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Applied and Environmental Microbiology, July 2001, p. 2927-2931, Vol. 67, No. 7
Service des Études
Médicales1 and Division Recherche
et Développement,2
Électricité de France, 78401 Chatou Cedex, and
Laboratoire de Biologie Cellulaire EA 1655, Faculté de
Pharmacie, 69373 Lyon Cedex 08,3 France
Received 3 November 2000/Accepted 15 April 2001
Free-living Naegleria fowleri amoebae cause primary
amoebic meningoencephalitis (PAM). Because of the apparent
conflict between their ubiquity and the rarity of cases observed, we
sought to develop a model characterizing the risk of PAM after
swimming as a function of the concentration of N. fowleri.
The probability of death from PAM as a function of the number of
amoebae inhaled is modeled according to results obtained from animals
infected with amoeba strains. The calculation of the probability of
inhaling one or more amoebae while swimming is based on a double
hypothesis: that the distribution of amoebae in the water follows a
Poisson distribution and that the mean quantity of water inhaled while swimming is 10 ml. The risk of PAM for a given concentration of amoebae
is then obtained by summing the following products: the probability of
inhaling n amoebae × the probability of PAM
associated with inhaling these n amoebae. We chose the
lognormal model to assess the risk of PAM because it yielded the
best analysis of the studentized residuals. Nonetheless, the levels of
risk thereby obtained cannot be applied to humans without correction,
because they are substantially greater than those indicated by
available epidemiologic data. The curve was thus adjusted by a factor
calculated with the least-squares method. This provides the PAM risk in
humans as a function of the N. fowleri concentration in the
river. For example, the risk is 8.5 × 10
0099-2240/01/$04.00+0 DOI: 10.1128/AEM.67.7.2927-2931.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Assessing the Risk of Primary Amoebic
Meningoencephalitis from Swimming in the Presence of Environmental
Naegleria fowleri
8 at a
concentration of 10 N. fowleri amoebae per liter.
*
Corresponding author. Mailing address: Service des
Études Médicales, EDF-GDF, 22-28 rue Joubert, 75009 Paris, France. Phone: 33 1 55 31 46 02. Fax: 33 1 55 31 46 20. E-mail:
pierre-andre.cabanes{at}edfgdf.fr.
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