Neti pot panic

April 3, 2012 12:43 PM

I used a neti pot with plain tap water and the saline solution. Then I read that you could get brain-eating bacteria from it. I am at work having a panic attack now. Hope me, Metafilter!

I'm not in Louisiana, where the neti pot deaths occurred. I have no idea how worried I should be. Should I go to the hospital and ask for massive antibiotics prophylactically? Or were these deaths extremely rare and localized and probably not something I should worry about? Have any MeFites used the neti without boiling the water first?

My sinuses are feeling a little inflamed, but nothing is coming out, and I feel a bit spacey -- however, this could be from the original condition I was trying to help, which is inner ear fluid, or from panic, or from staying up late last night and not getting much sleep.

I don't know how long it would take for the bacterial symptoms to set in. I used the pot last night about 2 a.m. so it's been about 12 hours. No stiff neck, headache, or nausea, just a feeling of sinus heaviness and pretty spaced out. I also used 4-Way Nasal Spray about three hours ago, and that was actually before noticing the heavy sinus feeling. It's the sinuses right below my eyes that are bothered the most. I took Sudafed also.

I'm looking for reassurance mainly. However, please let me know if you think I am in danger and what to do.

posted by sucky_poppet to health & fitness (30 answers total)

Well it's a brain parasite that you're at risk for. And it's fatal if you are infected. Also, deaths associated with this have happened all over the country -- not just in Louisiana.

However, the odds of getting infected from a single use are very, very small. Still, if you have decent health care, I suggest you call your primary care physician and see what they advice. It's possible they'll put you on antibiotics and/or antiparasitics as a precaution?
posted by imagineerit at 12:47 PM on April 3, 2012

Yeah, I think the whole brain-eating bacteria thing is phenomenally rare, so you probably don't have to worry.

Just buy distilled water (it's like $2 a gallon) and use that in the future.
posted by Fister Roboto at 12:48 PM on April 3, 2012 [1 favorite]

It's important, I think, to note that out of all the thousands of people using neti pots, and out of the hundreds in Louisiana specifically, there were only two deaths.

That seems like the textbook definition of "isolated incident."

And as for the "spacey" -- yeah, just used a neti pot last night, and it took a little while for things to totally shift. I"d chalk the spaceiness up to sleep loss and your sinuses continuing to plague you. And for the record, I also used plain tap water.

Again, to underscore - only two people died from this brain infection. Two. That's all.
posted by EmpressCallipygos at 12:48 PM on April 3, 2012 [5 favorites]

Relax. You are fine. This is no different from swimming and getting water up your nose, or laughing milk through your nose. I don't think too many people have gotten brain-eating bacteria from those things.

Deep breath. Your fine.
posted by bondcliff at 12:48 PM on April 3, 2012

you're
posted by bondcliff at 12:48 PM on April 3, 2012 [1 favorite]

The cases in Louisiana occurred because the people used tap water, and that tap water was contaminated with the amoeba Naegleria fowleri. They would have suffered the same fate if they'd snorted tap water up their nose; the problem was contaminated water, not that they were using a neti pot. People have been using neti pots for years with no ill effects. As long as you keep it clean and use clean water for your saline solution, there's no cause for alarm.
posted by xedrik at 12:49 PM on April 3, 2012 [4 favorites]

For what it's worth, I have done this as well with no ill effects (I live in Massachusetts.). You don't say where you live, but, I think that the issue was that the area had to be pretty warm year round for that kind of bacteria to flourish.

If you're really concerned you should just call your doctor. Good luck!
posted by Hanuman1960 at 12:49 PM on April 3, 2012 [1 favorite]

I know heaps of people who use neti pots when they're sick. None of them have had their brains eaten (by bacteria or otherwise).

If you must have official reassurance, call an ENT specialist and tell them what you told us. But really, I think if it was a serious threat, they would have been pulled from stores. There isn't a money-soaked neti pot lobby keeping them on the shelves or anything.
posted by troika at 12:50 PM on April 3, 2012 [1 favorite]

It's extremely rare and you have no symptoms. You can use boiled or distilled water in the future and feel safe.
posted by demiurge at 12:52 PM on April 3, 2012

The chances of you having gotten a terrible parasitic infection from this are beyond minuscule, just as your chances of having gotten a terrible parasitic infection from the last time you went swimming and got water up your nose are beyond minuscule. You have a much, much better chance of getting struck by lightning.

