Israel's Health Ministry Advises Precautions Against Brain-Eating Amoeba in Sea of Galilee

Following confirmed infections by the Naegleria fowleri amoeba, Israel's Ministry of Health has updated its swimming recommendations for the Sea of Galilee (Kinneret). While acknowledging the extreme rarity of the infection, the ministry stressed its severe and life-threatening nature, urging swimmers to adopt precautionary measures to minimize risk.

Infection occurs when water containing the amoeba enters the nose, allowing the organism to reach the brain. The ministry clarified that drinking contaminated water does not cause infection, nor is it transmitted person-to-person. The amoeba thrives in warm, fresh water, making the summer months, when the Sea of Galilee is warmer, a period of increased risk.

Recommended precautions include using nose plugs, avoiding diving and submerging the head, preventing water from forcefully entering the nose, and refraining from disturbing silty lakebeds in shallow areas. The ministry emphasized that despite the low risk, the severity of the disease, which progresses rapidly and has a high mortality rate, necessitates these measures.

The ministry also released a FAQ addressing the "brain-eating amoeba." Naegleria fowleri is a single-celled amoeba found in freshwater sources that can, in rare instances, cause primary amoebic meningoencephalitis (PAM), a severe and fast-acting inflammation of the brain and its surrounding membranes. Unlike other water contaminants, testing for amoebas is unreliable due to their uneven distribution, making risk assessment dependent on broader epidemiological and environmental data.

Since 2022, Israel has recorded four cases of Naegleria fowleri infection. One case was diagnosed in 2022. In July 2024, two additional cases were identified, with epidemiological investigations linking both patients to swimming near the Aqua Park at Gai Beach on the Sea of Galilee. The fourth, and current, case involved a child who swam at Kursi Beach on the Sea of Galilee approximately one week prior to hospitalization.

Globally, the disease is rare, with fewer than 500 documented cases in scientific literature. In the United States, 167 cases have been reported between 1962 and 2024. The ministry advises seeking immediate medical attention if symptoms like fever, severe headache, nausea, vomiting, stiff neck, confusion, or unusual drowsiness occur after swimming in freshwater, especially if it was a mikveh (ritual bath), and to inform medical staff about the recent exposure.