Sinus Rinsing & Neti Pots | Prevention & Control | Naegleria fowleri | CDC

Sinus Rinsing & Neti Pots | Prevention & Control | Naegleria fowleri | CDC

Sinus Rinsing & Neti Pots

Neti pots look like little teapots with long spouts and are used to rinse the nasal passages with a saline (salt-based) solution. They have become popular as a treatment for congested sinuses, colds, and allergies, and for moistening nasal passages exposed to dry indoor air ^{6, 7}.

Very rarely, Naegleria fowleri infections have been reported when people submerge their heads ^{1, 2} or irrigate their sinuses (nose) ^3-5 using contaminated tap water. If you are making a solution for irrigating, flushing, or rinsing your sinuses (for example, by using a neti pot, sinus rinse bottle, or other irrigation device), use safe water to protect yourself.
Take at least one of these actions to lower your risk of becoming infected:

• Boil: Use water that has been previously boiled for 1 minute and left to cool.
  • At elevations above 6,500 feet, boil for 3 minutes.
• Filter: Use a filter designed to remove some water-loving germs.
  • The label may read "NSF 53" or "NSF 58."
  • Filter labels that read “absolute pore size of 1 micron or smaller” are also effective.
• Buy: Use water with a label specifying that it contains distilled or sterile water.
• Disinfect: Learn how to disinfect your water to ensure it is safe from Naegleria.
  • Chlorine bleach used at the right level and time will work as a disinfectant against this germ.

If you are making a solution for irrigating, flushing, or rinsing your sinuses (for example, by using a neti pot), use the right kind of water to protect yourself.

Rinse the irrigation device after each use with safe water, and leave the device open to air dry completely.
For more information on neti pots and other nasal rinsing devices, see FDA’s Consumer Update: Is Rinsing Your Sinuses Safe?

References

1. Louisiana Department of Health & Hospitals. DHH Confirms Death of a Child Associated with Rare Amoeba Found in St. Bernard Parish Home. September 5, 2013.
2. Dorsch MM, Cameron AS, Robinson BS. The epidemiology and control of primary amoebic meningoencephalitis with particular reference to South Australia. Trans R Soc Trop Med Hyg. 1983;77(3):372-7.
3. Yoder JS, Straif-Bourgeois S, Roy SL, Moore TA, Visvesvara GS, Ratard RC, Hill V, Wilson JD, Linscott AJ, Crager R, Kozak NA, Sriram R, Narayanan J, Mull B, Kahler AM, Schneeberger C, da Silva AJ, Beach MJ. Deaths from Naegleria fowleri associated with sinus irrigation with tap water: a review of the changing epidemiology of primary amebic meningoencephalitis. Clin Infect Dis. 2012;1-7.
4. Shakoor S, Beg MA, Mahmood SF, Bandea R, Sriram R, Noman F, Ali F, Visvesvara GS, Zafar A. Primary amebic meningoencephalitis caused by Naegleria fowleri, Karachi, Pakistan. Emerg Infect Dis. 2011;17(2):258-61.
5. CDC. Primary amebic meningoencephalitis associated with ritual nasal rinsing — St. Thomas, U.S. Virgin Islands, 2012. MMWR Morb Mortal Wkly Rep. 2013;62(45):903.
6. Rabago D, Zgierska A, Mundt M, Barrett B, Bobula J, Maberry R. Efficacy of daily hypertonic saline nasal irrigation among patients with sinusitis: a randomized controlled trial. J Fam Practice. 2002;51(12):1049-55.
7. Rabago D, Zgierska A. Saline nasal irrigation for upper respiratory conditions. Am Fam Physician. 2009;80(10):1117-9.