Death by Neti Pot?

person using neti pot
Photo Credit: danmachold

Two recent Louisiana deaths from the ‘brain-eating amoeba’ Naegleria fowleri have been attributed to the usage of tap water for nasal irrigation employing neti pots. These follow on the 2010 death of a Pakistani who practiced wudu, a form of deep nasal irrigation, using tap water.

The yoga nasal irrigation technique, called Jala Neti in Sanskrit, is a Shatkarma (purification practice) used to cleanse the nasal passages of mucus and particulates. Modern users typically employ a teapot-looking device to pour salt water solution into one nostril and allow it to run out the other while the mouth is kept open to breathe. This practice has been shown effective for ease of symptoms related to hay fever, sinusitis, and other nasal conditions.

Infections from Naegleria fowleri are rare, and almost always fatal. Infection typically occurs while swimming or bathing in warm freshwater lakes or rivers, particularly when the water is low and in muddy areas. Infections have also been reported from bathing in inadequately chlorinated swimming pools and nasal irrigation with inadequately treated drinking water.

The amoeba enters through the nostrils and then bores through the skull, where it emits two enzymes to dissolve protein-rich brain tissue for consumption. Initial stages may appear similar to bacterial meningitis which includes headache, fever, nausea, vomiting, and stiff neck. Later symptoms progress to confusion, loss of balance, seizures, and hallucinations. Initial onset of symptoms occurs 1-7 days following infection, after which death usually occurs within 1-12 days.

Louisiana officials stipulate the amoeba poses no danger in drinking water, and only becomes fatal when allowed to enter through the nasal passages. While true, other sources claim the amoeba cannot survive in properly treated municipal water, suggesting the Louisiana sources of drinking water responsible for these deaths may have been inadequately treated.

Naegleria fowleri cannot survive in salt water, which has led some to speculate that the usage of tap water for neti is safe if adequate salt is added. This is based on the assumption that salt will hypothetically “kill” the amoeba. Given that failure to use salt in one’s neti pot results in burning and stinging, it is unlikely the deceased didn’t use it. However, no sources comment on whether salt was used.

Health authorities now recommend that boiled, distilled, or purified water always be used for nasal irrigation, echoing longstanding recommendations by neti pot manufacturers.

If a brain-eating amoeba isn’t inspiration enough to use distilled water in your neti pot, the varying standards of US tap-water purity should be equally motivating. Using neti with unpurified water may introduce harmful chemicals or elements into the nasal cavities, and potentially exacerbate the allergens or mucousa the practice is believed to attenuate.

Are you a neti pot user? Have you used tap water in your neti pot before?

Comments 11

  1. I actually just wrote about this yesterday too. My biggest concern is that they have such an amoeba in a public water supply in the first place – that is the big issue here. But unfortunately its being gleamed over with press induced hysteria on brain munching amoebas.

  2. We have a filter system in place for our tap water. However, my Dad uses a Neti pot on a regular basis due to chronic congestion. He also boils his water first.

  3. I do use tap water in my neti pot, but I am thinking from now on I’ll use distilled water just to be safe. It certainly is much more complicated to boil it and then let it cool to a usable temperature. But does boiling tap water kill the bacteria? or must you use distilled or other purified water?

  4. LucyClark – Boiling water will kill any known infectious bacteria and amoebas. If you are worried about chemical contamination, however, such as industrial waste or fracking by-products, you will need to obtain distilled water.

  5. I am sad to hear of these terribly unfortunate stories. On my first use I used a “smart water” water bottle that had been on my counter. I had never seen a nasal irrigation aside from YouTube videos. I unfortunately used tap water t perform this task and now I am scared as ever. I live in Orange County, California. Is this brain eating amoeba something I should be worried about, now that I have already squirted tap water in to my nasal cavity? I hope I am not to late n this discussion.

  6. Saxmac – Please don’t worry about using tap water, I’ve been doing it for years and I’m still alive! These are very rare reports, so the chances of Naegleria fowleri being in your water supply is unlikely. But do start using water that has been boiled or distilled.

    1. I’m in Orlando, Fl and just used my neti pot for the first time in years!! I used unboiled tap water from my kitchen sink. I didn’t know not to do that. I am freaking out and literally making myself sick from worry. It’s only been two day since I used it and the waiting is agonizing. I googled what to put in a neti pot but didn’t read beyond the two line recipe. I’m scared so scared.

  7. I’ve been really scared after knowing what happened by the use of tap water. There are times when I’ve myself used tap water. However I’ve never had any such symptom.

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