Can 'Neti Pots' cause brain-eating amoeba infections?

For years, health experts have cautioned that nasal rinsing devices like neti pots, when used with untreated tap water, can expose people to a deadly “brain-eating” amoeba. The US Centers for Disease Control and Prevention (CDC) has repeatedly warned that while these cases are rare, infections caused by Naegleria fowleri or Acanthamoeba are almost always fatal.

How the amoeba infects the brain

Naegleria fowleri, often called the brain-eating amoeba, thrives in warm freshwater lakes, rivers, and inadequately chlorinated pools. Infection occurs when contaminated water enters the nose and the amoeba travels to the brain, leading to primary amoebic meningoencephalitis (PAM).

Drinking contaminated water does not cause infection, but rinsing nasal passages with unsafe water can. Symptoms strike quickly and include high fever, severe headache, vomiting, confusion, and in many cases, coma.A study reviewed 10 patients in the US who fell ill between 1994 and 2022 after possible exposure through nasal rinsing. Three of the patients died. Researchers noted that all had weakened immune systems, and seven reported using nasal rinsing for sinus relief, at least two with neti pots, and two as part of traditional cleansing rituals.

Surge in cases raises concern

The risks are not limited to the US. In India’s southern state of Kerala, authorities have reported a sharp rise in infections. As of September 2025, health officials confirmed 69 cases of Naegleria fowleri since the start of the year, including 19 deaths.

According to Kerala’s health department, infections were once extremely rare, only one or two annually since 2016, but this year’s toll has been unprecedented. NDTV quoted state Health Minister Veena George as saying: “These are single, isolated cases, which has complicated our epidemiological investigations.”

Globally, only 488 cases of Naegleria fowleri infection have been reported since 1962, mostly in the US, Pakistan, and Australia, with a survival rate of just 5%.

The role of neti pots — and how to use them safely

Neti pots are small teapot-like devices made of ceramic or plastic, designed to flush saline solution through the nasal passages. Their popularity has soared in recent decades, especially among allergy and sinus sufferers. While they can provide relief, the danger comes when users substitute sterile water with untreated tap water.Tap water is generally safe for drinking and cooking, but it may contain low levels of microbes that become dangerous when forced into the nasal passages. To minimize risk, the CDC advises using only distilled, sterile, or previously boiled water. Tap water should be boiled for at least one minute (three minutes at higher altitudes), then cooled before use.