Boy's death from amoeba infection prompts Lily Lake beach closure

Lily Lake
Lily Lake in Stillwater is closed to swimmers Wednesday, Aug. 8. 2012 after a 9-year-old boy who had gone swimming at the lake died of a suspected amoeba infection.
MPR Photo/Jennifer Simonson

A child's death from a rare amoeba infection, possibly contracted by swimming, has prompted state health officials to close a beach on a small lake near Stillwater.

Authorities believe Naegleria fowleri, a widespread, freshwater amoeba that infects swimmers who get water in their noses is what killed Jack Ariola Erenberg, 9, who died Monday. Erenberg had been swimming in Lily Lake near his home.

His death is the second such incident in two years. Lily Lake is also one of the spots where a 7-year-old girl is thought to have gone swimming before she died of the same disease in 2010. Just over 100 people are known to have died of the disease in the U.S. since it was formally identified in the early 1960s.

Medical professionals call the infection frightening.

"It proceeds at a terrifying pace," said William Pomputius, an infectious disease consultant with Children's Hospitals and Clinics of Minnesota.

"The other thing that's disconcerting to us is that there are very few survivors. Even in cases where they've been recognized early," Pomputius said. "This is a very, very virulent organism once it's in the brain."

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That's apparently what happened in the latest case.

Jack Ariola Erenberg
Jack Ariola Erenberg, 9, died Tuesday, August 7, 2012 of a suspected amoeba infection. He's seen here in an undated photo provided by his father.
Photo courtesy Jim Ariola

The boy's father, Jim Ariola of Wyoming, said Jack fell ill while camping with his mom near Grand Marais. Doctors didn't think it was serious.

"They went back to the campsite because they thought it was just flu-like symptoms, you know," Arola said. "Saturday night, I got a call again, and [Jack's mother] said Jack's really sick. They think he's got meningitis and they want to fly him to Duluth in a helicopter. I hopped in my truck and he was in rough shape. This bug got to his brain really fast."

The boy's uncle, Nathan Rader of Maplewood, said Erenberg recently moved to Stillwater with his mom. He also had a brother and three sisters.

"Jack played football and hockey up in Rush City. The kid was just amazing. He loved knitting, he loved cats," Rader said. "If knitting was girl thing, he loved to do it, and he never cared one iota what people thought."

Rader said that no one realized the danger the lake might pose.

"Jack was probably at the beach with 100 other kids at the time he got sick," Rader said.

Experts say amoebas found in the lake were positively linked to the 2010 death, but that the bug is common.

"You can even find it in Siberia, basically, in lakes," said Richard Danila, Minnesota's assistant state epidemiologist.

For the Naegleria fowleri amoeba to grow, the water has to warmed above 85 degrees. It even thrives in hot spring water. It's considered endemic in the southern United States and has been reported in Australia and Pakistan, as well.

A paper on the 2010 case in Minnesota said that infection was more than 500 miles further north than any previously reported case, and warned that warm weather and climate change could expand the amoeba's geographic threat.

Health officials say precautions may be the only practical defense. They suggest that swimmers keep their head out of the water, wear a nose clip and stay out of stagnant, warm water.

But Jonathan Yoder, coordinator of waterborne disease surveillance for the Centers for Disease Control and Prevention, says the illness is so rare that no one really knows.

"The role of nose clips is something that's hard to study. But certainly the rationale for nose clips is that it would prevent water from being forced up the nose," Yoder said. "A common sense approach would seem that that might reduce the risk."

He said authorities did take more drastic action after nearly a dozen deaths were linked to two small lakes in Virginia decades ago.

"One of the lakes was actually filled in, and the other one was just closed to swimming," Yoder said.

Public health officials in Washington County plan to keep Lily Lake closed for now, but are unsure about the long term.

A funeral for Erenberg is scheduled for Saturday, and a memorial fund for the family has been established at Central Bank in Forest Lake.