But, yeah, what you did was, despite the extraordinarily low risk, unnecessarily foolhardy. If you boil the water, you have zero chance of getting a terrible parasitic infection from the neti pot, rather than a one in several million chance. So you boil the water. Don't do it again.
posted by Sidhedevil at 12:52 PM on April 3, 2012 [2 favorites]

I'm such a daredevil, I STILL use tap water.
posted by kimdog at 12:53 PM on April 3, 2012 [17 favorites]

Should I go to the hospital and ask for massive antibiotics prophylactically?

Not at all, I at least would be calling for heads to roll if anyone gave you antibiotics for a eukarytotic infection, which antibiotics are ineffective against, for an infection that is fantastically unlikely while you present with symptoms that are exactly what you would expect for someone who just used a netti-pot and is panicked.

Or were these deaths extremely rare and localized and probably not something I should worry about?

Yup, pretty much this. Think about it this way, the odds that you have a brain eating infection are astronomically unlikely, and even if you did somehow have it, there isn't really anything you could do anyway. This is pretty much the definition of something that makes ABSOLUTELY NO SENSE to worry about.

In the future I would recommend boiling the water first.
posted by Blasdelb at 12:55 PM on April 3, 2012 [3 favorites]

Doesn't it say on your neti pot instructions to boil the water or to use distilled water? I'm a little troubled by all the people who are all "Oh, I just use water out of the tap in mine"--my ENT was pretty clear about the importance of boiling the water, because it's a minor precaution to take against even a small chance of some kind of infection (and the brain-eating parasite thing is an extreme case, but there are other less serious potential risks of using water out of the tap).

Still, the same advice goes for you as for the person who was freaking out about having run a red light: people make mistakes about their safety every now and then, and they usually come through them fine. You'll do better next time.
posted by Sidhedevil at 12:56 PM on April 3, 2012

I'm with kimdog, I still just use tap water. I don't live in Florida, though. I don't bother with boiling the water because I just have a finite amount of energy to deal with life and stuff.
posted by annsunny at 12:59 PM on April 3, 2012

If you spent last week dreaming you might win the $600 million lottery, then you should be concerned about these odds. Otherwise, do not worry and use distilled wawa next time.
posted by JohnnyGunn at 12:59 PM on April 3, 2012

You're at greater risk of getting hit by a car on your way to work. Next time you use the neti pot, use boiled or distilled water.
posted by rtha at 12:59 PM on April 3, 2012

I always just use plain tap water. And I haven't died at all. Not even once.

Don't worry about it. In the future, boil/use distilled if it will make you feel better.
posted by phunniemee at 1:00 PM on April 3, 2012 [3 favorites]

From this FAQ on Naelgeria fowleri:

"The risk of Naegleria fowleri infection is very low. There have been 32 reported infections in the U.S. in the 10 years from 2001 to 2010, despite millions of recreational water exposures each year. By comparison, in the ten years from 1996 to 2005, there were over 36,000 drowning deaths in the U.S."

I think you'll be fine. You should probably see an ENT if you can to address your sinusitis.
posted by OsoMeaty at 1:00 PM on April 3, 2012

I just tap water because heating up distilled or previously boiled water is more trouble than I'm regularly willing to go through for this. I also eat raw oysters and unpasteurized cheese. YdeathMMY.
posted by mostlymartha at 1:01 PM on April 3, 2012 [5 favorites]

I understand what Sidhedevil is saying, but honestly I use tap water every single time. Why? Because I forget not to use (unboiled) tap water, I've somehow internalized that the chance of brain parasites is really, really small.

Next time, don't use plain tap water and you'll save yourself some stress.

If I could bet, I'd bet you're completely parasite free. I'm not sure anyone would take that bet though - they'd have to be betting that you got a brain parasite, and I'm not sure I could find that action.
posted by mrs. taters at 1:03 PM on April 3, 2012

One more anecdata point: I've been doing this every morning for at least 5 years, all over Texas (it's warm here), always with tap water. Sometimes I've even done it with well water, though I know I really shouldn't. It boils down (heh) to me taking the time to boil water, which means I'll never use the neti pot, or to take my tiny risk every day and thus prevent horrendous sinus infections and allergy symptoms. I pick the latter.
posted by fiercecupcake at 1:10 PM on April 3, 2012

Can I offer a time-saving suggestion to all of you folks who find boiling the water too onerous? What the Largely Mythological Husband and I do is to boil water and then leave it in the teakettle, so there's always boiled water available for the neti pot (actually, squeezy bottle in our case). If we finish the teakettle, we boil more water while we're doing the squeezy.

That way, we always have boiled water available, and we're just habituated to making the saline solution from the teakettle instead of from the tap.

