Nothing to Laugh About

Nothing to Laugh About 

Macabre Mask: The feeding cups of Naegleria fowleri, a single celled protist, may look comical but there is nothing funny about an infection of amebic meningitis: death within a week, with less than 1% survival rate. Fortunately, infections are very rare (“the medical equivalent of being struck by lightning”) although, paradoxically, the amoeba is abundant, living on bacteria in the sediments of warm lakes, ponds and hot springs, where lots of people swim. So relax, you’re not likely to be infected with the “brain eating ameoba”. But how would the amoeba get to your brain, anyway?

Highway to Hell Or Stairway to Heaven? Water forced up the nose could carry a form of the amoeba (trophozoid) that can get past the lining to the olfactory nerves that detect smells. From there, its a short ride to the olfactory bulb, the only part of the brain with a direct link to the outside world. Once in the brain, the amoeba feeds off cells using its sucker like feeding cups. Research showed that N. fowleri can loosen the tight junctions between lining cells, whereas its non-pathogenic cousin cannot. Some infections have been linked to the use of neti pots to irrigate the nasal chamber. While this ancient practice helps clear symptoms of allergies and colds, it can inadvertently cause amoebic infection. So, always use sterile water. 

Double Duty Drugs: Amebic meningitis is lethal because there are no effective drugs that target this microbe. Antibiotics don’t work. Recently, scientists at UCSF screened a chemical library of FDA-approved drugs and discovered that corifungin, an antifungal, kills Naegleria in a culture dish and in the mouse brain. Based on this, FDA has approved orphan drug status for corifungin to use against primary amebic meningoencephalitis. 

Pop Sci/Comic:

Image: The feeding structures of the amoeba Naegleria fowleri have a face-like appearance. Credit: D.T. John & T.B. Cole, Visuals Unlimited

Open Access Reference:

#ScienceEveryday    #microbes  

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61 Responses to Nothing to Laugh About

  1. Nicola Smith says:

    damn, one scary beastie

  2. Rajini Rao says:

    Now there really is a reason to be afraid of clowns. 

  3. What does the orphan drug status mean?

    edit: Ah, as I understand, it’s a way to be approved with less statistical burden. Makes sense for diseases where you cannot test the medicine on a significant number of patients, because there are not a significant number of them.

  4. Sunil DS says:

    thanks for showing your true face.

  5. In layman’s terms the scream mask infection lol

  6. I shouldn’t really joke, 1% survival rate, shocking :O

  7. Rajini Rao says:

    Dániel Darabos , an orphan drug is used to treat a rare disease. There are special tax incentives and legal status to encourage development of such drugs, since the financial benefit to pharma may be low. Rare diseases are also called orphan diseases. See:

    Also, since the drug is already FDA approved, it could be prescribed “off-label” by a physician, although I don’t know the restrictions/legalities of that. 

  8. Thanks for posting. Scary, but good to be informed.

  9. Rajini Rao says:

    Florence Gamiao , the picture is scary but the text is meant to reassure 🙂

  10. Long time ago, I wanted to use a neti pot for some sinus problems. I’m glad I didn’t.

  11. Rajini Rao says:

    Florence Gamiao , I read that neti pots have been scientifically validated and shown to provide good relief from symptoms. There are only two caveats: (1) don’t use tap water, use sterile or distilled water and (2) don’t overdo it, because removing mucus routinely actually makes one more susceptible to infection. 

  12. I’m glad I didn’t use them when I was not yet aware of the dangers. Perhaps now I could try them, now that I’m better informed.

  13. Rajini Rao says:

    Makes sense, glad that this helped! 

  14. Rajini Rao I am worried for Indians who are performing Jala Neti, with almost any water

  15. Rajini Rao says:

    R Prakash Prakash , I agree. I doubt that statistics are available on the number of cases of infection there. The amoeba is particularly common in warm tropical waters. 

  16. Chad Haney says:

    Our friend Feiasl posted about 10 people dying in Krachi from Naegleria fowleri.

    Koen De Paus has a less jovial image. Your image reminds me of the mask from the movie Scream.

    More info from the CDC.

  17. Rajini Rao says:

    Chad Haney , thanks for reminding me of Feisal’s post. I recall it now. Thanks also for the useful CDC link so people can get quality info on this. 

    ZOMG on that image from Koen De Paus !! I hope people check it out. 

  18. Jesse H says:

    I use alkolol but not too often.

  19. Rajini Rao says:

    Jesse H , Alkalol is sure to be sterile, so no worries there. 

  20. Chad Haney says:

    Good morning Rajini Rao. Tea has not kicked in yet so full sentences and thoughts are not available yet.

  21. Rajini Rao says:

    Chad Haney , I know the feeling. On my second cup of coffee here. I’m taking the Beatnik to lab these days (supposedly for a school science project) and he’s slowing me down even more. 

  22. Chad Haney says:

    Poor Beatnik Boy. He’s probably too young to be interested in the college women. Did I say that out loud?

  23. Rajini Rao says:

    Hehe, no interest in the fair sex at all. Fortunately, mucking in a tissue culture hood and playing with pipettes appears to hold his interest. 

  24. I alerted my folks of fb 🙂

  25. Bob Calder says:

    It’s not particularly rare in South FLorida where we “store” partially treated sewage in canals and lakes. People waterski in those lakes. Water traveling at high speed up the nose is a pretty good delivery system.

  26. Chad Haney says:

    You might remember this post. I’ll laugh if Beatnik Boy does this.

