You can read more about Dr. Tolan’s impressive credentials below.

To summarize, Dr. Tolan is the real deal, and is perhaps the best-qualified person to answer my question:

Will nasal saline rinses result in death from brain-eating amoeba??

The main points from that conversation are these:

• Using a Neti pot or other methods of doing nasal saline rinses won’t cause your death by brain-eating amoeba.
• Just to be safe, for nasal saline rinses, simply use boiled tap water, or simply buy a jug of distilled water.

There you have it. For the rest of what Dr. Tolan had to say, read on …

Image: Brain-eating amoeba, N. fowleri (image credit: CDC). The central B&W image is a "phase-contrast" from under the microscope; the pics on either side are stained brain tissue showing infection with amoeba ("Amoebic Meningoencephalitis")

As a world-renowned expert on infectious diseases of the central nervous system, I called Dr. Tolan to ask his opinion about the recent cases in the media, specifically cases of “brain-eating Amoeba” – Amoebic Meningoencephalitis (AM), linked to use of a Neti pot.

I wanted to get to the bottom of this because I have colleagues, patients and their families (and readers of this blog), asking me whether it’s safe to be doing nasal saline rinses at all. Are we risking Amoebic Meningitis by doing nasal saline rinses??

There are two reports that I am familiar with, and both have received a lot of attention on the web, in social media like Facebook and Twitter.

Here is what Dr. Tolan had to say:

Boogordoctor: Dr. Tolan, thank you so much for taking time to offer your expert opinion about Amoebic Meningoencephalitis, from Neti pot use.

Dr. Tolan: My pleasure, Dr. Faust, glad to help.

Boogordoctor: Are you familiar with the recent cases of AM linked to Neti pot use?

Dr. Tolan: I am not, since they have not yet been confirmed by the CDC (Centers for Disease Control and Prevention). I have not seen them reported in the MMWR (Morbidity and Mortality Weekly Report). Don’t believe everything that you read on the internet. Many things are sensationalized to boost readership.

On the other hand, there are some important points to make using these examples.

Boogordoctor: Such as?

Dr. Tolan:

• The first point for your readers to keep in mind is that AM is incredibly rare. There are usually about 3 cases per year in this country annually.
• Most of those cases occur after swimming in ponds in warm environments – Southern states.
• The next point to keep in mind is that the organism responsible for those cases is usually Naegleria fowleri. It is important to point out that N. fowleri is EVERYWHERE in our environment, including our municipal water supply. It is ubiquitous.
• N. fowleri is difficult to kill, especially in environments where it is happiest – in the South, for example. There is simply no way to chlorinate our water supply in the South to levels that will eliminate all N. fowleri. The farther South you go, the warmer the water, the greater the risk of having N. fowleri in your tap water (and ponds, lakes, etc.).
• My recommendation is, for people using Neti pots or other methods of nasal saline irrigations, USE DISTILLED WATER, or BOILED tap water. Distilled water is not absolutely sterile, but will have much lower risk of containing amoeba species than tap water.

Regarding these cases of AM related to Neti pot use that are reported online, I will be interested to see what the CDC investigators tell us. Regardless, it is important to emphasize how rare these cases are in this country.

Boogordoctor: Dr. Tolan, that is great advice, and supports what I have been telling people: use distilled water for your Neti pot or squeeze-bottle for nasal saline rinses – whether you use a store-bought salt preparation or make your own from a recipe.

Again, thanks so much for lending your expertise.

Dr. Tolan: You are very welcome, call any time.

My take on this: if you are doing nasal saline rinses, you have little to fear from Amoeba, as long as you are using distilled water or boiled tap water. You have a much (much) higher risk of exposure to N. fowleri by swimming in lakes or ponds in Southern states.

Conclusions

• It’s not about the Neti pot, or even about nasal rinses.
• It’s about the water.
• Just be sure your water is safe. How?
• Use distilled or boiled water for your nasal rinses!

The Life-Cycle of N. fowleri

The image below shows how N. fowleri (and some other amoeba species) get into our brains: simply swimming in ponds or lakes with high concentrations of amoeba (think warm, Southern states), can result in amoeba reaching our noses; they crawl through our “olfactory neuroepithelium” – that part of our noses that give us the sense of smell), and enter our brains that way. Bad news!

Image: Life-cycles of amoeba

Please leave a comment / reply and let us know how you are doing nasal saline rinses.

And thanks for visiting!

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About Dr. Robert Tolan

Dr. Tolan is a world-renowned expert on infections of the central nervous system.

