Naegleria Fowleri
Naegleria Fowleri
MATERIAL SAFETY DATA SHEET – INFECTIOUS SUBSTANCES
SECTION I – INFECTIOUS AGENT
NAME: Naegleria fowleri
SYNONYM OR CROSS REFERENCE: Naegleriasis, primary amoebic meningoencephalitis
CHARACTERISTICS: Free-living amoebas, trophozoites are 8-20 µm in diameter and produce broadly rounded lobopodia; cysts are single-walled, spherical, 8-12 µm in diameter; flagellate is pear-shaped and motile, can revert to the trophic stage
SECTION II – HEALTH HAZARD
PATHOGENICITY: Cause of primary amebic meningoencephalitis; characterized by a sudden onset of headache, fever, nausea, pharyngitits, and nasal obstruction or discharge; with disease progression other symptoms include lethargy, confusion, and stiff neck; convulsions may occur with rapid deterioration to coma and death within 1- 14 days; other symptomsinclude abnormalities of taste and smell, seizures, cerebellar ataxia, nuchal rigidity, photophobia
EPIDEMIOLOGY: Affects active, immunocompetent young people of both genders; predominant in the tropics; ubiquitous in warm fresh water; most cases are associated with patient having been to a swimming pool, freshwater lake, or pond a few days before the onset of symptoms; at least 192 cases reported worldwide, exposure may be common as antibodies to Naegleria fowleri is widespread
HOST RANGE: Humans; 1 reported case of infection in a South American tapir
INFECTIOUS DOSE: Not known
MODE OF TRANSMISSION: Naegleria invades brain and meninges via nasal mucosa; exposure through swimming in contaminated pools, stagnant ponds, freshwater lakes, thermal springs, hot tubs and spas; infection by inhalation of cysts in dust or soil particles
INCUBATION PERIOD: Usually 3-7 days
COMMUNICABILITY: Person-to-person transmission has not been documented
SECTION III – DISSEMINATION
RESERVOIR: Free-living inhabitant of freshwater, soil, and vegetation
ZOONOSIS: None
VECTORS: None
SECTION IV – VIABILITY
DRUG SUSCEPTIBILITY: Susceptible to amphotericin B in combination with oral rifampin; topical use of promadine isethionate is effective; other effective drugs include clotrimazole, miconazole and pimaricin
SUSCEPTIBILITY TO DISINFECTANTS: Susceptible to 1% sodium hypochlorite, 2% glutaraldehyde
PHYSICAL INACTIVATION: Sensitive to irradiation
SURVIVAL OUTSIDE HOST: Reproduces successfully at temperatures up to 46°C; cysts survive for long periods in the bottom sediments of lakes and rivers
SECTION V – MEDICAL
SURVEILLANCE: Monitor for symptoms; confirm by microscopic demonstration of motile amoebae in fresh CSF
FIRST AID/TREATMENT: Amphotericin B is the drug of choice
IMMUNIZATION: None available
PROPHYLAXIS: None available
SECTION VI – LABORATORY HAZARDS
LABORATORY-ACQUIRED INFECTIONS: None reported to date
SOURCES/SPECIMENS: Cerebrospinal fluid and brain biopsies
PRIMARY HAZARDS: Droplet or aerosol exposure of mucous membranes; accidental parenteral inoculation
SPECIAL HAZARDS: Aerosol or droplet exposure of the mucous membrane of the eye, nose or mouth with trophozoites and tissue homogenates
SECTION VII – RECOMMENDED PRECAUTIONS
CONTAINMENT REQUIREMENTS: Biosafety level 2 practices and containment facilities for all activities involving infectious stages of the parasite and the manipulation of known or potentially infectious tissues, fluids
PROTECTIVE CLOTHING: Laboratory coat; gloves when skin contact with infective stages is unavoidable
OTHER PRECAUTIONS: Biological safety cabinets are indicated when working with N. fowleri; immunocompromised and pregnant individuals should minimize exposure to pathogen
SECTION VIII – HANDLING INFORMATION
SPILLS: Allow aerosols to settle; wearing protective clothing cover the spill with absorbent paper towel and apply 1% sodium hypochlorite starting at the perimeter and working towards the center; allow sufficient contact time (30 min) before clean up
DISPOSAL: Decontaminate all wastes before disposal; steam sterilization, chemical disinfection, incineration
STORAGE: In sealed containers that are appropriately labelled
SECTION IX – MISCELLANEOUS INFORMATION
Date prepared: March, 2001
Prepared by: Office of Laboratory Security, PHAC
Although the information, opinions and recommendations contained in this Material Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.
Copyright © Health Canada, 2001
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