According to Louisiana State Epidemiologist Dr. Raoult Ratard. "Tap water is safe for drinking, but not for irrigating your nose."
His statement was in response to the deaths of two people in the suburbs of New Orleans, Louisiana, who died after using a neti pot containing tap water to irrigate sinuses. One was a 51-year-old DeSoto Parish woman, the other a 20-year-old St. Bernard Parish man. They became infected by a deadly amoeba which entered the body through the nose.
The deadly parasite known as the brain-eating amoeba is Naegleria fowleri Once it enters the body, it can cause primary amoebic meningoencephalitis. Symptoms include headache, fever, nausea, and stiff neck. Soon the disease progresses to dizziness, confusion, seizures, and hallucinations.
Untreated, death can occur within one to twelve days. Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center, explained it's rare, difficult to diagnose and treat,
"I had not heard of Naegleria being associated with Neti pot use, but it's perfectly biologically plausible, because tap water is not sterile. And when you inhale it directly into the sinuses, it's similar to a deep dive into brackish water."
Dr. Ratard recommends,
"If you are irrigating, flushing or rinsing your sinuses, for example, by using a Neti pot, use distilled, sterile, or previously boiled water to make up the irrigation solution."
Dr. Schaffner adds that you should pay attention to detail, "....rinse [the Neti pot] out thoroughly after use, and air-dry it," since water left in the Neti pot breeds bacteria and parasites.
Drinking non-sterile tap water cannot cause a Naegleria fowleri infection.
Primary amoebic meningoencephalitis "PAM is a rare but nearly always fatal infection caused by N. fowleri, a thermophilic, free-living ameba that inhabits freshwater ponds, lakes, and rivers, minimally chlorinated pools, and hot springs throughout the world (2). PAM results when amebae-contaminated water incidentally enters the nose during swimming or other aquatic activity, followed by migration of amebae to the brain through the olfactory nerve."
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