He is currently Chief, Division of Allergy, Immunology and Infectious Diseases, The Children’s Hospital at Saint Peter’s University Hospital, New Brunswick, New Jersey and Clinical Associate Professor of Pediatrics, Drexel University College of Medicine, Philadelphia, Pennsylvania.

He earned a Master’s Degree in Microbiology before earning his Medical Degree at Washington University School of Medicine. Following his training in Pediatrics, he pursued advanced training and research in Infectious Diseases at Washington University/St. Louis Children’s Hospital. He is board certified in Pediatrics by the American Board of Pediatrics, and also the Sub-Board of Infectious Diseases. He teaches at Drexel University, where he is Associate Clinical Professor.

Dr. Tolan’s research is funded by the NIH; he studies various infections in children and infants, and his list of publications is longer than I am tall.

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Resources:

http://new.dhh.louisiana.gov/index.cfm/newsroom/detail/2332

http://www.medicalnewstoday.com/articles/239422.php – be sure to read the comments: this isn’t about Neti pots! It’s about the WATER.

http://health.yahoo.net/articles/flu/neti-pot-deaths-linked-brain-eating-amoeba-tap-water

http://phoenix.about.com/od/health/qt/Ameba.htm

http://www.wwltv.com/news/health/Doctors-explain-cause-of-brain-eating-amoeba-128043523.html

Image Credit:  All images from the CDC (Centers for Disease Control and Prevention) Image Library, in the Public Domain.

_______________________________________

Hi, I’m Russell Faust, author of this medical education blog.

Let me know what topics are important to you and your child’s respiratory health.

Join the conversation by leaving a comment / reply below, or email me any time.

Thanks for visiting, see you here later.

In invite you to subscribe to this blog (it’s FREE).

Be sure to type in your best email address (the one that you actually use).  You will then receive an email with a “confirmation link” – click on that link to get weekly updates from this blog in your email.

It’s free, it’s convenient, it’s an easy way to stay up-to-date on information to keep you and your family healthy.  You can un-subscribe at any time.

Stay informed.

Stay healthy.

Until next time, remember … you can pick your friends, and you can pick your nose, but you can’t pick your friend’s nose (unless you’re a boogor doctor ;~D)

I group humidifiers roughly into 3 piles:

1- Evaporative

This type of humidifier uses a cloth or mesh belt that acts like a wick: it dips down into a vat of water, then rotates up so that a fan can blow across it and evaporate the water off the belt into the air. Effective way to humidify the air, but these have some downsides.

2- Ultrasonic

This is the so-called “cool mist” humidifiers. These use a small ultrasound transducer to vibrate a stream of water so that the water vaporizes. Effective, inexpensive. These have their own special disadvantages as well.

3- Steam Vaporizer

These are little more than a pot of water with a heating element that boils the water to produce steam. Very effective, but of course, they have their own issues, too.

Most of us are also familiar with the humidifier on our central heating system, if we have forced-air heat. The only thing to keep in mind with those is that the system should be cleaned. How often? I have no idea. The thing to do is to read the instructions for proper maintenance. I have asked several people if they have ever cleaned theirs, and the standard response has been “what?”.

There is another type of humidifier that I have no experience with – the “impeller” humidifier. These produce a cool mist using a rotating disk. I suspect they may have issues similar to the Ultrasonic type of humidifier (see below), but I have no personal experience with them.

So, after years of using these other 3 types of humidifiers in my home, including experience with multiple belt-evaporative humidifiers growing up in my parent’s home, here is my own assessment. My apologies to humidifier manufacturers. No doubt some will take offense at my admittedly simple and anecdotal comparison of these types of humidifiers, but this is based on decades of personal experience, and experience with each of these types of humidifier.

My Recommendation

My recommendation of Steam Vaporizer Humidifiers is based largely on 1 observation:

Very simply put, we humans are pretty lazy (let’s be generous and call it “forgetful”) when it comes to regular cleaning of things like a humidifier. Maybe it’s just me.

The fact is, unless we clean humidifiers on a regular basis – say, every 2-3 days –  the slimy crud that builds up in the water canister can contain viruses, bacteria, and mold (the worst). For humidifier types (1) and (2), that can be a huge problem.

These types of humidifier can spew into the air ANYthing that is in the water container. And there is nothing about their mechanism that kills “things” that might be in that water.

Contrast that with the Steam Vaporizer type of humidifier. The process of making steam (boiling the water) DOES kill anything that might be in that water container.

This can be very beneficial when we consider the “forgetful” nature of humans, for example, when we “forget” to clean out our humidifier water container (again), for weeks at a time.

