<i>Notes from the Field:</i> Primary Amebic Meningoencephalitis Associated with Nasal Irrigation Using Water from a Recreational Vehicle — Texas, 2024

Primary amebic meningoencephalitis (PAM) is a rare, often fatal brain infection caused by the free-living ameba, Naegleria fowleri (1).Infection is typically associated with recreational water activities; however, using tap water when performing nasal irrigation is also a risk factor for PAM (2-4).Improperly maintained municipal water and recreational vehicle (RV) water systems can be a source of waterborne disease; CDC recommends the use of distilled, sterile, or boiled and cooled tap water for nasal irrigation.*Household safe water practices can help prevent waterborne illness associated with RV water systems.This report describes a fatal case of N. fowleri infection associated with improper use of a nasal irrigation device with suspected contaminated tap water from an RV.