Brain eater: After boy's death, aunt urges safer swimming

For decades, brain-eating organisms were the stuff of legends– or of legendarily hot places like Texas, Arizona, and Florida. But the killer amoeba known as Naegleria fowleri really did invade and consume a boy's brain right here in Virginia. It happened last summer, and Bonnie Strickland knows all too well.

A lifetime resident of the Henrico County community of Glen Allen, Strickland lost her 9-year-old nephew in August in a case that sent shudders through the Commonwealth. She says it happened several days after the boy finished a week-long fishing camp.

"He went out for ice cream with his grandmother and my sister-in-law that Sunday night," recalls Strickland. "He complained of a slight headache."

The next morning, his mother tried to revive the listless boy with a bath, but he went silent when his mom asked him to climb into the tub and seemed confused when she asked him to get dressed.

"None of it was registering with him," recalls Strickland. "He went from healthy and active to not even recognizing any of us in a day. "

When she rushed over to an intensive-care-unit, Strickland says she'd never heard of the single-celled organism that feeds on cerebral fluid and gray matter. As medical personnel and family members pleaded for the boy to speak, the most coherent thing he could do was recite his ABCs.

"He was brain-dead a couple of days later," says Strickland.

On Friday, August 5, Christian Alexander Strickland was taken off life support. Now his aunt wants others to know what scientists from the Centers for Disease Control and Prevention have been saying: that the single-celled organism is ubiquitous in soil and fresh water– but that swimmers can use a finger-pinch, nose plugs, or face-covering goggles to keep it out.

"The CDC says it's in every type of water body in Virginia," says Strickland. "It's in all of them– deep water and shallow water."

Research indicates that in the hot days of late summer, when water temperatures exceed 80 degrees, N. fowleri emerge from the cysts in which they have been harmlessly hibernating. Ironically, even in their potentially-fatal stages, the amoeba can be safely swum among– and even ingested. The trouble starts when contaminated water is forced into the sinus cavity, something that has reportedly turned fatal for several young southern water-skiers and wake-boarders– and to one little boy who just loved fishing.

As family members pieced together the final days of Christian Strickland, they were told that he'd been dunked while horse-playing with other kids at the fishing camp. In the wake of his death, the Virginia Department of Health reportedly asked the camp owner not to reveal which waterways campers had visited. While such silence may provoke outrage from worried parents, it makes sense to Rebecca LePrell, the Department's director of environmental epidemiology.

"We certainly want parents and children to enjoy swimming in the James River and other fresh bodies of water in Virginia," says LaPrell, noting that labeling one water body as dangerous might mislead the public.

"Environmental factors play a big role," says LePrell, noting that like the fresh waters they inhabit, populations of N. fowleri tend to ebb and flow. "Water quality conditions can change on a daily basis, and the growth of the organism is tied to the changing water conditions."

The year 2007 was a sort of shark-summer for N. Fowleri because there were six confirmed American deaths, about double the average. That was the year that Virginia's health commissioner issued a warning that prompted the Lake Anna Civic Association to plunk down $10,000 to invite a team of Virginia Commonwealth University researchers for water testing. What the VCU team found might be called chilling– except that chilling would be the wrong word for a nuclear reactor-heated lake.

"Thermal enrichment of water can cause proliferation of amebae especially at temperatures of 86°F to 111°F," wrote the researchers. Their tests confirmed N. Fowleri in 9 of 16 Lake Anna sample sites and took heed of what the Civic Association had warned: that 99 percent of the water between the power plant and the dam gets recirculated by the the cooling pumps of the North Anna power plant.

"Amebae that are present in one location today," the researchers warned, "may be at another location tomorrow."

While Lake Anna's hot spots may serve as an unnaturally warm breeding ground, such N. fowleri-friendly pockets can occur naturally– when water stagnates, runs shallow, or churns up soil from the bed of the waterway, according to the Health Deparment's LePrell, who downplays the benefits of testing.

"We have to assume," she says, "there's always a low risk of infection."

If the risk is low, the fatality rate is high. Of the 100+ American cases recorded since the mid-1960s, only one person survived (a girl reportedly diagnosed quickly and bombarded with drugs in 1978). In the 10-year span from 2001 to 2010, all 35 Americans confirmed with N. fowleri– including a pair of adult Louisiana neti-pot users– died. But some say there could be many more victims.

An early 1970s Medical College of Virginia review of over 16,000 supposed meningitis deaths found five previously undisclosed cases. But it's not just southern waters. There's are two grieving families in Minnesota.

Far north of the usual hot spots, the family of the late Hailee LaMeyer didn't order an autopsy for their 11-year-old daughter who died after a July 4, 2008 swim in a shallow pond. A nurse, Hailee's mother has since gone public with her blame of N. fowleri.

"Never in our lives could we imagine that such an innocent young girl, doing something so innocent as swimming in the lake, would be infected by this monster amoeba and die just days later," Heidi LaMeyer wrote for Minnesota Public Radio.

Most of the victims are little kids, like 7-year-old Kyle Lewis of Texas. Kyle's father, Jeremy Lewis, recalls the August morning in 2010 when, after his son's two headache-ridden nights in a hospital, the attending doctor said the boy was probably just suffering from viral meningitis that would run its course without permanent harm. As the family began making plans to leave the hospital, Lewis showed the doctor a text message from his mother-in-law asking if anyone had considered N. fowleri.

"The doctor said, 'Mr. Lewis, if your son had Naegleria fowleri, he'd already be dead."

Less than 24 hours later, Kyle Lewis was dead. Mr. Lewis says that the fact that only four days typically elapse between the onset of flu-like symptoms and irreversible brain damage spurred him to create the KyleCares Foundation to spread awareness.

In Henrico, Bonnie Strickland recently joined friends and family at the dedication of new playground equipment and a memorial tree at Glen Allen Elementary School, where Christian would have been a third-grader this year. Strickland, who speaks out to educate parents, notes that her nephew's killer amoeba might never have been revealed but for the boy's open-minded doctor.

"It's brushed aside as rare," says Strickland. "But it doesn't feel rare to me."