Thailand statement on Naegleria fowleri

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The DDC confirms that the amoebas that cause primary amoebic meningoencephalitis (PAM) are not transmitted between people.

The DDC also makes recommendations for preventing infections caused by contaminated water from entering the nose. After confirmation that a Korean citizen died of Naegleria fowleri infection after returning from Thailand, the DDC recommends four self-protection practices and advises people to use caution when using water at home or swimming in unclean water. If people suffocate or breathe in water contaminated with the amoeba, Naegleria fowleri, they may be at risk of disease.

Dr. Taris Krasanarayong, Director General, DDC reported that a Korean national contracted Naegleria fowleri and died after returning from Thailand. Symptoms in people infected with Naegleria fowleri usually appear within 1-12 days of exposure (median 5 days). Transmission occurs when Naegleria fowleri enters the nose and migrates to the brain along the olfactory nerve. Initial symptoms can include headache, fever, nausea, vomiting, neck stiffness, and tremors. This disease can quickly progress to death if not treated properly.

Primary amoebic meningoencephalitis (PAM) caused by Naegleria fowleri has been reported worldwide. Only 17 cases were reported in Thailand in the last 40 years (1983-2021), of which 14 (82%) were fatal. Most were male, with a mean age of 12 years (range, 8 months to 71 years). Of the cases, 16 were Thai nationals and one case was a Norwegian national who left Thailand. The majority of cases are encountered during the summer. Most patients with this disease had a history of choking on or forcibly inhaling (through their nose) contaminated water from natural sources such as swimming pools and wells. People do not become infected by drinking contaminated water, and infected people have never been shown to pass the amoeba to another person.

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Self-protection practices against Naegleria fowleri include 1) Refraining from swimming or diving in unclean natural water sources. 2) Be careful not to choke on the water and prevent it from entering the nasal cavity (in case of suffocation, try to expel the water quickly); 3) Use boiled water or hygienic saline solution when cleaning the nasal cavity; 4) seek medical professionals immediately at the hospital for those at risk and whose symptoms are suspected; Suspected patients should inform healthcare professionals of a history of exposure to unclean water or water choking in order to obtain an accurate diagnosis. During the Songkran Festival, avoid splashing dirty water and avoid using water from public water sources to wash your nose. Swimming pools must be kept clean according to the standards recommended by the Ministry of Health, with a free residual chlorine level of 1-2 mg/L.

Dr. stated. Tars. Dr. Taris shared his condolences with the family of the deceased and appreciated the information provided by the Embassy of the Republic of Korea in Thailand. This information prompted the DDC to notify the public about PAM and Naegleria fowleri. The letter was an example of the long-term cooperation in health security between Thailand and the Republic of Korea.

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