Dulski Theresa M, Montgomery Forrest, Ramos Jeanette M, Rosenbaum Eric R, Boyanton Bobby L, Cox Courtney M, Dahl Steven, Kitchens Cole, Paul Terry, Kahler Amy, Roundtree Alexis, Mattioli Mia, Hlavsa Michele C, Ali Ibne K, Roy Shantanu, Haston Julia C, Patil Naveen
MMWR Morb Mortal Wkly Rep. 2025 Mar 27;74(10):167-172. doi: 10.15585/mmwr.mm7410a2.
A fatal case of primary amebic meningoencephalitis (PAM), an infection caused by Naegleria fowleri, was diagnosed in Arkansas in a young child in September 2023. A public health investigation was completed, with epidemiologic, laboratory, and environmental data suggesting that a splash pad (an interactive water play venue that sprays or jets water on users and has little or no standing water) with inadequately disinfected water was the most likely site of the patient's N. fowleri exposure. This case is the third occurrence of splash pad-associated PAM reported in the United States; all three cases involved inadequately disinfected water. PAM should be considered in patients with acute meningoencephalitis and a history of recent possible exposure to fresh water, including treated recreational water (e.g., in splash pads or pools), via the nasal passages. Proper design, construction, operation, and management of splash pads can help prevent illnesses, including N. fowleri infections. Increased awareness, collaboration, and communication among clinicians, hospitals, laboratories, CDC, health departments, the aquatics sector, and the public can help support N. fowleri infection identification, treatment, prevention, and control efforts.
2023年9月，美国阿肯色州一名幼儿被诊断出患有由福氏耐格里阿米巴原虫引起的原发性阿米巴脑膜脑炎（PAM）致死病例。一项公共卫生调查已完成，流行病学、实验室和环境数据表明，一个水上游乐场（一种向使用者喷水或射水且几乎没有积水的互动水上娱乐场所）的水消毒不充分，最有可能是该患者接触福氏耐格里阿米巴原虫的地点。该病例是美国报告的第三起与水上游乐场相关的PAM病例；所有三起病例都涉及消毒不充分的水。对于患有急性脑膜脑炎且近期有可能通过鼻腔接触淡水（包括经过处理的娱乐用水，如在水上游乐场或游泳池中）的患者，应考虑PAM。水上游乐场的合理设计、建造、运营和管理有助于预防疾病，包括福氏耐格里阿米巴原虫感染。临床医生、医院、实验室、美国疾病控制与预防中心、卫生部门、水上运动部门和公众提高认识、加强协作与沟通，有助于支持福氏耐格里阿米巴原虫感染的识别、治疗、预防和控制工作。
