Nasal Irrigation - Nasal Irrigation Warning

Nasal Irrigation Warning

While nasal irrigation is generally well tolerated, at least two deaths from Naegleria fowleri have been reported from use of a neti pot. Naegleria fowleri present in unboiled or otherwise unsterilized water causes the fatal brain infection primary amoebic meningoencephalitis (PAM).

The probability of death from this Naegleria infection is as high as 98%, but the parasite can be killed by boiling water before use. According to Louisiana State Epidemiologist Raoult Ratard, "if you are irrigating, flushing, or rinsing your sinuses, for example, by using a neti pot, use distilled, sterile or previously boiled water to make up the irrigation solution."

• In Pakistan, on October 15, 2010, a 54-year-old male Ghulam Mustafa Khalid was admitted to a Karachi hospital, suffering from typical signs of meningitis. It was quickly diagnosed as PAM and attempts to administer Amphotericin B, initially via IV then by intrathecal injection, had no effect. Cranial decompression of the patient likewise yielded no results, and the patient died on October 22, 2010. He was in perfect health, had no history of swimming, however, he had a habit of deep nasal cleansing with tap water while doing wudu, which could possibly be the reason of this infection. Laboratory tests confirmed the presence of N. fowleri.

• In the United States, in June, 2011, a young Louisiana man died after flushing his sinuses with infected tap water.

• In the United States, in December 2011, a 51 year-old woman in Louisiana died after flushing her sinuses with infected tap water.

Naegleria fowleri contamination of water supplies is rare, as even light chlorination will kill the parasite.