The recent death of a teenager after contracting a rare water-borne illness at a waterpark has made the sports community sit up and take notice. Such infections, it is noted, might be rare, but is there any way to guard against them?
It is thought the 18-year-old, Lauren Seitz of Westerville, Ohio, became infected by the Naegleria fowleri amoeba, which attacks the brain, when her raft overturned as she and friends visited the US National Whitewater Center near Charlotte while on a church group trip. She died a week after the incident.
According to an article in Yahoo! News, chlorination and filtration systems at the artificial water rapids course, where Olympic kayakers have trained, were found to be inadequate to kill the organism, whose slang name is the ‘brain-eating amoeba.’ CDC officials noted that ordinarily, the chlorination and ultraviolet light (both used to sanitize water) would have killed the organism. However, Dr. Jennifer Cope of the CDC told CNN, the amoeba was probably able to grow to such concentrations because of the amount of dirt and debris in the water, which turned the water “turbid” or murky and interfered with the effectiveness of the sanitation process.
“When you add chlorine to water like that, the chlorine reacts with all that debris and is automatically consumed,” explained Cope. “It is no longer present to inactivate a pathogen like Naegleria.” The same theory applies to the UV light sanitation system at the water park. “If you're passing turbid water through UV light, the rays cannot inactivate pathogens,” she said.
All 11 samples the CDC took from the waterpark tested positive for the amoeba. CBS News noted the whitewater center closed its whitewater rafting and kayaking operations on June 24. The fast-water channels will be drained, dried and scrubbed to kill any vestiges of the amoeba, the non-profit said on its website. The center didn't indicate when the rapids course might reopen.
Also muddying the waters is a lack of regulation. Charlotte’s whitewater center is the only one of three similar parks in the nation that is not regulated to help prevent waterborne illnesses. (The two other parks, located in Maryland and Oklahoma, receive regular testing, according to the Charlotte Observer.) In the Mecklenburg County area of North Carolina, where the problem park is located, officials who regulate water quality do not routinely test for the presence of the amoeba. But that may change, as this incident has catapulted the problem to national prominence.
Regulating the center’s water “will be looked at going forward because (the death) has brought a lot of attention to the potential for problems,” Dr. Marcus Plescia, Mecklenburg County’s health director, told the Observer.
The deadly amoeba thrives in warm-water environments such as lakes and rivers (and is thus rarely found in private systems such as a waterpark), and infections occur only when water is forced up the nose, allowing the organism to travel up the nasal passages to the brain. Even then, researchers say, the chance that it may affect one person and not another is simply that – chance. Even other teenagers falling out of the same raft as Seitz were unaffected by the amoeba.
According to CBS News, the amoeba is common in lakes and other kinds of warm, fresh water, yet it's very rare that it will make anyone sick, said Dr. Thomas Kerkering, chief of infectious diseases at Virginia Tech Carilion School of Medicine in Roanoke, Virginia.
Nationwide, only 138 peoplehave been stricken by the disease between 1962 and 2015, according to the CDC. Florida and Texas have had the most cases with 34 each in that time. North Carolina had four cases prior to Seitz, none of them involving the whitewater center, while Ohio is one of 32 states without a recorded case over the five-decade span. All five cases last year were fatal. One case each was found in California, Oklahoma and Arizona; two cases were found in Texas. The most recent was in Texas last August.
Rare though it is, the amoeba is notoriously deadly. There is no vaccine against it. Sports event planners with open-water events, or any events where a risk might be found are advised to work with independent professional testing companies that can test water samples and provide alerts regarding any possible pathogens.
Planners may also wish to consult with an event insurance company to plan for any additional coverage that may be necessary.
According to Sports Destination Management contributing writer Lorena Hatfield, marketing manager with K&K Insurance Groups, which provides coverage for sports events, planners should ascertain first, that the coverage needed is available. K&K, for example, she noted, “does not offer coverage for water parks, but we do have programs with water risks such as camps and campgrounds. K&K does offer coverage for this type of exposure under our transmissible pathogens coverage. If a claim were to be brought against an organization that had purchased this coverage, they would be insured. It’s important to know that this is not standard coverage offered in the general marketplace.”
In addition, it may be advisable for planners to consult with their organization’s legal counsel who can review whether adequate warning is being provided to athletes on registration materials and other information.
In addition, venues and sports planners should tell athletes to take preventive measures, as follows:
Always assume that there is a low level of risk anytime there is an event involving swimming, diving or waterskiing in warm freshwater in the South.
Hold your nose shut or use nose clips when you go into the water.
Exhale forcefully through the nose if you find yourself going into the water unexpectedly.
Avoid digging in or stirring up sediment in potentially infectious bodies of water.