An investigation of one death case probably caused by Naegleria fowleri infection in Hubei, 2021

  Objective  To identify the infection source of a primary amoebic meningoencephalitis case probably caused by Naegleria fowleri infection reported for the first time by a hospital in Jingzhou of Hubei provice in August 2021 and provide evidence for the prevention and control of such infection.

  Methods  The information about case’s disease onset, exposure history and clinical characteristics were collected from family member, doctor and villagers and field investigation was conducted to identify the infection source.

  Results  The case was a 47 years old men who lived in rural area of Jingzhou, He cleaned waterweeds in a pond in front of his home from 1^st August to 7^th August, 2021. The case had fever and headache on 9^th August, slipped into a coma with alalia on 11^th August, and mechanical pump was used to maintain his life on 15^th August after a deep coma. Naegleria fowleri infection was considered after the testing of case's cerebral spinal fluid by high throughput sequencing on 16^th August, local CDC received the report and immediately began an investigation on the same day. The case died after the discharge on 17^th August. A suspected cyst of Naegleria fowleri was found in water sample from the pond. Warning signs were set around the pond to prevent others contact with the pond water, and health education was conducted in the village.

  Conclusion  The primary amoebic meningoencephalitis case, who died 9 days later after onset, was probably caused by Naegleria fowleri infection after contact with the pond water. It is necessary to strengthen the disease and environment surveillances in areas where primary amoebic meningoencephalitis has occurred and improve the health education in local people.