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 Pathological Naegleria species in the U.K.

Page updated 26/4/03

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)



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.

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