The other huge advantage is the low purchase price of Steam Vaporizer humidifiers. We have 5 or 6 of these in our home, and never paid more than $15 for one; some were on sale for $10!!

Regardless of the type of humidifier that you decide to use, keep it clean. You don’t want to use a humidifier thinking that it is a remedy for your child’s sinusitis, only to find out that they contracted a fungal sinus infection from the mold in your humidifier!

How to Keep it Clean

Clean with vinegar – distilled white vinegar – every three days. Be sure to rinse thoroughly.

What Water to Use?

Ideally, you will use distilled or demineralized water. Pretty inexpensive from your regular grocery store.

How Humid Should I Make It?

The ideal humidity level for your home is between 30 and 50 percent.

How Will I Know?

Ask at your hardware store for a “hygrometer” or humidistat. It looks a little like a thermometer, and measures moisture in the air.

Too High / Too Low

You probably already know about humidity that is too low. Winter time nose-bleeds due to drying of the nasal lining.

Humidity that is too high can be a huge problem if you have allergies or asthma. Dust mites love high humidity. Molds love high humidity. Their allergens can trigger asthma exacerbations and allergies.

Final Tips

• Keep your home humidity between 30 and 50 percent!
• If you use a humidifier in a bedroom, turn the humidifier off during the day; open up the bedroom to air it out.
• Don’t let the area around the humidifier remain moist – the wall or carpet may become wet. That is a fine environment for mold to grown.
• Consider placing your humidifier on a plastic tray that can be cleaned off (vinegar).

Final words of CAUTION:

• Steam Vaporizers boil water to produce humidity. The heating element will be HOT. Keep these humidifiers out of reach of your little boogorheads!
• Many people like to use some sort of “medicated” or “mentholated” rub to help decongest little noses. These “rubs” do NOT decongest the nose. Worse: many of the “rubs” contain ingredients that are TOXIC – even lethal – to infants!!For examples, “Camphor-phenique,” Vicks VapoRub, and Bengay, can cause fatal poisoning if swallowed.  Topical camphor can also be absorbed directly through mucus membranes (like the nose), so NEVER use it around the nose or eyes.

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Resources

This Blog:

• Anatomy of Nose Bleeds in Children:
  http://www.boogordoctor.com/2010/03/anatomy-nose-bleeds/
• Your Child’s Nose is Bleeding: What To Do Right Now:
  http://www.boogordoctor.com/2010/03/nose-bleeds-in-children-what-to-do/
• 8 THings You Can Do To Reduce Your Child’s Nose Bleeds:
  http://www.boogordoctor.com/2010/03/6-things-you-can-do-to-reduce-your-childs-nose-bleeds/
• 8 Reasons To See a Physician For Your Child’s Nose Bleeds:
  http://www.boogordoctor.com/2010/03/8-reasons-to-see-a-physician-for-your-childs-nose-bleeds/
• What to Look for in a Humidifier: the Good, the Bad, the Ugly:
  http://www.boogordoctor.com/2010/03/what-to-look-for-in-a-humidifier-the-good-the-bad-the-ugly/
• Nasal and Sinus Anatomy (and Physiology):
  http://www.boogordoctor.com/2010/04/nasal-and-sinus-anatomy-and-histology/
• 8 Dangerous Complications of Sinusitis, but 3 That Can Kill:
  http://www.boogordoctor.com/2010/04/8-complications-of-sinusitis-3-that-can-kill/
• Saline Sinus Rinses: What Good Are They, Part 4/4:
  http://www.boogordoctor.com/2010/05/pediatric-sinusitis-asthma-saline-sinus-rinses-what-good-are-they-44/
• 8 Principles to Control Your Child’s Sinusitis:
  http://www.boogordoctor.com/2010/06/pediatric-sinusitis-chronic-allergic-rhinitis-asthma-natural-remedies/
• Dust Mite Review: 12 Steps to Reduce Dust Mites in Your Home:
  http://www.boogordoctor.com/2010/09/dust-mites-pediatric-asthma-allergic-rhinitis-sinusitis/
• Rhinitis of Pregnancy – What It Is, What To Do About It:
  http://www.boogordoctor.com/2011/03/rhinitis-of-pregnancy-what-it-is-what-to-do-about-it/

_______________________________________

Hi, I’m Russell Faust, author of this medical education blog.

Image: Russell Faust

Let me know what topics are important to you and your child’s respiratory health. Join the conversation by leaving a comment / reply below, or email me any time.

Thanks for visiting, see you here later – we will be going into more detail on how to rid your children of allergies, rhinitis, sinusitis, and other chronic aero-digestive inflammatory disorders on this site.

