A child died earlier this month after likely becoming infected with a deadly amoeba at a splash pad in Arlington, Texas, the city says.
The child, whose age and identity are being withheld for privacy reasons, died Sept. 11 after visiting the splash pad at Don Misenhimer Park.
The city said they were notified the child had been hospitalized at Cook Children's Medical Center with primary amebic meningoencephalitis (PAM) on Sept. 5 and immediately closed the park's splash pad. The city said they also proactively closed all public splash pads for the remainder of the year as a precaution.
In a statement released Monday, the city said an investigation by the Tarrant County Public Health Department "determined two possible sources for the child’s exposure to water containing Naegleria fowleri: the family’s home in Tarrant County or the Don Misenhimer Park splash pad in Arlington."
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Samples of the water at the splash pad were taken and sent to the Centers for Disease Control and Prevention who confirmed on Friday that those samples were positive for N. fowleri ameba and that, therefore, the splash pad was the likely source of the exposure to the deadly parasite.
The city said that while all splash pads passed their annual review before the summer season began their investigation into the ameba highlighted deficiencies in water quality testing at some parks that should have been done over the summer.
“We have identified gaps in our daily inspection program,” Deputy City Manager Lemuel Randolph said. “Those gaps resulted in us not meeting our maintenance standards at our splash pads."
The city said records from Misenhimer Park and the Beacon Recreation center showed "Parks and Recreation employees did not consistently record, or in some cases did not conduct, water quality testing that is required prior to the facilities opening each day."
In their statement, the city said that testing included checking for chlorine, a disinfectant used to prevent harmful organic matter, such as N. fowleri, from living in the water.
"When chlorine level readings were below minimum state standards at those locations, the inspection log did not consistently reflect what action city employees took to bring the chlorination levels up," the city said. "For example, the logs did not always show how much disinfectant chemical was manually added to the splash pad’s water system. The logs also did not consistently include a follow-up reading to confirm that the water chlorination levels were at acceptable levels after treatment."
The city said a review of inspection logs found that water chlorination readings were not documented at Don Misenhimer's splash pad on two of the three dates that the child visited the location in late August and early September.
"Documents show that chlorination levels two days before his last visit were within acceptable ranges. However, the next documented reading, which occurred the day after the child visited, shows that the chlorination level had fallen below the minimum requirement and that additional chlorine was added to the water system," the city said.
Randolph said in a statement that all of the splash pads will remain closed until they have assurance systems are operating as they should and that a maintenance protocol is in effect that is consistent with the city, county, and state standards.
The city said the park is equipped with a backflow device that keeps water at the park from flowing back into the city's water supply and that it passed an annual inspection in April 2021 and again on Sept. 7, 2021. In their statement Monday, the city said Arlington’s drinking water supply was not affected, and the water quality continues to meet all regulatory safety guidelines set by state and federal authorities.
"This has been limited to a specific splash pad here in Arlington. We have shut down in the abundance of caution all splash pads in Arlington until we can continue and complete our review into what was done wrong, what was done poorly, and what could be done better," said Arlington Mayor Jim Ross.
What is Primary Amebic Meningoencephalitis (PAM)?
PAM is a rare and often fatal infection caused by the Naegleria fowleri ameba. The parasite, commonly known as the brain-eating amoeba, typically infects people when contaminated water enters the body through the nose. Once the ameba enters the nose, it travels to the brain where it causes PAM, which is usually fatal.
The CDC reports "infection typically occurs when people go swimming or diving in warm freshwater places, like lakes and rivers. In very rare instances, Naegleria infections may also occur when contaminated water from other sources (such as inadequately chlorinated swimming pool water or heated and contaminated tap water) enters the nose 1-4. You cannot get infected from swallowing water contaminated with Naegleria."
The risk of N. fowleri infection is very low, with 37 reported infections in the United States between 2010 and 2020, and only 151 since 1962, according to the CDC. Most infections, according to CDC data, present in July and August.
Symptoms of PAM typically present within nine days of infection, according to the CDC. Other than this child, there have been no other instances of this infection reported to Tarrant County Public Health.
The most recent case of PAM in North Texas claimed the life of 10-year-old Lily Avant who died in 2019 nearly a week after doctors confirmed she had contracted Naegleria fowleri swimming in a river near her home in Whitney.