parasitology , 1980 , vol. 10 (pg. 51 - 64 ) Google Scholar Crossref Search ADS PubMed WorldCat Stevens et al., 1981 Stevens A.R. , Shulman S.T. , Lansen T.A. , Cichon M.J. , Willaert E. . Primary amoebic meningoencephalitis: a report of two cases and antibiotic and immunological studies , Journal of Infectious Diseases , 1981 , vol. 143 (pg. 193 - 199 ) Google Scholar Crossref Search ADS PubMed WorldCat Thong, 1982 Thong Y.H. . Chemotherapy for primary amebic meningoencephalitis (Letter) , New England Journal of Medicine , 1982 , vol. 306 (pg. 1295 - 1296 ) Google Scholar Crossref Search ADS PubMed WorldCat Thong et al., 1979a Thong Y.H. , Rowan-Kelly B. , Ferrante A. . Delayed treatment of experimental amoebic meningoencephalitis with amphotericin B and tetracycline , Transactions of the Royal Society of Tropical Medicine and Hygiene , 1979 , vol. 73 (pg. 336 - 337 ) Google Scholar Crossref Search ADS PubMed WorldCat Thong et al., 1979b Thong Y.H. , Rowan-Kelly B. , Ferrante A. . Treatment of experimental Naegleria meningoencephalitis with a combination of amphotericin B and rifamycin , Scandinavian Journal of Infectious Diseases , 1979 , vol. 11 (pg. 151 - 153 ) Google Scholar Crossref Search ADS PubMed WorldCat Walters et al., 1981 Walters R.P. , Robinson B.S. , Lake J.A. . Experiences in the control of Naegleria in public water supplies in South Australia , Proceedings of the 9th Federal Convention of the Australian Water and Wastewater Association , 1981 (pg. 1 - 11 ) Section 3 Perth, 1981 Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC Warren and Ridgway, 1978 Warren I.C. , Ridgway J. . Swimming pool disinfection , Water Research Centre Technical Report TR90 , 1978 United Kingdom OpenURL Placeholder Text WorldCat This content is only available as a PDF.

Journal

Transactions of The Royal Society of Tropical Medicine and HygieneOxford University Press

Published: Jan 1, 1983

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