A young woman has died after contracting a brain-eating amoeba in an indoor swimming pool.
The 30-year-old man is believed to have contracted Naegleria fowleri, which is 97 percent fatal, at a wave pool in Taiwan.
He is believed to have been learning to surf when water entered his nose, the main route of infection with the amoeba.
The woman was taken to hospital after suffering seizures, headaches, fever and stiffness in her neck and shoulders. She died three days later.
This comes after a 29-year-old American man also died from the amoeba in 2018 after visiting a wave pool at a water park in Texas.
The woman, aged 30, is believed to have contracted N. fowleri at an indoor swimming centre (tests being carried out are shown in the image above)
Tests revealed the amoeba in the pool basement, and officials said this could have been a leak from the pipes.
Tests diagnosed his infection as an amoeba, and follow-up swabs taken at the facility also showed there was too little chlorine in the water to kill the pathogen.
Subsequent tests revealed the pathogen was in a puddle in the center’s basement, and health officials said it could have easily spread from there to the pools via staff boots.
N. fowleri hides in warm freshwater and can infect people when water enters the nose, allowing it to infect the olfactory nerve and then travel through it to the brain, where it kills tissue and causes swelling that leads to death.
The patient had visited the New Taipei City indoor water park in northern Taiwan before developing the infection in July 2023.
There are fewer than ten cases of amoeba infection in the United States each year, and they are usually associated with swimming in warm freshwater.
But in 2018, a 29-year-old man also died from the brain-eating amoeba in Texas after visiting a surfing pool and becoming infected.
Fabrizio Stabile from New Jersey died just one day after being diagnosed with the infection. He had visited BSR Cable Park.
Of the 135 people infected in the United States, only four have survived (some with severe brain damage).
In 2018, American Fabrizio Stabile died after contracting the amoeba at an indoor swimming centre in Texas. He had also been using a wave pool.
N. fowleri kills about 99 percent of all people it infects and is fatal because it spreads rapidly to the brain and begins killing tissue.
In the case report, published in the CDC’s monthly journal Emerging Infectious Diseases, health officials said: “For beginning surfers, maintaining balance in the water can be difficult, and falling into waves frequently allows water to flow into the nose.”
They added that because chlorine was already low in the main pool that supplied water to the wave pool, it was likely “even lower” in this pool.
Officials contacted 12 employees and 630 clients after detecting the case who had visited the center around the same time, but none reported symptoms of N. fowleri infection.
It was not clear how the woman became infected, although authorities believe the pool is the most likely source.
Of 56 samples taken from the pool, only one tested positive for N. fowleri, and it was a puddle in the basement under the staircase leading to the chlorination tanks.
Experts suggested that this puddle could have been a leak from the water system, indicating it was contaminated with N. fowleri.
But they also said it was possible that employees had stepped in the puddle and then carried N. fowleri into the pool, where it would have entered the water.
Independent testing showed chlorine levels in the main pool were about 0.87 parts per million (ppm), well below the one to three ppm needed to kill microbes.
Because this fed into the wave pool, officials feared levels may have been even lower in this area.
Staff at the New Taipei City centre in northern Taiwan said they change all the water at the facility every two to three months.
They also add chlorine to the pools daily and test the water, although no records of the results were released.