In December 2011, The Louisiana Department of Health and Hospitals reported the first two cases of death-by-neti-pot. Both deaths were due to lethal encephalitis caused by Naegleria fowleri, a freshwater amoeba. The first victim, a 20-year old man, died in June; it was known that he had used a neti pot, but the connection was thought to have possibly been “a fluke,” according to health officials. Then in October, a 51-year old Louisiana woman also died of encephalitis due to N. fowleri amoebiasis after neti pot use, and authorities rang warning bells to the national press.
State epidemiologist Raoult Ratard may have said it best when he told NPR, “Drinking water is good to drink, very safe to drink, but not to push up your nose.” N. fowleri infection is exceptionally rare, with only 32 reported cases of between 2000 and 2010, according to the Louisiana health department’s statement. Most infections are acquired through swimming in fresh water.
Clinical Takeaway: The instructions on neti pots’ labeling already say to use only distilled or boiled water; the CDC adds that filtering water is sufficient if the pore size is one micron or less, but popular home filters (Brita, PUR, etc) do not achieve this. Physicians should routinely advise patients of the importance of water purification whenever prescribing or endorsing neti pot use.
Lousiana Department of Health and Hospitals website statement, “North Louisiana Woman Dies from Rare Ameba Infection.”
Despite the bad press, a quick web search proves using a neti pot can still be sexy and fun: