A nine-year-old Virginia boy has died after swimming in water infected by a bug known as the "brain-eating amoeba," according to reports. The rare infection has killed two other people in the U.S. this summer.
The Richmond Times-Dispatch reported that Christian Alexander Strickland, 9, of Henrico County, became infected after he went to a fishing camp in the state.
The child died from meningitis Aug. 5 and Bonnie Strickland, his aunt, told the paper that Naegleria fowleri — or "brain-eating amoeba" as it is sometimes known — was a suspected cause of the illness.
Virginia health department officials confirmed a case of meningitis and an infection by the bug.
"Sadly, we have had a Naegleria infection in Virginia this summer," Dr. Keri Hall, state epidemiologist at the Virginia Department of Health, in a statement, according to the Times-Dispatch.
The rare infection also killed a 16-year-old Florida girl this month, who fell ill after swimming. Those two deaths are consistent with past cases, which are usually kids — often boys — who get exposed to the bug while swimming or doing water sports in warm ponds or lakes.
The third case, in Louisiana, was more unusual. It was a young man whose death in June was traced to the tap water he used in a device called a neti pot. It's a small teapot-shaped container used to rinse out the nose and sinuses with salt water to relieve allergies, colds and sinus trouble.
Health officials later found the amoeba in the home's water system. The problem was confined to the house; it wasn't found in city water samples, said Dr. Raoult Ratard, Louisiana's state epidemiologist.
The young man, who was only identified as in his 20s and from southeast Louisiana, had not been swimming nor been in contact with surface water, Ratard added.
He said only sterile, distilled, or boiled water should be used in neti pots.
The illness is extremely rare. About 120 U.S. cases — almost all of them deaths — have been reported since the amoeba was identified in the early 1960s, according to the Centers for Disease Control and Prevention.
About three deaths are reported each year, on average. Last year, there were four. There are no signs that cases are increasing, says Jonathan Yoder, who coordinates surveillance of waterborne diseases for the CDC.
Naegleria fowleri moves into the body through the nose and destroys brain tissue, according to the Centers for Disease Control and Prevention. The bug causes primary amoebic meningoencephalitis, a nearly always fatal disease of the central nervous system, the CDC reported.
Naegleria fowleri is usually found warm, stagnant water in freshwater lakes, ponds and rivers. It can also be found in wells.
No known treatment for infectionCurrently, there is no proven treatment for people who develop a brain infection with this bug, said Dr. Roy Gulick, chief of infectious disease at New York-Presbyterian/Weill Cornell Medical Center. It's recommended that the disease be treated with an antifungal medication called amphotericin B and second drug called rifampin, often prescribed to fight tuberculosis, but because diagnosis is often delayed, the infection is usually fatal, Gulick said.
“It’s a very rare disease,” he explained. “There have only been 111 cases reported since 1962. So it’s difficult to know what an effective treatment might be.”
Vaccine wouldn't have prevented deaths
Inoculation with the meningitis vaccine wouldn’t have prevented these deaths, said Gulick. That’s because the vaccines target meningitis-causing bacteria, and this is an amoeba.
One of the difficulties facing doctors and researchers is the very rarity of the disease. "People don’t think of the diagnosis,” Gulick said. “And people usually present two to 15 days after exposure. Death usually results 3 to 7 days after symptoms appear.”
Another problem, he said, is that the symptoms of this kind of brain infection are common to several other illnesses.
“When the amoeba gets into the brain, the symptoms are non specific: fever, nausea, stiff neck, headache,” he said. “There are many diseases that can cause those kinds of symptoms.”
Still, Gulick said, “anyone presenting with these symptoms should seek medical attention because they can be caused by diseases that are far more common, including viral and bacterial meningitis.”
No evidence of an outbreakThough two cases might spark fears of an outbreak, Gulick says there’s no evidence to suggest that this is anything other than coincidence. No one knows why some people develop a brain infection while others don’t.
“It’s a very rare infection,” Gulick said. “Millions are likely exposed, but only a very small percentage develop this."
The Associated Press and msnbc.com contributor Linda Carroll contributed to this report.