I know this might not work for everyone, but it's really helped make our routine more streamlined.
posted by Sidhedevil at 2:10 PM on April 3, 2012 [1 favorite]

If you do roll the dice and use tap water, at least use cold water. The hot water comes from a warm dark nasty stagnant cauldron in your basement, aka your water heater.
posted by PSB at 2:15 PM on April 3, 2012

To actually answer your question: no, you shouldn't do anything because (1) the probability is so low as to not be worth worrying about and (2) there's not really any treatment anyway.

For future use you could also - in addition to boiled or distilled water - use filtered water. Anything that's effective against Cryptosporidium or Giardia ( absolute 1 micron filters) will also remove fowleri. Even the less effective ones will remove 70% or more of the microbe. So sayeth the CDC.

Personally I just use tap water as well. I'm not convinced that the water out of my heater IS a problem; the CDC makes mention of the problem temp being water < 47C and I can get 47.3C out of my tap, indicating the water in my heater is actually above that level and thus presumably inhospitable to fowleri.
posted by phearlez at 2:51 PM on April 3, 2012 [1 favorite]

I'm such a daredvil I just use tap water up my nose - WITHOUT A NETI POT. Clears me right up. And I'm not dead. For many years. I'm either super awesome or an idiot, only you can decide.
posted by goo at 6:02 PM on April 3, 2012

The way my husband does it is using Brita-filtered water and heating it in the (700-watt) microwave for a minute and a half. It's super easy—and hey, if you want a good filter suggestion, check out the thread a few down from this one!
posted by limeonaire at 6:02 PM on April 3, 2012

Oh, and he puts in a packet of that saline-solution stuff once the water's hot. It helps it not burn when you put it up your nose!
posted by limeonaire at 6:04 PM on April 3, 2012

What everyone else has said--this is an incredibly rare occurrence, and not something you should be seeking prophylactic treatment for.

My partner is still concerned about it, because he's unwilling to accept the miniscule risk involved when getting the parasite is guaranteed to be fatal, so he's started keeping a big container of distilled water (the kind that dispenses easily from a tap at the bottom, like a tea jar or Gatorade cooler) in the bathroom to fill his sinus rinse bottle with. He decided on this because it's more convenient than boiling the water every morning, even though it means using a cold sinus rinse.
posted by rhiannonstone at 6:04 PM on April 3, 2012

I'm sorry you've been so upset about this! Everyone's right, there were only 32 cases between 2001 to 2010 and nearly all of those were from swimming. So the risk is incredibly small, but it's definitely something that really sticks in people's minds. Plus I don't know about you, but for me Sudafed + lack of sleep is a recipe for anxiety. Hope you get a good night's sleep tonight and feel better, but if you are still concerned, you can always contact CDC at 1-800-CDC-INFO or by email ([e-mail]).

The next time you use a neti pot, maybe using sterile water would make you feel less anxious. In general it's always good to pay attention to hygiene when rinsing your sinuses, so that you don't introduce bacteria or other pathogens into them while rinsing. Using boiled or distilled water is good, as is making sure your neti pot gets cleaned and dried between uses. I've actually switched to the premade sterile saline nasal rinses that you can buy at the drug store. It's kind of the same situation that contact lens users were in during the 80s. People used to use salt tablets with tap water, but after several clusters of eye infections most people switched to sterile premade saline solution. I figure if I'm going to be forcing water into my sinuses, I'd like it to be sterile.
posted by k96sc01 at 7:18 PM on April 3, 2012

k96sc01, you shouldn't be forcing water into your sinuses. This is a lesson I learned the hard way: proper neti pots take some patience, at least when you get used to having water flow in one nostril and out the other, moreso if there's some gunk in the way.

And I stress "some" gunk. Do not try to use a neti pot if your nose is clogged, unless you want to flush the one good nostril out through your mouth. And the directions for this commercial neti pot and nasal irrigation solution warn against using if you have an ear infection. Also be careful when draining out the last of the water. You can lightly blow both of your nostrils at once. Do NOT blow your nose with one nostril shut, as if you could get a sinus or ear infection. I had a minor fever for a few days, after getting impatient and trying to blow more water out of my nose than was naturally flowing out.

Spend time with your head down, and tilt your head back and forth to get water out of your sinuses. I do this over a toilet, as I have a harder time trying to drain out over a sink. I also look straight up, letting some of the water drain down into my mouth, then tilting my head back down.

It's not always pleasant, but when you get the hang of it, neti pots can really help some nasal issues.
posted by filthy light thief at 2:56 PM on April 5, 2012 [1 favorite]