Tuesday, the Louisiana Department of Health (DHH) confirmed the presence of the Naegleria fowleri ameba in the North Monroe Water System, which serves the town of Sterlington, at the 701 Guthrie Road sampling site. The privately owned water system, which serves approximately 8,400 residents in the North Monroe area along U.S. Route 165, was tested by LDH as part of the State's new public drinking water surveillance program. LDH notified the water system and local officials Tuesday afternoon. The Department asked the water system to conduct a 60-day chlorine burn to ensure that any remaining ameba in the system are eliminated. Water system operators will begin the burn as soon as possible.
The North Monroe Water System did not meet the required chloramine disinfectant levels set forth by the 2013 emergency rule at the location where the sample tested positive for the ameba. The North Monroe Water System also previously failed to maintain a 0.5 mg/L residual of chlorine in the water before the system was tested, which is why state officials sampled the system for the ameba in August. Three other sites on the system tested negative for Naegleria fowleri, although two of these did not meet the requirement for the minimum disinfectant residual level. Tap water from the North Monroe Water System is safe for residents to drink, but the Department urges residents to avoid getting water in their noses. Naegleria fowleri is an ameba that occurs naturally in warm, still freshwater.
North Monroe Water System buys its drinking water from the Monroe Water System. The Department also tested water samples from the Monroe Water System for Naegleria fowleri; those results were negative for the ameba.
As Naegleria fowleri infections are extremely rare, testing for this ameba in public drinking water is still relatively new and evolving. LDH conducts sampling of public drinking water systems for Naegleria fowleri each summer when temperatures rise. So far, LDH has tested a total of 27 systems for the ameba. Positive results for the ameba have previously been discovered this summer in Terrebonne, St. Bernard and Ascension parishes. All three affected water systems are conducting chlorine burns as well.
Naegleria fowleri causes a disease called primary amebic meningoencephalitis (PAM), which is a brain infection that leads to the destruction of brain tissue. In its early stages, symptoms of PAM may be similar to bacterial meningitis.
The Department requested that the water system conduct a 60-day free chlorine burn. The chlorine burn will help reduce biofilm, or organic buildup, throughout the water system and will kill the ameba. The water system has agreed to conduct this precautionary measure.
Precautionary Measures for Families
According to the CDC, every resident can take simple steps to help reduce their risk of Naegleria fowleri infection. Individuals should focus on limiting the amount of water going up their nose. Preventative measures recommended by the CDC include the following:
- DO NOT allow water to go up your nose or sniff water into your nose when bathing, showering, washing your face, or swimming in small hard plastic/blow-up pools.
- DO NOT jump into or put your head under bathing water (bathtubs, small hard plastic/blow-up pools); walk or lower yourself in.
- DO NOT allow children to play unsupervised with hoses or sprinklers, as they may accidentally squirt water up their nose. Avoid slip-n-slides or other activities where it is difficult to prevent water going up the nose.
- DO run bath and shower taps and hoses for five minutes before use to flush out the pipes. This is most important the first time you use the tap after the water utility raises the disinfectant level.
- DO keep small hard plastic/blow-up pools clean by emptying, scrubbing and allowing them to dry after each use.
- DO use only boiled and cooled, distilled or sterile water for making sinus rinse solutions for neti pots or performing ritual ablutions.
- If you need to manually top off the water in your swimming pool with tap water, follow the guidance below.
- DO ensure that the filter is running and top off your pool by adding water directly* into the skimmer box.
- DO NOT top off your pool by submerging the hose in the body of the pool.
- *NOTE: The hose should be submerged into the skimmer box or pool water. Hold the end of your hose in the air at least two inches above the flood-level rim of the skimmer box. This can be accomplished by securing the hose to a heavy object such as a chair or cinder block above the skimmer and ensuring the hose will run into the skimmer box without the hose being submerged.
- DO keep your swimming pool or hot tub adequately disinfected before and during use. Adequate disinfection standards are listed below.
- For pools, keep pH levels from 7.2 to 7.8. If you are using cyanuric acid-free chlorine, use between two and 10 parts per million. If you are not using cyanuric acid-free chlorine, keep chlorine levels at one to three parts per million.
- For hot tubs and spas, keep pH levels from 7.2 to 7.8, and keep either free chlorine levels from two to four parts per million or free bromine levels from four to six parts per million.
Residents should continue these precautions until testing no longer confirms the presence of the ameba in the water system. Residents will be made aware when that occurs. For further information on preventative measures, please visit the CDC website here: http://www.cdc.gov/parasites/naegleria/prevention.html.
The Louisiana Department of Health strives to protect and promote health statewide and to ensure access to medical, preventive and rehabilitative services for all state citizens. To learn more about LDH, visit www.dhh.louisiana.gov. For up-to-date health information, news and emergency updates, follow DHH's Twitter account and Facebook.