NCDHHS: High Health Risk Contact Chowan River Algal Bloom

Raleigh -- Public health officials with the North Carolina Department of Health and Human Services and the Cumberland County Department of Public Health are reporting that an individual died after developing an illness caused by an amoeba that is naturally present in warm freshwater during the summer. The individual became ill after swimming in Fantasy Lake Water Park in Cumberland County on July 12, 2019.

Press Release

Jul 25, 2019

Laboratory testing at the federal Centers for Disease Control and Prevention confirmed the individual’s illness was caused by Naegleria fowleri, an amoeba (one-celled living organism) commonly found in warm freshwater. Naegleria fowleri, referred to as the brain-eating amoeba, does not cause illness if swallowed but can be fatal if forced up the nose, as can occur during diving, water-skiing or other water activities. 

These rare infections usually occur when it is hot for prolonged periods of time, which results in higher water temperatures and lower water levels. Symptoms of Naegleria fowleri infection start with severe headache, fever, nausea and vomiting and progress to stiff neck, seizures and coma.

Local health officials are working with the water park to provide guidance and education about the presence of Naegleria fowleri and how to take precautions when in natural bodies of freshwater.  

"Our sympathies are with the family and loved ones," said State Epidemiologist Zack Moore, M.D. "People should be aware that this organism is present in warm freshwater lakes, rivers and hot springs across North Carolina, so be mindful as you swim or enjoy water sports." 

Naegleria fowleri infections are rare, with only 145 known infected individuals in the U.S. (between zero and eight cases annually) from 1962 through 2018. North Carolina had five cases during that time period. This amoeba can cause severe illness up to nine days after exposure. A person cannot be infected with Naegleria fowleri by drinking water and the amoeba is not found in salt water.

As there is no means to eliminate this amoeba from fresh water lakes, in warmer areas where this infection has been more common, recommended precautions include:

Limit the amount of water going up your nose. Hold your nose shut, use nose clips or keep your head above water when taking part in warm freshwater-related activities. 
Avoid water-related activities in warm freshwater during periods of high water temperature and low water levels. 
Avoid digging in or stirring up the sediment while taking part in water-related activities in shallow, warm freshwater areas.
For more information on Primary Amebic Meningoencephalitis visit