Ultraviolet – Chlorine combined treatment efficiency to eliminate Naegleria fowleri in artificial surf lagoons

Naegleria. fowleri, a protozoa belonging to the free-living amoeba group, is the causative agent of a central nervous system affecting disease that is fatal in more than the 95% of the reported cases. This parasite can be found in warm water bodies such as lakes, rivers or inadequately disinfected swimming pools. On the other hand, chlorination and UV light treatment are two of the most extensively used disinfection methods in recreational water facilities.

In this study the effect of chlorination and UV light on N. fowleri trophozoites was studied in a close water circuit with the aim to assess the efficacy of this disinfection methods in large pools. The obtained results showed that the chlorination was able to decrease the number of viable cells despite the elimination was not totally achieved. Nonetheless, the combination of the UV light with the chlorination allowed the complete removal of the N. fowleri trophozoites from the water in experimental testing conditions.

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Absence of an standardized water treatment protocol to eliminate N. fowleri.

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Treatment based only on chlorine was ineffective to eliminate N. fowleri.

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Combined chlorination and UV light treatment was effective to completely eliminate N.fowleri.

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Combination of chlorine - Uv would be a promising method for water disinfection.

Environmental abiotic and biotic factors affecting the distribution and abundance of Naegleria fowleri

Naegleria fowleri is a free-living protozoan that resides in soil and freshwater. Human intranasal amoebae exposure through water or potentially dust particles can culminate in primary amoebic meningoencephalitis, which generally causes death. While many questions remain regarding pathogenesis, the microbial ecology of N. fowleri is even less understood. This review outlines current knowledge of the environmental abiotic and biotic factors that affect the distribution and abundance of N. fowleri. Although the impacts of some abiotic factors remain poorly investigated or inconclusive, N. fowleri appears to have a wide pH range, low salinity tolerance and thermophilic preference. From what is known about biotic factors, the amoebae preferentially feed upon bacteria and are preyed upon by other free-living amoebae. Additional laboratory and environmental studies are needed to fill in knowledge gaps, which are crucial for surveillance and management of N. fowleri in freshwaters. As surface water temperatures increase with climate change, it is likely that this amoeba will pose a greater threat to human health, suggesting that identifying its abiotic and biotic preferences is critical to mitigating this risk.

Legionella pneumophila and Protozoan Hosts: Implications for the Control of Hospital and Potable Water Systems

Legionella pneumophila is an opportunistic waterborne pathogen of public health concern. It is the causative agent of Legionnaires’ disease (LD) and Pontiac fever and is ubiquitous in manufactured water systems, where protozoan hosts and complex microbial communities provide protection from disinfection procedures. This review collates the literature describing interactions between L. pneumophila and protozoan hosts in hospital and municipal potable water distribution systems. The effectiveness of currently available water disinfection protocols to control L. pneumophila and its protozoan hosts is explored. The studies identified in this systematic literature review demonstrated the failure of common disinfection procedures to achieve long term elimination of L. pneumophila and protozoan hosts from potable water. It has been demonstrated that protozoan hosts facilitate the intracellular replication and packaging of viable L. pneumophila in infectious vesicles; whereas, cyst-forming protozoans provide protection from prolonged environmental stress. Disinfection procedures and protozoan hosts also facilitate biogenesis of viable but non-culturable (VBNC) L. pneumophila which have been shown to be highly resistant to many water disinfection protocols. In conclusion, a better understanding of L. pneumophila-protozoan interactions and the structure of complex microbial biofilms is required for the improved management of L. pneumophila and the prevention of LD.

Primary Amebic Meningoencephalitis: What Have We Learned in the Last 5 Years?

Primary amebic meningoencephalitis (PAM) is a devastating infection of the brain caused by the thermophilic free-living ameba, Naegleria fowleri. Infection can occur when water containing the ameba enters the body through the nose, usually during recreational water activities such as swimming or diving. Historically, in the USA, cases were mostly reported from the warmer southern-tier states. In the last 5 years, several notable changes have been documented in PAM epidemiology including a northward expansion of infections and new types of water exposures. The recent reports of two PAM survivors provide hope for improved outcomes with early diagnosis and aggressive treatment. Advanced molecular laboratory tools such as genome sequencing might provide more insight into the pathogenicity of N. fowleri. Clinicians treating patients with meningitis and warm freshwater exposure are encouraged to consider PAM in their differential diagnoses.

The occurrence of Naegleria fowleri in recreational waters in Arizona

Naegleria fowleri is a free-living amoeba found in waters in warmer regions that causes primary amoebic meningoencephalitis, a rare but almost universally fatal disease. The goal of this project was to assess the occurrence of N. fowleri and other thermophilic amoebae in 33 recreational surface waters across Arizona to determine if their presence could be correlated with seasonal or other environmental factors. First, 1-L grab samples were collected over two years and analyzed using polymerase chain reaction and amoebae viability. Seasonality was observed, with N. fowleri and thermophilic amoebae (20% and 30%, respectively) being detected more often in the winter and spring combined than in the summer and fall combined (7.9% and 9.5%, respectively). The spring and fall both had an average temperature of 18°C, yet had different occurrence data (18.2% versus 5.9% for N. fowleri, respectively; 27.3% versus 0% for viable amoebae, respectively). These results are in stark contrast to previous studies in which N. fowleri has been found almost exclusively during warmer months. Over the two-year study, N. fowleri was detected in six and thermophilic amoebae in eight of the 33 recreational water bodies. Five of these were lakes near Phoenix that tested positive for N. fowleri and thermophilic amoebae over multiple seasons. These lakes differed significantly (P ≤ 0.05) from the other 28 surface waters, with a lower average temperature in the spring, a higher temperature in the fall, a higher pH and turbidity in the summer, and a lower electro-conductivity in the spring. They also had lower Escherichia coli and heterotrophic bacteria levels during colder months. Future N. fowleri monitoring in Arizona should focus on these five lakes to further elucidate the factors that contribute to the low occurrence of this amoeba in the summer or which might explain why these lakes appear to be reservoirs for the organism.