RALEIGH, NC — The North Carolina Department of Health and Human Services has released findings from its investigation into the rare brain infection that killed a North Carolina teenager earlier this summer. The case involved Naegleria fowleri, an amoeba found in warm freshwater that can cause primary amebic meningoencephalitis, or PAM.
Coastal Carolina News original coverage
While the investigation cannot conclusively determine the exact location of exposure, state officials say the evidence points to a water feature at a community‑based organization in Durham. The teen was reported to have interacted with the feature during the likely exposure period, including splashing water onto his face.
The Durham County Department of Health closed the water feature on August 28, 2026. Subsequent testing by the CDC confirmed the presence of Naegleria fowleri. The feature remains closed.
Naegleria infections are extremely rare – only 167 cases have been reported nationwide between 1962 and 2024. The amoeba does not cause illness when swallowed. Infection occurs when contaminated water enters the nose, allowing the organism to travel to the brain. This most often happens during activities such as diving, jumping into water, rafting, or water‑skiing, but can occur during any activity that forces water up the nose.
Infections have also been documented when people use contaminated water for nasal cleansing during religious practices, use untreated tap water in neti pots or sinus‑rinsing devices, or accidentally get contaminated water up the nose during recreational play.
Symptoms typically begin about five days after exposure but can appear anywhere from one to twelve days. Early signs include severe headache, fever, nausea, and vomiting. The illness progresses rapidly to stiff neck, seizures, and coma. Once symptoms begin, PAM usually causes death within about five days. Fewer than 10 cases are diagnosed in the United States each year.
These infections tend to occur during prolonged periods of hot weather, when water temperatures rise and water levels drop. Naegleria fowleri thrives in temperatures up to 115°F.
Health officials say the amoeba cannot be removed from natural freshwater, but residents can lower their risk by taking basic precautions:
- Keep water out of your nose during warm‑freshwater activities by holding your nose, using nose clips, or staying above the surface.
- Avoid putting your head underwater in hot springs or thermal waters.
- Skip jumping or diving into warm freshwater during periods of high temperatures and low water levels.
- Avoid stirring up sediment in shallow, warm areas.
- Use only distilled water for nasal rinsing.
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