Death by Neti Pot? Not likely, Experts Say.

Recently, a 69-year-old woman died of a brain-eating amoeba. Want to know how doctors think she got it? They believe it had to do with a neti pot used one year earlier.

Specifically, a new case study outlines the seemingly insignificant problems that led to the woman’s death (1). The paper states the woman had used tap water in her neti pot for about a month.

She was trying to get rid of a chronic sinus infection and was advised to use this method after medication failed.

Unfortunately, the woman hadn’t followed directions properly. The neti pot’s label would have recommended that she use sterilized water instead of tap.

What many don’t know is that those directions are there for a reason—to save your life.  

Shortly after using her neti pot, the woman developed a persistent bump and skin rash on her nose. Doctors biopsied the bump, but it was an entire year before anyone proposed an amoeba as the problem.

The woman had also had a previous bout with breast cancer. Up until the amoeba diagnosis, doctors had pursued cancer and other skin conditions first.

By the time the doctors prescribed amoeba-fighting medication, the woman couldn’t be saved.

Experts Shed Light on Neti Pot Safety.

Such a horrific situation certainly raises eyebrows on using neti pots. If they can cause someone to die, then why do doctors recommend them?

Keeping children safe from lead poisoning.

First, infection by amoebas are rare, especially the brain-eating kind. According to the CDC, only 200 cases of this particular amoeba have been found worldwide. About 70 of those were diagnosed in the United States (2).

Dr. Eric Mann, a doctor at the FDA, says that nasal irrigation is usually safe when used the right way (3).

In addition, Dr. Ben Bleier shed some light on the neti pot’s safety in Time magazine (4). Bleier is an associate professor of otolaryngology at Harvard Medical School and Massachusetts Eye and Ear.

According to Bleier, the roof of the nose is one of the few areas that somewhat exposes the brain to the outside world. That’s why using sterile water is so important for nasal irrigation.

People should not use tap water, says Dr. Bleier. Distilled and previously boiled water are the best options.

If boiling, the FDA recommends boiling for 3 to 5 minutes, then cooling before use. Previously boiled water can be stored in a refrigerator for up to 24 hours.

Bleier also mentions making sure the neti pot or bottle is clean. You can wash it with hot, soapy water or sterilize it before use in a microwave.

Dr. Charles Cobbs, the neurosurgeon who had conducted surgery on the woman, told LiveScience that people shouldn’t be afraid. The infection is so rare that he had never heard of it. However, Cobbs advises neti pot users to “definitely use sterile water” (5).  

References:

1. Pipera, K. J., Fostera, H., Susantoa, D., Mareea, C. L., Thorntona, S. D. & Cobbs, C. S. (2018). Fatal Balamuthia mandrillaris brain infection associated with improper nasal lavage. International Journal of Infectious Diseases, 77: 18-22. Doi: https://doi.org/10.1016/j.ijid.2018.09.013
2. Centers for Disease Control and Prevention. (2016, February 17). Parasites – Balamuthia mandrillaris – Granulomatous Amebic Encephalitis (GAE). Retrieved from https://www.cdc.gov/parasites/balamuthia/index.html.
3. U.S. Food and Drug Administration. (2017, January 24). Is Rinsing Your Sinuses With Neti Pots Safe? Retrieved from https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm316375.htm.
4. Ducharme, J. (2018, December 7). A Doctor Says a Woman Died From a Brain-Eating Amoeba After Using a Neti Pot. Are They Safe? Time. Retrieved from http://time.com/5473884/are-neti-pots-safe/.
5. Miller, S. G. (2018, December 6). ‘It Was Just Dead Brain Tissue’: Seattle Woman Dies from Extremely Unusual Infection. LiveScience. Retrieved at https://www.livescience.com/64254-brain-amoeba-balamuthia-mandrillaris.html.