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A young woman has died after contracting a brain-eating amoeba from an indoor swimming pool.
The 30-year-old is believed to have caught Naegleria fowleri — which is fatal in 97 percent of cases — from a wave pool in Taiwan.
She is thought to have been learning how to surf when water got up her nose — the main way that people are infected with the amoeba.
The woman was taken to hospital after suffering from seizures, headaches, a fever and stiffness in the neck and shoulders. She died three days later.
It comes after a 29-year-old US man also died from the amoeba in 2018 after visiting a wave pool at a water park in Texas.
The woman, 30, is believed to have caught N. fowleri from an indoor swimming center (pictured above are tests being carried out)
Testing revealed the amoeba in the pool's basement, with officials saying this could have been seepage from pipes
Revealed above is the pool of water in the basement near the pool filtration and chlorination equipment where the N. fowleri was detected
Tests diagnosed her amoeba infection, with follow-up swabs at the center also showing there was too little chlorine in the water to kill the pathogen.
Further tests revealed the pathogen in a puddle in the center's basement, with health officials saying it could easily have spread from there to pools via the boots of staff.
N. fowleri lurks in warm freshwater, and can infect people when water is washed up the nose — allowing it to infect the olfactory nerve and then travel along it to the brain, where it kills tissue and causes swelling leading to death.
The patient had visited the New Taipei City indoor water park in the north of Taiwan before developing the infection in July 2023.
In the US, less than ten cases of the amoeba are recorded every year — and are commonly linked to swimming in warm freshwater.
But in 2018, a 29-year-old man also died from the brain-eating amoeba in Texas after visiting a surf pool and becoming infected.
Fabrizio Stabile, from New Jersey, died just one day after his infection was diagnosed. He had visited BSR Cable Park.
Of the 135 people infected in the US, only four have ever survived — in some cases being left with serious brain damage.
In 2018, American man Fabrizio Stabile died after catching the amoeba from an indoor swimming center in Texas. He had also been using a wave pool
N. fowleri kills about 99 percent of everyone it infects, and is deadly because it rapidly spreads to the brain and starts to kill tissue
Writing in the case report, published in the CDC's monthly Emerging Infectious Diseases journal, health officials said: 'For beginner surfers, maintaining balance on the water can be difficult, and falling into the waves frequently enables water to flow into the nose.'
They added that because chlorine was already low in the main swimming pool which supplied water to the wave pool, it was likely 'even lower' in this pool.
Officials contacted 12 employees and 630 customers after detecting the case who had visited the center at around the same time, but none reported any symptoms of an N. fowleri infection.
It was not clear how the woman was infected, although officials believe that the swimming pool is the most likely source.
Out of 56 samples taken at the pool, only one tested positive for N. fowleri — and it was a puddle in the basement below the ladder leading to the chlorination tanks.
Experts suggested this puddle may have been seepage from the water system, suggesting it was contaminated with N. fowleri.
But they also said it was possible that employees had stepped in the puddle and then carried N.fowleri up to poolside where it would have entered the water.
Separate testing showed that chlorine levels in the main pool were about 0.87 parts per million (ppm), well below the one to three ppm needed to kill off microbes.
Because this fed into the wave pool, officials feared levels could have been even lower in this area.
Staff at the center in New Taipei City, north Taiwan, said they change all the water in the facility every two to three months.
They also add chlorine to the pools daily and test the waters, although records of the results were not revealed.