In 1962 the Center for Disease Control (CDC) began keeping records of human illness caused by the naturally occurring free-living amoeba Naegleria fowleri, which has often been called the brain eating amoeba. N. foweri received its notoriety due to the rare and often fatal infection of the brain known as primary amoebic menigoencephalitis (PAM). The majority of PAM cases have been traced to human emersion in natural water bodies, such as lakes or rivers, or from water parks, however in the fall of 2011 the death of a 51-year-old woman and 20-year-old man in Louisiana were linked to PAM caused by the use of tap water in neti pots for sinus irrigation. Upon further investigation N. fowleri was found in the neti pots and in the plumbing of the homes, which are in two geographically separate parts of the state, DeSoto Parish and St. Bernard Parish. Two years later, in September of 2013, a child in St. Bernard Parish died from PAM, and water from the home also tested positive for N. fowleri. In the fall of 2013, the treated water from DeSoto Parish and St. Bernard Parish tested positive for the parasite. In response to finding N. fowleri in the water systems, the Louisiana Department of Health and Hospitals (LDHH) issued an emergency rule on Nov. 7, 2013 requiring that all water systems in the state maintain a residual disinfectant level of 0.5 mg/L, and increase their number of routine sampling sites by 25%. A 0.5 mg/L level has been shown to control N. fowleri in Australia where it was first identified in drinking water systems in the 1970s.
Corona led the State of Louisiana’s technical response to the N. fowleri deaths from drinking water in 2013, including organizing and facilitating the international science advisory workgroup engaging CDC, USEPA, and academic experts; developing N. fowleri laboratory capacity and methods collaboratively with CDC and other experts; and coordinating the 2-year statewide N. fowleri sampling effort in raw and treated water locations. Corona also assisted water utilities that experienced and addressed positive N. fowleri detections through sampling plans, regulatory coordination, nitrification control plans, and capital and operational improvements to maintain effective disinfectant residual concentrations.