A very rare form of meningitis caused by a brain-eating amoeba is suspected in the death of a 24-year-old San Diego woman, public health officials confirmed Tuesday.
Kelsey McClain died last week from a suspected case of primary amebic meningoencephalitis (PAM) caused by an amoeba associated with warm freshwater, according to health officials.
A report from the San Diego County Medical Examiner confirms McClain’s death was pronounced at 6:30 p.m. on Aug. 17 at Sharp Grossmont Hospital in La Mesa — eight days after her 24th birthday. The report cites McClain’s cause of death as cardiopulmonary arrest due to complications of bacterial meningitis.
The report says McClain first developed a headache on Aug. 13 and went to Sharp Grossmont Hospital the following day. Suffering from symptoms including a fever, vomiting and worsening headache, she came back to the hospital on Aug. 15.
“Her chest and head CTs were negative,” the report states. “A lumbar puncture was performed, which was presumptive for bacterial meningitis.”
McClain was given antibiotics. Overnight, she became sleepy, agitated and had “seizure-like activity,” the document says. She was intubated and transferred to the ICU. On Aug. 17, she was pronounced brain dead.
The report says there were no suspicious circumstances surrounding her death, and no reports of trauma, abuse or history of illicit drug use in the young woman's medical history.
Health officials say the organism linked to McClain’s PAM-suspected death is known as Naegleria fowleri.
According to the Centers for Disease Control and Prevention (CDC) and California Department of Public Health, the amoeba is commonly found in warm freshwater and soil and can cause a “rare and devastating infection of the brain” that is almost always fatal.
The CDC says the amoeba infects people when contaminated water enters the body through the nose. Once it enters the nose, it travels to the brain where it causes PAM.
The infection occurs when people swim or dive in warm freshwater, including lakes and rivers.
Yuma County Public Health officials say McClain had gone swimming in the Colorado River, in the regions of Martinez Lake and Fisher’s Landing, one week before becoming infected.
She then returned home to San Diego County.
Navaz Karanjia, the medical director at UC San Diego's Neurocritical Care Unit, said there is no proven cure, but a drug for another parasitic infection could help.
"The drug is called miltefosine," she said. "That has shown promise and could be helpful in saving people's lives."
However, since the hospital could not diagnose her problem, they were unable to try the drug in McClain's case.
Health officials say Naegleria is commonly found in freshwater all over the world, but infections are rare. In the U.S., Naegleria infections usually occur in warm southern states. Between 2005 and 2014, a total of 35 infections were reported, despite millions of recreational water exposures each year. This recent infection is one of eight reported in Arizona since 1962.
"It's important when one hears about something so frightening to keep it in perspective," said Karanjia. "For every one person who dies of naeglaria, a 1000 people will die of a drowning."
The Yuma County Public Health Services District says McClain’s case serves as a reminder for people to exercise caution while taking part in recreational water activities.
The health services district says preventive measures to avoid becoming infected with the organism include:
- Be familiar with your surroundings and avoid swimming or jumping into bodies of warm freshwater, hot springs and thermally-polluted waters
- Avoid swimming or jumping into freshwater during periods of high temperature and low water volume, particularly in areas with stagnant water
- Hold the nose shut or use nose clips when jumping or diving into bodies of warm freshwater such as lakes, rivers or hot springs
- Avoid digging in or stirring up the sediment while swimming in shallow water areas
"While infections with Naegleria fowleri are rare, when they do occur, it is usually during the summer months of July, August and September and when weather has been warmer than normal allowing for higher fresh water temperatures and lower water levels," Diana Gomez, Director of the Yuma County Public Health Services District, explained.
The CDC says people cannot be infected with this organism by drinking water contaminated with Naegleria, and the infection cannot spread from one person to another.
Yuma County Public Health officials are now awaiting confirmation from the CDC regarding the PAM link to McClain’s death.
NBC 7 in San Diego reached out to Sharp Grossmont Hospital Tuesday for comment on McClain's case. Bruce Hartman, spokesperson for Sharp Grossmont, issued this statement:
“It is indeed a tragedy that this patient contracted this rare and fatal amoebic infection. We are working closely with San Diego County Public Health and the Centers for Disease Control and Prevention (CDC) as they investigate this case and how the infection was contracted. According to the CDC, there have only been 132 other reported cases of Naegleria fowleri infections since 1962, with only a handful occurring each year.”
In an unrelated case, 20-year-old north San Diego resident Koral Reef died in October 2014, also after contracting a rare, brain-eating amoeba.
Her mother, Cybil Meister, told NBC 7 she believes a family trip to Lake Havasu in Arizona was the source of the infection that killed her daughter.
Around Thanksgiving of 2013, Reef’s family noticed she wasn’t feeling well, and was suffering from headaches, a stiff neck and sensitivity to light and heat. By January 2014, her health worsened and by June 2014, she went to the emergency room.
Doctors were never able to pinpoint Reef’s condition. By September 2014, Meister said her daughter began losing her vision. An MRI revealed an amoeba covering Reef’s brain. In October 2014, Reef died.
In Reef’s case, doctors ultimately determined she died from a deadly, brain-eating amoeba known as Balathumia. Her mother believes Reef contracted the bacteria on that trip to Lake Havasu.