  27. Rajini Rao says:

    Bob Calder , I’m beginning to realize it is the force of delivery up the nose that must be key to the infection. Thanks. 

  28. Rajini Rao says:

    Chad Haney , lol. There goes my lab supply of pipet tips! 😉


  29. Bob Calder says:

    Rajini Rao If I were to model it, I would have duration and force. High force tends to prevent or bypass crevices and surfaces on the opposite side of a passage. Allowing liquid to sit or soak once inside is likely just as good. Thus neti pots work well as a delivery system.

    I was listening to a description on how to disinfect a thermal manifold yesterday. 🙂

    The chemist and CEO of Five Star also explained the role of surfactants. I guess the baking soda in the packet is a fair one.

  30. Thanks for the information Rajini Rao I used to go for pranyama classes and the instructor showed us how to perform the Jala neti. I was scared to try it and didn’t but I wasn’t aware of the risks until now! How safe are swimming pools?

  31. Chad Haney says:

    Swimming pools with chlorine are safe as far as I know.

  32. Bob Calder says:

    I think there is more danger to your sinus membranes from chorimates if you accidentally inhale. Ouchie!

  33. Let anthropologists talk about 🙂

  34. Rajini Rao says:

    Bob Calder , true..chlorine aggravates sinuses  

    Siromi Samarasinghe , for someone suffering with allergies and mucosal inflammation, the Jala neti offers a non-drug alternative, so it’s not all bad. I’ve never felt the urge to inhale water myself. I saw a comment somewhere that made a joking remark about waterboarding oneself. 

  35. Rajini Rao says:

    Jake Koch 🙂

    Jose M. G. Guerreiro , I see what you did there 🙂

  36. Azlin Bloor says:

    And now, for a lighter bedtime read! Next time I’m in a pond, I shan’t do my breathe in water trick! 

    Just reminded me of the huge public paddling pool they have here where hundreds of kids will pop in over the summer, no chemicals, no renewing! Folks can’t understand why I don’t let my kids in! 

  37. Rajini Rao says:

    Azlin Bloor , I think public pools for little kids without disinfectants are a disaster waiting to happen. We all know about those “accidents” in the pool and kids who go in with diapers. I think E. coli infections would be rife there. 

  38. Azlin Bloor says:

    Grosses you out, doesn’t it? 

  39. Rajini Rao says:

    Certainly does, Azlin Bloor 😦

  40. Bob Calder says:

    Rajini Rao as a nasal steroid user of over 25 years, I can say that a body-friendly nasal lavage works wonders on formerly productive membrane that has been made into semi-skin over the years to flush out the inevitable infection. I will continue to use my neti pot until you invent some sort of stem-cell-overhaul-for-mucosa treatment.

  41. Rajini Rao I had read that the organism is very sensitive to chlorine, and that even lightly chlorinated water is safe.

  42. James Clark says:

    To me.. orphan drugs probably r frowned upon by r government…since they probably have cures for many diseases… but couldn’t make as much$$$…if treatment was issued only once..

  43. Rajini Rao says:

    David Andrews , that’s a relief. So tap water, which is lightly chlorinated should be okay barring the odd problem. 

    James Clark , orphan drugs are not frowned upon by the government. Instead, the govt. offers incentives to drug companies to offset the lack of financial incentives.

  44. James Clark says:

    Drug Co. R a pretty crooked bunch of individuals…. what about the independent researchers?..I have much more trust and confidence n the lil man…ya know?

  45. Rajini Rao says:

    James Clark , pharmaceutical companies answer to their shareholders and are based on profit. They are no different from any other private sector industry in this regard: the auto industry, Wall Street investment firms, food or beverage industry, and so on. If you had shares in one of these, you would demand good return on your investment. That is just capitalism. I think drug companies are not much better or worse than any of the others I’ve mentioned. If you want research to be done by independent scientists (the l’il man) then be sure to show your support in the voting booth 🙂

  46. Chad Haney says:

    James Clark if you also do not trust the government but want to support research, you can also donate to places like the American Cancer Society or the American Heart Association. 

    Academic researcher such as Rajini Rao and myself do a lot of the ground work before drug companies get involved. There are no cures that drug companies are sitting on. I would be very interested in reading any reputable evidence that a drug company is sitting on a cure.

  47. Jim Carver says:

    Rajini Rao It appears that there is not a liability issue for a doctor who prescribes an off-label drug as the FDA can’t tell someone how to practice medicine.

    What the FDA does say is that drug companies can’t market their products for an off-label use since they weren’t tested for that purpose. There is a famous case of Pfizer and its subsidiary Warner-Lambert who paid the largest fine ever for such practices.

    This is of course what the product data sheet says on every prescription I’ve ever had. So, at least in the US, they should be GTG. I’m sure the mileage varies by country.

    There have been court cases where the off-label marketing was found to be free speech in the US…to further muddy the waters.

  48. Rajini Rao says:

    Fascinating, thanks for clearing this up Jim Carver. I will note that in research labs, the FDA-approved drug collection has been a boon to finding new uses for old drugs. There have been several success stories.  

  49. Chad Haney says:

    There is a whole facility that does that here.

  50. Just found out that coulrophobia is the fear of clowns. According to the Wiki entry, the term was probably coined on the internet, which is cool in itself, and is derived from the Greek for “stilt walker”. 

  51. Rajini Rao says:

     Mark Bruce , that’s a dubious honor 🙂

  52. Wow sounds pretty scary orphan disease huh im watch my nose! Thanks Rajini Rao

  53. Chad Haney says:

    I know Lacerant Plainer​

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