| Naegleria
fowleri,
the principle pathogenic species is particularly abundant in warm water
and as the UK is famously devoid of warm water, so the incidence of Naegleria
pathogenesis has been comparatively low. Two well documented
cases of primary amoebic meningoencephalitis (PAM) have been recorded
however, including a famous tourist spot, and pathogenic Naegleria
species have been isolated from the U.K.
The first
possible case of PAM caused by Naegleria was diagnosed
retrospectively (Symmers,
1969). The
patient was a "lad of Essex", the specimen was dated 1909 and
the diagnosis had been carcinoma but it is thought that the Naegleria
amoeba was confused with carcinoma cells. This case cannot ever be
confirmed of course, but if it were it would surely be the first in the
world? A second possible case from Belfast in Ireland is also
recorded (Symmers,
1969).
A 10 year old girl who had just recovered from a near drowning developed
symptoms of meningitis and was admitted after 24 days and had
amoebae in her CSF, the original description of the amoeba (1937) was a
limax with a prominent nucleus.
The first
confirmed PAM case involving Naegleria was a 2 year old boy who
together with two other children developed meningitis after playing in a
muddy puddle (August 1969 in Bristol, England) after a particular warm
summer (Apley
et al, 1970).
Fortunately, the two other children who were suspected of being infected
with the same amoebae were treated with amphotericin B recovered. Naegleria
were not confirmed in one of the cases but
they were confirmed from the fatal case and one of the survivors (Saygi
et al, 1972).
The second
positive case of PAM caused by Naegleria was reported from the
naturally warm waters of the Bath springs (Cain
et al, 1981) |
|
References:-
Apley, J., Clarke, S. K. R., Roome, A.
P. C. H., Sandry, S. A., Saygi, G., Silk, B. & Warhurst, D. C.
(1970) Primary amoeba meningoencephalitis in Britain. Brit.Med.J. 1,
596-599.
Cain, A. R. R., Wiley, P. F.,
Brownell, B. & Warhurst, D. C. (1981) Primary amoebic
meningoencephalitis. Arch. Dis. Childhood. 56, 140-143.
Kilvington, S., Mann, P. G. &
Warhurst, D. C. (1991) Pathogenic Naegleria amoebae in the waters
of Bath: a fatality and its consequences. in Hot Springs of Bath (Kellaway,
G. A., ed) pp. 89-96, Bath City Council.
Saygi, G., Warhurst, D. C. & Roome,
A. P. C. H. (1973) A study of amoebae isolated from the Bristol cases of
primary amoebic encephalitis. Proc.Roy.Soc.Medicine. 66, 277-282.
Symmers, W. S. C. (1969) Primary
amoebic meningoencephalitis in Britain. Brit.Med.J.. 4, 449-454.
Warhurst, D. C., Roome, A. P. C. H.
& Clarke, S. K. (1976) Letter: Amoebic meningoencephalitis in
Britain. Brit.Med.J. 1, 961-962. |
