Naegleria fowleri

Naegleria fowleri

MATERIAL SAFETY DATA SHEET - INFECTIOUS SUBSTANCES

SECTION I - INFECTIOUS AGENT

NAME: Naegleria fowleri

SYNONYM OR CROSS REFERENCE: Naegleriasis, primary amoebic meningoencephalitis

CHARACTERISTICS: Free-living amoebas, trophozoites are 8-20 µm in diameter and produce broadly rounded lobopodia; cysts are single-walled, spherical, 8-12 µm in diameter; flagellate is pear-shaped and motile, can revert to the trophic stage

SECTION II - HEALTH HAZARD

PATHOGENICITY: Cause of primary amebic meningoencephalitis; characterized by a sudden onset of headache, fever, nausea, pharyngitits, and nasal obstruction or discharge; with disease progression other symptoms include lethargy, confusion, and stiff neck; convulsions may occur with rapid deterioration to coma and death within 1- 14 days; other symptomsinclude abnormalities of taste and smell, seizures, cerebellar ataxia, nuchal rigidity, photophobia

EPIDEMIOLOGY: Affects active, immunocompetent young people of both genders; predominant in the tropics; ubiquitous in warm fresh water; most cases are associated with patient having been to a swimming pool, freshwater lake, or pond a few days before the onset of symptoms; at least 192 cases reported worldwide, exposure may be common as antibodies to Naegleria fowleri is widespread

HOST RANGE: Humans; 1 reported case of infection in a South American tapir

INFECTIOUS DOSE: Not known

MODE OF TRANSMISSION: Naegleria invades brain and meninges via nasal mucosa; exposure through swimming in contaminated pools, stagnant ponds, freshwater lakes, thermal springs, hot tubs and spas; infection by inhalation of cysts in dust or soil particles

INCUBATION PERIOD: Usually 3-7 days

COMMUNICABILITY: Person-to-person transmission has not been documented

SECTION III - DISSEMINATION

RESERVOIR: Free-living inhabitant of freshwater, soil, and vegetation

ZOONOSIS: None

VECTORS: None

SECTION IV - VIABILITY

DRUG SUSCEPTIBILITY: Susceptible to amphotericin B in combination with oral rifampin; topical use of promadine isethionate is effective; other effective drugs include clotrimazole, miconazole and pimaricin

SUSCEPTIBILITY TO DISINFECTANTS: Susceptible to 1% sodium hypochlorite, 2% glutaraldehyde

PHYSICAL INACTIVATION: Sensitive to irradiation

SURVIVAL OUTSIDE HOST: Reproduces successfully at temperatures up to 46°C; cysts survive for long periods in the bottom sediments of lakes and rivers

SECTION V - MEDICAL

SURVEILLANCE: Monitor for symptoms; confirm by microscopic demonstration of motile amoebae in fresh CSF

FIRST AID/TREATMENT: Amphotericin B is the drug of choice

IMMUNIZATION: None available

PROPHYLAXIS: None available

SECTION VI - LABORATORY HAZARDS

LABORATORY-ACQUIRED INFECTIONS: None reported to date

SOURCES/SPECIMENS: Cerebrospinal fluid and brain biopsies

PRIMARY HAZARDS: Droplet or aerosol exposure of mucous membranes; accidental parenteral inoculation

SPECIAL HAZARDS: Aerosol or droplet exposure of the mucous membrane of the eye, nose or mouth with trophozoites and tissue homogenates

SECTION VII - RECOMMENDED PRECAUTIONS

CONTAINMENT REQUIREMENTS: Biosafety level 2 practices and containment facilities for all activities involving infectious stages of the parasite and the manipulation of known or potentially infectious tissues, fluids

PROTECTIVE CLOTHING: Laboratory coat; gloves when skin contact with infective stages is unavoidable

OTHER PRECAUTIONS: Biological safety cabinets are indicated when working with N. fowleri; immunocompromised and pregnant individuals should minimize exposure to pathogen

SECTION VIII - HANDLING INFORMATION

SPILLS: Allow aerosols to settle; wearing protective clothing cover the spill with absorbent paper towel and apply 1% sodium hypochlorite starting at the perimeter and working towards the center; allow sufficient contact time (30 min) before clean up

DISPOSAL: Decontaminate all wastes before disposal; steam sterilization, chemical disinfection, incineration

STORAGE: In sealed containers that are appropriately labelled

SECTION IX - MISCELLANEOUS INFORMATION

Date prepared: March, 2001

Prepared by: Office of Laboratory Security, PHAC

Although the information, opinions and recommendations contained in this Material Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.

Copyright © Health Canada, 2001

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