A Missouri resident is fighting for life in the intensive care unit after contracting one of the rarest yet most deadly infections known to medicine: Naegleria fowleri, often referred to as the brain-eating amoeba. The case, traced back to waterskiing on the popular Lake of the Ozarks, has sparked renewed questions about how people can be exposed to this microscopic threat—and whether everyday activities like showering or drinking tap water could carry risks.Naegleria fowleri is a single-celled organism that lives naturally in warm freshwater such as lakes, rivers, and hot springs. It thrives in temperatures between 77°F and 115°F, meaning it is more commonly found in waters during hot summer months when levels are low and temperatures rise.Despite its frightening nickname, the amoeba doesn’t “eat” brains in a literal sense. Instead, when water contaminated with N. fowleri enters through the nose—often during swimming, diving, or watersports—the organism can travel to the brain. Once there, it causes primary amebic meningoencephalitis (PAM), a devastating infection that destroys brain tissue.The U.S. Centers for Disease Control and Prevention (CDC) describes PAM as “almost always fatal.” In fact, the fatality rate exceeds 97%, with just four survivors out of 167 confirmed cases in the United States between 1962 and 2024.How Does the Infection ?The key factor is nasal exposure, not ingestion. Simply drinking contaminated water does not cause illness. The amoeba must enter through the nose and reach the brain’s olfactory nerves. This is why activities like:Waterskiing, wakeboarding, or diving in warm freshwaterSwimming in poorly maintained pools or splash padsUsing contaminated tap water for nasal rinses or Neti potsare considered riskier than simply consuming the water.Cases have even been linked to routine activities such as bathing or showering in places where water systems were contaminated. While rare, this route of exposure is considered possible if water is forced high into the nasal cavity.What Are the Symptoms?Symptoms usually develop within 3 to 12 days after exposure. They begin subtly, resembling common viral illnesses, but progress rapidly:Early: headache, fever, nausea, vomitingLater: stiff neck, confusion, hallucinations, seizuresAdvanced: coma and death, typically within five days of symptom onsetThis rapid progression makes timely diagnosis extraordinarily difficult. By the time PAM is suspected, the infection is usually advanced.How Rare Is Brain-Eating Infection, Really?The good news is that Naegleria fowleri infections are extremely rare. In the U.S., an average of just two to three cases per year are reported, despite millions of people swimming in warm lakes and rivers.Globally, however, cases have been documented in more than 40 countries. A review up to 2018 found 381 cases worldwide, with a shocking 92% mortality rate. The highest number of cases were recorded in the United States, Pakistan, Mexico, and India. Australia, too, has documented outbreaks, particularly in regions with warmer climates.Is It Safe To Drink Tap-Water?One of the most unnerving aspects of Naegleria fowleri is when it shows up in municipal water supplies. In 2024, officials in Queensland, Australia, confirmed its detection in drinking water systems in the towns of Augathella and Charleville. So should Americans be worried about catching the infection from their tap? Here’s the science:Drinking contaminated water does not cause infection. The digestive system neutralizes the amoeba.Nasal exposure is the risk. Taking a shower, using a Neti pot, or even children playing with hoses or sprinklers could theoretically force water up the nose.Proper water treatment works. Adequate chlorination and maintenance of municipal systems eliminate the risk.In the U.S., isolated incidents linked to Neti pots used with unboiled tap water have been reported, underlining why the CDC stresses that nasal rinses must use distilled, sterile, or previously boiled water.In Missouri, the patient’s exposure was likely tied to high-speed watersports on Lake of the Ozarks during a spell of hot weather. Waterskiing increases the risk because it forces water deeply into the nasal passages.Officials have not reported other cases connected to the lake, emphasizing just how rare the infection is, even in favorable conditions. Still, the case has heightened awareness and anxiety, particularly as climate change increases the likelihood of warmer water temperatures in many regions.How Can You Protect Yourself?There is no guaranteed way to eliminate risk, but health experts offer several practical precautions:Avoid swimming in warm freshwater during heatwaves or when water levels are low.Keep your head above water in lakes, rivers, or hot springs.Don’t dive or jump in. Water forced up the nose is the main risk factor.Use nose clips if you plan to submerge in freshwater.Stick to saltwater or properly chlorinated pools. The amoeba cannot survive in these environments.Use sterile or boiled water for nasal rinses. Never rely on straight tap water.The idea of a “brain-eating amoeba” is terrifying, but public health experts emphasize that the odds of infection are extraordinarily low. Millions of people swim in lakes every year without incident.The far greater concern, they say, is that when cases do occur, they are often misdiagnosed as bacterial meningitis until it’s too late. Public awareness, while important, should be balanced with the reality that preventive measures—like avoiding nasal exposure to untreated warm freshwater—are usually enough.The Missouri case is a tragic reminder of just how deadly Naegleria fowleri can be, but also how vanishingly rare it is. You cannot catch it by drinking tap water, and routine showers in well-maintained municipal systems are safe. The risk only arises when contaminated warm freshwater is forced into the nose.For now, experts say vigilance, not panic, is the right response. With simple precautions, Americans can keep enjoying summer lakes and rivers while understanding the small but serious risks that come with them.