If you are interested in these topics, please click here to subscribe to this blog (it’s FREE).

Be sure to type in your best email address (the one that you actually use).  You will then receive an email with a “confirmation link” – click on that link to get weekly updates from this blog in your email.

It’s free, it’s convenient, it’s an easy way to stay up-t0-date on information to keep you and your family healthy.  You can un-subscribe at any time.

Stay informed.

Stay healthy.

Until next time, remember … you can pick your friends, and you can pick your nose, but you can’t pick your friend’s nose (unless you’re a boogor doctor ;~D)

I usually  try to take a poll down once a couple hundred results are recorded. This poll has reached over 290 results, and the results were not what I had expected:

What Methods Do We Use for Nasal Saline Rinses?

51% still use the Neti pot, as you can see from the figure, the majority of us.

42% use the Squeeze-bottle – from Nasopure, NeilMed, there are several available (more on this below).

4% still use the Suction-bulb! That is a surprise.

For those of you who don’t know what that is, think back to those blue or green rubber-like bulbs that many people use to suction a baby’s nose out.

There were a couple of wise-alecs who claimed to use their garden-hose to rinse their noses out!! Nice image.

boogordoctor Nasal Saline Poll Results

What Are Saline Nasal Rinses Good For?

I have reviewed nasal saline rinses elsewhere on this blog, but let’s briefly review their value. Saline Nasal Rinses are good for those with:

• allergic rhinitis
• rhinitis from any cause (chemical rhinitis, say in a swimmer from chlorinated pool)
• sinusitis – acute or chronic
• simple viral URI syndrome
• asthma – optimizing nasal hygiene will benefit your lungs!
• otitis (ear infections) – again, optimal nasal hygiene reduces ear infections
• anyone who is exposed to air pollutants – either indoors or outdoors
• anyone with reflux that contributes to otitis or rhinitis/sinusitis
• once you have achieved a healthy nose – best way to keep it that way!

Whatever is bothering your nose, this will rinse it away. Think of nasal saline rinses like a car-wash for your nose – rinse off the dirt: mold, virus, bacteria, particulate pollutants, chemical toxins, etc.

You get the idea. Basically, ANY “Itis” or inflammatory disorder of the respiratory tract will benefit from optimal nasal hygiene.

Why is that?

Read about the Unified Airway Model to find out:

• What is the Unified Airway?
• It’s All Connected: the Unified Airway

Let Me Make A Recommendation

If you are doing nasal saline rinses …

First: stop using a suction-bulb. Primitive. Too risky for nasal trauma, likely to cause nose-bleeds. The goal here is to be nice to your nose, not to hurt it.

If you are using a Neti pot, time to switch to a squeeze-bottle.

There is an easier way to rinse your nose with saline – especially if you are doing saline rinses with a child.

For those of you who are struggling with the Neti pot to rinse a child’s nose, you know what I mean. Rinsing a child’s nose can be enough of a wrestling match without also struggling to get the positioning just right.

There is now a “Nicer Neti,” as the Nasopure bottle is referred to.

Of all the possible methods for doing nasal saline rinses, this is by far the easiest. And their bottle is BPA-free!

No odd head/neck contortions to get the positioning just right.

And if you have children who need nasal saline rinses, be sure to check out the videos on the Nasopure site: they show 3- and 4-year-old children easily doing nasal saline rinses. By themselves. Without the wrestling match. It’s that easy.

For Transparency:  I have NO financial or other arrangements with Nasopure.com or Dr. Hana Solomon. It is simply that this is the easiest system that I have found (and I have used them ALL), and the one that I use personally for myself and my own children, and the one that I recommend for my patients in clinic.

For those who might be interested in signing up for FREE email updates from this blog – no SPAM ever – you will receive a decent discount for everything on the Nasopure site.

If you or your child(ren) struggle with rhinitis or sinusitis, Dr. Hana’s book is a must-have:

Clearing The Air One Nose at a Time, by Dr. Hana Solomon.

Readers of this blog will recognize this as the book that I was intending to write!

_________________

Thanks for visiting.

Thanks especially to Kim, Jenna, and Lisa, for taking the time to leave comments, ask questions, and most importantly – to share their experiences with all of us. Your contributions to our little community of boogor-heads is greatly appreciated!

I appreciate your comments and questions.  Keep ‘em coming.  Please, “be excellent to one another.”

I invite you to subscribe (it’s FREE) to this blog for weekly updates – you won’t be swamped by updates, I simply cannot write for the blog everyday.

Click here to receive free weekly updates: (http://eepurl.com/FGnP)

Type in your best email address (the one you actually use).

