Naegleria fowleri in drinking water distribution systems

The free-living amoeba Naegleria fowleri causes the highly fatal disease primary amoebic meningoencephalitis. N. fowleri is found globally in the environment but has been increasingly detected in engineered water systems, such as drinking water distribution systems (DWDSs), with fatal infections recorded from Pakistan, USA and Australia. N. fowleri's presence in DWDSs appears to be regulated by a combination of physical, chemical and biological conditions. Suboptimal chlorine residuals enable the increase of the microbial richness and the presence of specific microbial taxa (i.e. Meiothermus) may also influence the presence and persistence of N. fowleri. The use of ‘biological tools’ has the potential to be applied as biomarkers in combination with other currently used detection methods (chlorine residual and temperature). These combined tools could be key to enabling the better prediction of N. fowleri colonisable sites, thus allowing for pre-emptive management of N. fowleri in the DWDS.