PDF(Pubmed)
Abstract：
Primary amebic meningoencephalitis (PAM) is a rare and lethal infection caused by Naegleria fowleri. We report an epidemiological and environmental investigation relating to a case of PAM in a previously healthy boy age 8 years. An interview of the patient\'s family was conducted to determine the likely exposure site and to assess risk factors. Data from the United States Geological Survey site at Waterloo, NE, on the Elkhorn River were used to estimate water temperature and streamflow at the time and site of exposure. Data from the National Weather Service were used to estimate precipitation and ambient air temperature at the time and site of exposure. Despite conventional treatment, the patient died 2 days after hospital admission. The patient participated in recreational water activities in the Elkhorn River in northeastern Nebraska 5 days before symptom onset. In the week before exposure, water and ambient air high temperatures reached annual highs, averaging 32.4°C and 35.8°C, respectively. The day before infection, 2.2 cm of precipitation was reported. Streamflow was low (407 ft3/s). Infections in several northern states, including Nebraska, suggest an expanding geographic range of N. fowleri transmission, which may lead to increased incidence of PAM in the United States. Similar environmental investigations at suspected exposure sites of future cases will allow data aggregation, enabling investigators to correlate environmental factors with infection risk accurately.
摘要：
原发性阿米巴脑膜脑炎（PAM）是一种罕见的致死性感染，由福氏Naegleria引起。我们报告了与先前健康的8岁男孩中的PAM病例有关的流行病学和环境调查。对患者家属进行了访谈，以确定可能的暴露部位并评估危险因素。数据来自滑铁卢的美国地质调查局现场，NE,在Elkhorn河上，用于估算暴露时间和地点的水温和流量。来自国家气象局的数据用于估算暴露时间和暴露地点的降水和环境空气温度。尽管常规治疗,患者入院2天后死亡.患者在症状发作前5天参加了内布拉斯加州东北部Elkhorn河的休闲水上活动。在曝光前一周，水和环境空气高温达到年度高点，平均温度为32.4°C和35.8°C，分别。感染前一天,报告了2.2cm的降水。流流量低(407ft3/s)。北部几个州的感染，包括内布拉斯加州,表明牛牛传播的地理范围不断扩大，这可能导致美国PAM发病率增加。在未来病例的可疑暴露地点进行类似的环境调查将允许数据汇总，使调查人员能够准确地将环境因素与感染风险相关联。
