Brain-Eating Amoeba Testing to Expand Beyond Florida Across the US

Jose Alexander, MD, a clinical microbiologist and director of microbiology, virology, and immunology for AdventHealth Orlando, and his team have expanded access to their brain-eating amoeba test beyond Florida. “AdventHealth is accepting samples for testing from any hospital across the US,” said Alexander in a recent Advent Health press statement.

Although it is known colloquially as a brain-eating amoeba, primary amebic meningoencephalitis (PAM) is a rare but deadly disease caused by infection with Naegleria fowleri. This condition is highly fatal, with only five known survivors thus far.

On average, patients begin experiencing symptoms, including frontal headache, fever, nausea, and vomiting, within five days. After that, patients progress to the second stage of the illness, which causes a stiff neck, seizures, altered mental status, hallucinations, coma, and eventually death.

According to the CDC, there are some potential treatments for PAM with medications that are thought to act on the condition, including amphotericin B, azithromycin, fluconazole, rifampin, miltefosine, and dexamethasone. Left untreated, most patients die within 18 days of symptom onset.

Despite the availability of potential treatments, many patients are not diagnosed in time to establish care. The standard diagnostic methods for PAM include clinical evaluation or microscopic examination. The routine microscopic examination requires a culture of fresh cerebrospinal fluid (CSF) or brain tissue and can take up to six days to analyze, significantly delaying treatment.

Understanding the need for prompt and rapid diagnosis, Alexander and his team developed a blood test that detects amoebas in 1 mL of CSF within three hours, an exponentially faster process.

“One of the main advantages me and my team had was that the amoeba testing platform is also used for COVID-19 testing. In the future, it will also be used for detecting the Legionella spp. in respiratory samples,” Alexander told LifeSciencesIntelligence in a 2022 interview.

Until recently, this testing option was only available for providers at AdventHealth Orlando; however, further research and data allowed AdventHealth clinicians and researchers to expand access to testing, allowing healthcare professionals to ship samples for diagnosis.

Widened access will become increasingly critical as warming water temperatures increase the prevalence of these organisms.

“We’ve run these Rapid Amoeba PCR tests through several sample transportation temperatures to determine sample stability and quality,” said Alexander. “Spinal fluid samples can now be shipped at room temperature if testing is expected within 48 hours and refrigerated if expected within seven days.”

Beyond accelerating the diagnosis and treatment process, access to rapid testing can help public health experts establish epidemiological data and develop policies accordingly.