Your email is safe - will never be shared or sold. Ever.

Click here to read our Privacy Policy: http://wp.me/PR4iB-r

When the confirmation email from boogor doctor arrives, click on the link to give your okay to receive free weekly updates, occasional book reviews or product reviews, occasional discount-coupons for products that I use (not affiliates), all without needing to visit the website.

It’s free, it’s convenient. No ads. No spam. You can un-subscribe at any time. How cool is that?

Stay Informed.

Stay Healthy.

Best of health and success to you and your families.

Until next time, remember … you can pick your friends, and you can pick your nose, but you can’t pick your friend’s nose (unless you’re a boogor doctor :~D)

I recently thanked y’all for making my first ever blogging experience a good one. I have met many friends through this blog, and according to emails and comments, have helped some children (and a few adults) reduce or eliminate symptoms from their respiratory disorders.

My mission is to educate, and help families make informed choices regarding the health of their children.

From my perspective, this blog – boogordoctor.com – has been a success. It has been a great year, thanks to all of you – the readers of this blog site, and subscribers of email updates.

I want to especially thank those of you who take the time to leave comments or email me with comments and questions. I really appreciate your commitment to our little community of “boogor heads”.

In case you are new to this site, or joined us only recently, here is a list of the Top 15 Most Popular articles over this first year (most popular first):

8 Dangerous Complications of Sinusitis, But 3 That Can Kill

Illustrated review of the complications of sinusitis, categorized into intracranial, orbital, and local.

Nasal and Sinus Anatomy (and Histology)

Extensive illustrated review of nasal and sinus anatomy. Helpful foundation for understanding your child’s sinusitis.

Top 10 Food Allergens

A review of the 10 most common food allergies, and what to do if you suspect that your child has food allergies.

Anatomy of Nose Bleeds in Children

An illustrated review of the anatomy of nose bleeds in children.

Saline Sinus Rinses

The last in a series of how-to articles on saline nasal rinses for managing rhinitis and sinusitis: recipes, things that can be added to improve results, how often to do the rinses, etc.

TESTING: CT Imaging the Sinuses

Illustrated guide to Sinus CT scans: how to “read” a sinus CT image.

Reflux and Otitis: Does GERD Cause Ear Infections?

Illustrated review of the medical evidence for the role of reflux in ear infections, and how to use that information for you child.

3 Year Old Boy Hospitalized for Sinus Infection: Simple Cure

Illustrated case review of a young boy who was hospitalized for severe chronic sinusitis, and how we saved him some major surgery.

8 Choking Hazards for Babies and Infants

Illustrated review of food choking hazards for little tykes, how to minimize the risk, and what to do if you suspect that you infant has choked on something.

Honey: Nature’s Antibiotic

Review of nature’s strong antibiotic – honey: why it is such a strong anti-bacterial, and how to use that information.

Your Child’s Nose is Bleeding: What to do Right Now

Brief review for managing your child’s nose bleed.

Use Plants to Purify and Detoxify Your Air

An interesting story about how a man dying from severe asthma in India, and some NASA research, found that plants can purify our air.

It’s All Connected (Unified Airway and Sinusitis, Otitis, Rhinitis, Asthma, …)

How the Unified Airway model explains the connection between reflux, ear infections, sinusitis, and many other disorders of the aero-digestive tract.

8 Principles to Control Your Child’s Sinusitis

8 simple steps that can help you eliminate your child’s sinusitis.

What is the Unified Airway?

Illustrated explanation of the Unified Airway Model.

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Image Credit:

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Thanks for visiting.

I appreciate your comments and questions.  Keep ‘em coming.  Please, “be excellent to one another.”

I invite you to subscribe (it’s FREE) to this blog for weekly updates – you won’t be swamped by updates, I simply cannot write for the blog everyday.

Click here to receive free weekly updates: (http://eepurl.com/FGnP)

Type in your best email address (the one you actually use).

Your email is safe - will never be shared or sold. Ever.

Click here to read our Privacy Policy: http://wp.me/PR4iB-r

When the confirmation email from boogor doctor arrives, click on the link to give your okay to receive free weekly updates, occasional book reviews or product reviews, occasional discount-coupons for products that I use (not affiliates), all without needing to visit the website.

It’s free, it’s convenient. No ads. No spam. You can un-subscribe at any time. How cool is that?

Stay Informed.

Stay Healthy.

Best of health and success to you and your families.

Until next time, remember … you can pick your friends, and you can pick your nose, but you can’t pick your friend’s nose (unless you’re a boogor doctor :~D)