The DDC further provides recommendations to prevent infections caused by contaminated water from entering the nose. Following the confirmation that a Korean national died from a Naegleria fowleri infection after returning from Thailand, the Department of Disease Control (DDC) recommends four self–protection practices and advises people to be mindful when using water at home or swimming in unclean water. If people choke on or forcibly aspirate water contaminated by the ameba, Naegleria fowleri, they may be at risk for disease.
Dr. Tares Krassanairawiwong, Director-General, DDC reported that a Korean national was infected with Naegleria fowleri and died after returning from Thailand. Symptoms for those 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, stiff neck, seizure, and trembling. This disease can progress rapidly to death if not properly treated.
Primary amebic meningoencephalitis (PAM) caused by Naegleria fowleri has been reported worldwide. Only 17 cases in Thailand have been reported in the previous 40 years (1983–2021), 14 (82%) of which have been fatal. The majority of them were male, with a median age of 12 years (range of 8 months to 71 years old.) Of the cases, 16 were Thai nationals and one case was a Norwegian national who departed Thailand. The majority of cases were encountered during the summer. Most patients with this disease had a history of choking on or forcibly aspirating (through their noses) contaminated water from natural sources such as pools and wells. People do not get infected by drinking contaminated water and infected people have never been shown to transmit the ameba to another person.
The self–protection practices against Naegleria fowleri include 1) refraining from swimming or diving in unclean natural water sources; 2) being careful not to choke on water and preventing it from entering the nasal cavity (in the case of choking, try to expel the water quickly); 3) using boiled water or sanitary saline solution when cleaning the nasal cavity; 4) immediately seeking medical professionals at a hospital for those who are at risk and have suspected symptoms; suspected patients should inform the healthcare workers of their exposure history to unclean water or choking on water for 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 should be kept clean according to the standards recommended by the Department of Health, with a free residual chlorine level of 1-2 mg/L.
Dr. Tares stated. Dr. Tares shared his sympathies for 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 communication was an illustration of the long-standing health security cooperation between Thailand and the Republic of Korea.
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