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Naegleria fowleri is a rare but dangerous amoeba found in some warm freshwater and other environments. It can cause primary amebic meningoencephalitis (PAM) if contaminated water goes up the nose and reaches the brain. Drinking contaminated water does not cause PAM, and the infection does not spread between people. In the United States, the CDC says typically fewer than 10 people get PAM each year.
What is Naegleria fowleri?
Naegleria fowleri is a free-living amoeba that lives in soil and warm water. The nickname “brain-eating amoeba” refers to the severe brain infection it can cause; it does not mean the organism is commonly encountered or that exposure usually leads to illness.
The infection is called primary amebic meningoencephalitis, or PAM. CDC records 167 reported U.S. cases from 1962 through 2024. Those figures describe the United States, not the worldwide total. CDC’s overview of Naegleria fowleri was dated July 21, 2025.
How does infection happen?
PAM occurs when water containing the amoeba enters the nose and the organism travels to the brain. Swallowing contaminated water is not a route of infection, and PAM is not transmitted from person to person.
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Exposure is most often associated with activities in warm freshwater, such as swimming or diving. Rarely, contaminated tap or faucet water used for nasal rinsing has also been implicated. CDC lists possible environments including lakes, rivers, ponds, hot springs, geothermal water, warm industrial discharge, water heaters, and poorly maintained recreational venues.
| Setting | What to know |
|---|---|
| Warm freshwater activities | Water entering the nose is the relevant exposure. CDC advises assuming the amoeba may be present in fresh water, while the overall chance of infection remains very low. |
| Nasal rinsing | Contaminated tap or faucet water can pose a risk if it is used to rinse the nose. The rinse bottle or neti pot itself does not make unsafe water safe. |
| Properly maintained, disinfected swimming pools | CDC’s swimming guidance does not identify these pools as a route of infection. |
How can you lower the risk?
During warm freshwater activities
CDC advises people to assume Naegleria fowleri may be present in lakes, ponds, rivers, hot springs, and other fresh water. That is a precaution, not a claim that every body of water is known to be contaminated. Because infection requires water to go up the nose, steps that reduce nasal exposure can lower risk:
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- Keep your head above water when practical, especially in warm freshwater.
- Use nose clips or hold your nose shut when jumping or diving.
- Avoid stirring up sediment in shallow areas, where the amoeba may be present.
These measures reduce opportunities for water to enter the nose; they cannot guarantee that a natural water source is free of the amoeba. See CDC’s swimming prevention guidance, dated July 16, 2025.
When rinsing your nose
Use water that is safe for nasal rinsing. CDC’s guidance says: “If you rinse your sinuses or cleanse your nasal passages, make sure the water you use is safe.” Follow current public-health directions for preparing or obtaining safe water; do not assume ordinary tap water is suitable for nasal rinsing. A neti pot or squeeze bottle does not disinfect its contents. CDC’s nasal-rinsing guidance provides its water-safety directions.
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If authorities warn about a water system
Follow the instructions from local public-health and water authorities. If contamination is suspected, CDC advises preventing water from going up the nose and following the relevant local response. A local notice does not mean municipal tap water in general is unsafe, and a drinking-water advisory should not be treated as interchangeable with nasal-rinsing guidance. See CDC’s guidance on public water systems.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.What symptoms should prompt urgent care?
Early PAM symptoms can resemble common illnesses. They include headache, fever, nausea, and vomiting. Symptoms usually begin about five days after exposure, but CDC says onset can range from one to 12 days.
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The disease can progress quickly. Later symptoms may include stiff neck, confusion, inattention, seizures, hallucinations, and coma. Seek medical care right away for sudden fever, headache, vomiting, or stiff neck—especially after warm freshwater exposure. Do not wait for every symptom to appear. CDC’s symptoms guidance describes the warning signs and urgency.
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