Brain-eating amoeba worries experts after advance in cases
On Wednesday, July 8, 2026, Steve Smelski recalled with deep sadness the loss of his 11-year-old son, Jordan, after what was supposed to be a relaxing family vacation in Costa Rica. The boy died due to a brain infection caused by Naegleria fowleri, popularly known as the “brain-eating amoeba”. This microscopic organism, often found in unmaintained lakes, hot springs and swimming pools, invades the human body through the nostrils, especially during water activities, and then rapidly attacks brain tissue. Smelski, now 67, said that “Jordan swam one day, once, and now he’s gone.”
Last year marked a global record, with more than 200 cases of Naegleria fowleri infections recorded in India, constituting the largest outbreak ever documented. In recent months, the country continues to report new cases, increasing the global total, which previously totaled less than 500 cases. This unprecedented increase has generated great concern among scientists, who note the presence of the amoeba in regions where its detection was uncommon, indicating a possible geographic expansion of the pathogen.
In April, in Brazil, a nine-year-old child in Rondônia died from Naegleria fowleri infection, according to information from the local Health Surveillance Agency.
Molecular parasitologist Anastasios Tsaousis, from the University of Kent, in the United Kingdom, predicts that “there will be more cases in the future”, with the infection being observed in different parts of the globe.
The cerebral devastation caused by the amoeba
Steve Smelski, a resident of Florida, in the United States, recalled the moments when his son spent several hours in a natural hot spring near his hotel in Costa Rica, before starting to feel severe headaches.
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After returning home, Jordan’s condition worsened, with vomiting appearing. His parents took him to a hospital, where the boy began to hallucinate, reporting seeing insects on the ceiling. Smelski described the anguish: “He looked at us, but he didn’t know who we were. I don’t think he knew who he himself was.”
The medical team faced difficulties in diagnosing Jordan, who subsequently suffered a seizure and was admitted to the ICU, where he died. The father expressed his regret, stating that “seven and a half days after swimming, he was gone”, highlighting his son’s perfect health before the infection.
Jordan’s cause of death was primary amoebic meningoencephalitis, a brain infection caused by Naegleria fowleri. Initially, the diagnosis was confused with meningitis, due to the similarity of symptoms. However, by the time the true condition was identified, the stage of infection was already advanced, causing severe brain swelling and permanent damage. Smelski described the disease’s brutal impact: “It takes your brain away, it takes away your thoughts, you stop being who you are.”
Geographic expansion: the reason for the emergence of amoeba in new regions
Data from a 2025 analysis, released in the Journal of Infection and Public Health, indicates that between 1962 and 2023, a total of 488 cases of infection were reported globally. Most incidents were concentrated in the southern United States, Pakistan and Australia, with an alarming mortality rate of approximately 97%.
However, in the last two decades, there has been a proportional increase in detections in the northern hemisphere, covering countries such as Italy and Belgium. Additionally, recent cases over the past 15 years have emerged in colder northern regions of the United States, including Minnesota. The previous year, Slovakia also documented its first confirmed Naegleria fowleri infection.
Other occurrences were associated with environments other than the lakes and rivers usually linked to the amoeba. In 2023, Taiwan recorded the death of a man exposed to Naegleria fowleri at an indoor surfing spot. In the same period, in the United States, a child died after being infected by a contaminated “water mat”.
Global warming, which raises the temperatures of lakes and reservoirs, has been a crucial factor in the expansion of the amoeba to areas where the climate was previously unfavorable for its development, explaining part of its emergence in new locations.
“When the water heats up, the amoeba becomes more active”, explained Tsaousis, highlighting that “this increases the possibility of people being infected during recreational activities”. Although there is no reason for widespread panic, the expert recommends that the population remains “attentive” to the growing risks.
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Tsaousis also considers that improvements in scientific amoeba detection techniques may be contributing to the greater number of reported cases. He hypothesizes that “the numbers may have always been high, and now we are simply seeing these cases increase because we know how to get tested.”
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Children: the group most vulnerable to amoeba infection
Experts point out that Naegleria fowleri is more likely to infect children than adults. Professor Ian Wright, a water science expert at the University of Western Sydney in Australia, explained that “the age at which most people suffer from the disease when they contract the infection is 12 years old, as children love splashing hot water”, describing the situation as “very cruel”.
It is also hypothesized that the nasal-brain barrier in younger individuals could be more easily breached by the amoeba, exposing children to an increased risk. Wright compared the infection to “a nightmare, a horror movie, or a Stephen King novel,” concluding that “it is very unlikely to contract the infection, but if it does occur, you will probably die.”
In cases of early detection, the medical approach involves a combination of medications and actions to mitigate brain swelling. Despite these efforts, the survival rate has historically remained alarmingly low.
However, a recent outbreak in the southern Indian state of Kerala, a well-known tourist destination, has brought new insights into the lethality of the disease. More than half of the 200 people infected survived, a proportion significantly higher than the historical survival rate, which was around 3%, new research in the journal Communications Medicine revealed.
The findings suggest that Naegleria fowleri infections may not be as invariably fatal as once believed. The international team of researchers responsible for the study points out that early-stage diagnosis, growing medical awareness and the implementation of more standardized treatment protocols were factors that likely drove these more positive results.
Essential guidelines to avoid contamination
In addition to recreational contact with water, Naegleria fowleri can invade the body through nasal irrigation systems, such as long-nozzle bottles used to alleviate symptoms of colds, sinusitis and allergies. A tragic example occurred last year in Texas, where a 71-year-old woman died after two weeks using one of these devices with tap water in her RV.
Nasal washing is also a practice present in religious rituals, such as in Islam, and in holistic health systems, such as ayurveda, of Indian origin.
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Although the risk of infection is naturally low, adopting simple measures can minimize it even further.
The US Centers for Disease Control and Prevention (CDC) strongly recommends using distilled, sterilized, or boiled and cooled water for nasal hygiene procedures, as contaminated tap water has been linked to rare cases of the infection.
During activities in warm, fresh waters, the agency suggests precautions to prevent water from entering the nostrils, such as holding the nose or using a nose clip when diving or jumping. Ian Wright ends with a clear recommendation: “When in doubt, just don’t put your head in the water.”
