Health

Three die of meningitis after using NHS-approved device to clear blocked sinuses


THREE people have died of meningitis after using an NHS-approved device to clear blocked sinuses.

Neti pots work by pouring sterile, salt water into one nostril and letting it drain out the other by tilting your head sideways.

 Neti pots work by pouring sterile, salt water into one nostril and letting it drain out the other by tilting your head sideways

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Neti pots work by pouring sterile, salt water into one nostril and letting it drain out the other by tilting your head sidewaysCredit: Getty – Contributor

The devices, which look like a genie’s lamp, are usually made from plastic, steel or ceramic and are available from high street chemists for as little as £5.

But experts have warned of the potentially fatal dangers of not following the product’s instructions after the deaths of three people in the US.

Last year, a woman from Seattle died after contracting a very rare condition, amoebic meningitis, from not using a neti pot correctly.

The 69-year-old was prescribed the device by her doctor to treat a persistent sinus infection.

But instead of using cooled, boiled water, she filled her neti pot with tap water.

It unfortunately contained a tiny amoeba – a microscopic single-celled organism – called Naegleria fowleri.

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Less than 1mm in diameter, it travelled through her sinuses and crossed into her brain where it started to eat healthy cells and triggered amoebic meningitis.

Rare brain infection

Symptoms of the rare brain infection strike within days, and include headache, behavioural disturbances, fever, nausea and vomiting.

It can be treated with antibiotics but is fatal in 90 per cent of cases.

A post-mortem showed that much of her brain had been destroyed, causing her death.

It came after two similar cases in 2011 where patients used tap water instead of sterile water causing their deaths from the same rare form of meningitis.

The organism that caused all three deaths in the US is found in water that exceeds temperatures of around 25C.

Globally, it’s caused around 250 cases of meningitis – most have involved swimming in contaminated lakes or pools where water is forced up nostrils when someone jumps in.

Thrives in warm water

It’s less of a threat in the UK where mains tap water is around 20c, but in the summer it can reach the temperatures required for amoeba to thrive.

However, British domestic water supplies are treated with chlorine, which has been shown to kill the organism.

While the risks from neti pots are clearly low, millions of people don’t follow the instructions properly.

Research from the University of Alberta in Canada found almost half of neti pot owners used tap water to rinse.

Almost two thirds of the 100 patients who took part in the 2012 study said they found it too “inconvenient” to use cooled boiled water.

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Around 70 per cent said they rarely cleaned their neti pots, which could also lead to infections.

The researchers warned: “The extremely rare, but typically fatal, risk of meningitis makes this a potential health hazard.”

What is Amoebic Meningitis?

Amoebic meningitis is a rare brain infection caused by Naegleria fowleri – a single-cell organism too small to be seen without a microscope.

Naegleria fowleri lives in soil and warm freshwater around the world.

It grows best at higher temperatures up to 46°C and can survive for short periods at higher temperatures. It can be found in:

  • Bodies of warm freshwater, such as lakes and rivers
  • Geothermal (naturally hot) water, such as hot springs
  • Warm water discharge from industrial plants
  • Untreated geothermal (naturally hot) drinking water sources
  • Swimming pools that are poorly maintained or minimally-chlorinated
  • Water heaters
  • Soil

Naegleria fowleri does not live in salt water, like the ocean.

Most infections have been linked to swimming in southern-US states, like Florida and Texas.

In very rare instances, Naegleria infections may also occur when contaminated water from other sources enters the nose.

For example when people submerge their heads or cleanse their noses during religious practices.

Early signs of amoebic meningitis are similar to symptoms of bacterial meningitis, including:

  • Headache
  • Fever
  • Nausea
  • Vomiting
  • Stiff neck

While later symptoms include:

  • Confusion
  • Lack of attention to people and surroundings
  • Loss of balance
  • Seizures
  • Hallucinations

After the start of symptoms, the disease progresses rapidly and usually causes death within about 5 days.

Several drugs are effective against Naegleria fowleri in the laboratory. However, their effectiveness is unclear since almost all infections have been fatal, even when people were treated.

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In the 10 years from 2009 to 2018, 34 infections were reported in the United States and there were 3 survivors.

To reduce the risk of infection people should focus on limiting the amount of water going up the nose and lowering the chances that Naegleria fowleri may be in the water.

Source: CDC

Dr Tony Narula, former president of the professional body ENT UK, told the Daily Mail neti pots are safe and effective if used correctly.

But he added: “Bacteria and other organisms can fester in dirty water, so it’s important to clean them every time you use them.

“If not, you could breathe them in and put yourself at risk.”

Ear ache? Try a warm sock full of salt on your ear


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