A tragic case in Durham, North Carolina, has renewed public attention on primary amebic meningoencephalitis, a rare and usually fatal brain infection caused by the amoeba Naegleria fowleri. State health officials identified a community organization’s water feature as the likely source of exposure, prompting a facility closure and fresh CDC testing.
Investigation Points to Durham Water Feature in Teen’s Death
State health officials investigating the death of a North Carolina teenager from a rare brain infection have identified a manmade water feature as the most likely source of exposure. The North Carolina Department of Health and Human Services stated that while investigators could not conclusively determine the exact location of exposure, epidemiological, laboratory, and environmental findings pointed directly to the site in Durham, North Carolina. An NCDHHS report read: While this investigation does not allow us to conclusively determine the location of exposure, the epidemiologic, laboratory, and environmental findings suggest that the El Futuro water feature was the most likely source.
The teen, whose name was withheld to protect family privacy, visited El Futuro—a nonprofit mental health organization supporting Latino families with a clinic on Chapel Hill Road—and splashed water on his face in the outdoor green space on August 13. He was admitted to the emergency room on August 21 after experiencing severe headaches for two days, returned to the emergency room on August 22, and died on August 31. NCDHHS was notified of a suspected case of Naegleria fowleri on August 23, and first announced the case on August 27 when the teen was critically ill and receiving medical care.
Durham County health officials closed the water feature on August 28 for Centers for Disease Control and Prevention testing. Testing later confirmed the presence of Naegleria fowleri at the Centers for Disease Control and Prevention, and the site remains closed to the public. On Tuesday, “Keep Out” signs and orange traffic cones could be seen around the green space. 14-year-old Zamaya Strickland says she lives nearby and the green space always has visitors, noting that not even a few weeks ago there were people there.
NC Department of Health and Human Services and Durham County Public Health informed El Futuro that testing identified the presence of Naegleria fowleri in a water feature at our green space. Our hearts are broken for the young boy who lost his life and for his family. We are committed to supporting his family and our community through this devastating loss. We will continue to fully cooperate with public health officials. The water feature has been closed since we were first contacted by county officials. El Futuro
Understanding Naegleria fowleri and Infection Risks
Naegleria fowleri is a microscopic amoeba commonly found in warm freshwater lakes, ponds, and rivers. When contaminated water enters the nose, the organism can travel to the brain and cause primary amebic meningoencephalitis, an illness that is rare and usually fatal. Swallowing contaminated water does not cause infection, but the amoeba can infect people when water enters the nose and travels to the brain.
Symptoms can begin one to 12 days after exposure and may include severe headache, fever, nausea, and vomiting before progressing to stiff neck, seizures, and coma.
Case Distribution Across the United States
While infections draw intense public scrutiny due to their severity, they remain exceptionally rare, infecting fewer than 10 people a year in the U.S. Only 167 U.S. cases were reported between 1962 and 2024, according to NCDHHS. Looking at a broader historical dataset covering 1937 to 2025, the CDC logged 180 total reported cases with known exposure locations, with annual totals ranging from zero to eight cases. Cases that occurred between 1937 and 1961 were identified later through a review of past records.
Geographic patterns show that southern regions bear the brunt of the caseload. As the CDC stated on its website: States with warmer climates have the most PAM cases, but they do occur in northern states as well.
Among individual states, Texas leads the historical tallies with 40 reported infections, followed closely by Florida with 37 cases recorded between 1937 to 2025. Virginia and California also rank among the states with the highest reported brain-eating amoeba infections according to the Centers for Disease Control and Prevention.
Public Health Recommendations and Prevention Measures
Health officials recommend keeping water out of the nose during warm freshwater activities by using nose clips, holding the nose shut, or keeping the head above water. They also advise using only distilled water when performing nasal rinses.
State health officials continue to monitor water safety as local communities navigate the aftermath of the recent incidents linked to warm freshwater exposure and contaminated environments.