I have succumbed to what I hope is my last cold of the calendar year. (If I manage to fit in another after this, I will be tempted to claim it as a testament to my efficiency, rather than the capriciousness of my immune system.) And, seeking relief of my symptoms, I have returned to using my neti pot.
However, since last I used this handy device for nasal irrigation, I saw this news item:
Louisiana’s state health department has issued a warning about the dangers of improperly using nasal-irrigation devices called neti pots, responding to two recent deaths in the state that are thought to have resulted from “brain-eating amoebas” entering people’s brains through their sinuses while they were using the devices.
Both victims are believed to have filled their neti pots with tap water instead of manufacturer-recommended distilled or sterilized water. When they used these pots to force the water up their noses and flush out their sinus cavities — a treatment for colds and hay fever — a deadly amoeba living in the tap water, called Naegleria fowleri, worked its way from their sinuses into their brains. The parasitic organism infected the victims’ brains with a neurological disease called primary amoebic meningoencephalitis (PAME), which rapidly destroys neural tissue and typically kills sufferers in a matter of days.
OK, first thing? Every neti pot user I have spoken to since seeing this story uses tap water. I no longer have the box for my neti pot (on which the instructions for use were printed), but I cannot recall the instructions stressing — or even mentioning — that the neti pot only be used with distilled or sterilized water.
Not that I don’t routinely ignore recommendations or void warrantees. It’s just that I generally do so consciously, rather than accidentally.
Anyway, a headcold sucks. Brain-eating amoebae would probably suck even more.
Commentary I have seen on this story suggests that the real danger is not so much nasal irrigation with tap water as the questionable quality of Louisiana tap water. The quality of the tap water in the San Francisco Bay Area is pretty high. So, probably I could safely continue to use tap water in my neti pot.
But, now that I have the possibility of introducing brain-eating amoebae into my brain on the brain (as it were), the magnitude of the bad outcome (amoebae eating my brain) is big enough that I’d rather reduce the risk of that happening to zero. And, I’d feel like a fool (in the moments of self-awareness that I had before my brain got eaten) if I did fall victim to this bad outcome, as unlikely as it is, by betting wrong.
Which means, I’m now boiling my tap water first before I use it to irrigate my nasal passages. And, as I get used to this new protocol, I’m risking the discomfort of applying saline solution that has not cooled down quite enough.
But so far, I haven’t seen any news items about brain tissue denatured by using a neti pot with too-hot saline solution.
I use my electric tea kettle’s left over water that had been boiled and cooled since the previous use. The kettle holds about twice as much as it takes to brew, so when planning on neti-ing, I fill the pot full, and neti before the next brew-cycle.
Three people died from the infection this summer: http://news.discovery.com/human/brain-eating-amoeba-110818.html. One of them in Louisiana. They contracted it while swimming (or diving which can force water up your nose). The amoeba flourishes in warm fresh water. Swimming in lakes in the south during July, August and September during drought periods are the main risk. For the amoeba to be found in tap water suggests inadequate water treatment.
The package instructions clearly say that tap water must not be used, because of impurities, notably chlorine. It clearly says to always boil the tap water first.