Two cases of young patients who developed brain-eating amoeba infections with very different outcomes led AdventHealth scientists to develop a new method for testing for the three most common life-threatening amoebas found in fresh water, the health system announced on its latest AdventHealth News Briefing.
The new test reduces the time for a result from potentially days to as little as five hours, a significant improvement for an infection in which every second counts.
“There are just no words to express how important this is,” said Steve Smelski, who, along with his wife, Shelly, started the Jordan Smelski Foundation for Amoeba Awareness after their 11-year-old son died in 2014. “Many people don’t consider this diagnosis until it is too late.”
Jose Alexander, microbiologist and medical director of the microbiology, virology, and immunology department for AdventHealth Central Florida, said his team embarked on a mission to develop the test after Jordan Smelski’s case and that of another patient two years later who became one of the rare survivors of amoeba infection after swimming in fresh water.
“We understood the critical importance of a rapid and reliable diagnostic tool, but it wasn’t and still isn’t commercially available,” Alexander said. “Our experience with the previous cases and the lack of testing for identifying the presence of free-living amoebas in spinal fluid led us to start a journey of research and trial and error in looking for the best approach.”
The process of developing the test took years, including a pause because of the COVID-19 pandemic. The teams and equipment used to analyze amoeba samples were, for a period of time, entirely devoted to coronavirus testing.
But by the spring, Alexander said, COVID-19 infections waned enough for the teams to resume verifying the test, and it officially became available this summer to physicians suspicious of such an infection. Like the now well-known PCR test for COVID-19, the new test detects genetic material from the amoeba, though a sample of cerebral spinal fluid rather than an easier nasal swab must be used.
Amoeba infections can occur after swimming or other exposure to untreated fresh water such as lakes or ponds (chlorinated swimming pools do not pose a risk). The microscopic organisms can make their way through a patient’s nose to the brain, where an infection can take hold and cause the patient to decline rapidly.
The most common amoebas, Naegleria fowleri, Balamuthia mandrillaris, and Acanthamoeba spp. can cause neurological symptoms similar to other forms of encephalitis such as fever, headache, and stiff neck.