Pediatric Death from Rare Naegleria Fowleri Infection Linked to Arlington Splash Pad
On Sept. 5, 2021, Tarrant County Public Health and the City of Arlington were notified that a child was hospitalized at Cook Children’s Medical Center with primary amebic meningoencephalitis, a rare and often fatal infection caused by the Naegleria fowleri ameba. To protect the identity of the child, who died at the hospital on Sept. 11, no additional details will be provided.
A Tarrant County Public Health investigation determined two possible sources for the child’s exposure to water containing Naegleria Fowleri: the family’s home in Tarrant County or the Don Misenhimer Park splash pad in Arlington. On Sept. 24, the Centers for Disease Control and Prevention confirmed the presence of active Naegleria Fowleri amoeba at the splash pad from water samples and determined the Arlington site was the likely source of the child’s exposure.
The risk of Naegleria Fowleri infection is very low, with only 34 reported infections in the United States between 2010 and 2019, according to the CDC. Naegleria Fowleri infects people when water containing the ameba enters the body through the nose. This typically occurs when people go swimming or diving in warm freshwater places, such as lakes and rivers. In very rare instances, the ameba has been identified in other sources, such as inadequately chlorinated swimming pool water or heated and contaminated tap water.
The City of Arlington closed the Don Misenhimer Park splash pad on Sept. 5, immediately following notification of the child’s illness, and proactively closed all public splash pads for the remainder of the year out of an abundance of caution. Symptoms of primary amebic meningoencephalitis typically present within nine days of infection, according to the CDC. Other than this child, there have been no other instances of this infection reported to Tarrant County Public Health.
Since Sept. 5, the City has been working with the county, the Texas Commission on Environmental Quality, the Texas Department of State Health Services and the Centers for Disease Control and Prevention to determine whether the splash pad was the source of the infection and what conditions may have allowed the ameba to exist in the treated water.
City and county officials, under direction of the CDC, collected a series of water samples from the splash pad and sections of the system that provide water to the facility and the surrounding area between Sept. 10 and Sept. 14. These samples were sent to the CDC for testing. On Sept. 16, the CDC said that the samples collected from the Arlington splash pad tested “preliminary positive” for the presence of Naegleria Fowleri amoeba. Those test results were confirmed on Sept. 24.
As part of its response plan, the City of Arlington is conducting a thorough review of splash pad equipment and supplies, maintenance, and water quality inspection policies, procedures and training to ensure safe recreational spaces for residents and visitors. All city splash pads passed their annual inspection prior to the start of the summer season. Water quality testing data, however, has shown the need for improvement, city officials said.
“We have identified gaps in our daily inspection program,” Deputy City Manager Lemuel Randolph said. “Those gaps resulted in us not meeting our maintenance standards at our splash pads. All of the splash pads will remain closed until we have assurance that our systems are operating as they should, and we have confirmed a maintenance protocol consistent with city, county and state standards.”
Records from two of the four splash pads, the ones at Don Misenhimer Park and The Beacon Recreation Center, show that Parks and Recreation employees did not consistently record, or in some cases did not conduct, water quality testing that is required prior to the facilities opening each day. This includes checking for chlorine, which is a disinfectant used to prevent harmful organic matter.
When chlorine level readings were below minimum state standards at those locations, the inspection log did not consistently reflect what action city employees took to bring the chlorination levels up. For example, the logs did not always show how much disinfectant chemical was manually added to the splash pad’s water system. The logs also did not consistently include a follow-up reading to confirm that the water chlorination levels were at acceptable levels after treatment.
Additionally, a review of inspection logs found that water chlorination readings were not documented at Don Misenhimer splash pad on two of the three dates that the child visited the location in late August and early September. Documents show that chlorination levels two days before the child's last visit were within acceptable ranges. However, the next documented reading, which occurred the day after the child visited, shows that the chlorination level had fallen below the minimum requirement and that additional chlorine was added to the water system.
Click here to review 2021 City of Arlington splash pad inspection records and other splash pad documents.
The City of Arlington’s drinking water supply is not affected, and the water quality continues to meet all regulatory safety guidelines set by state and federal authorities.
The Don Misenhimer Park splash pad is equipped with a backflow prevention device designed to isolate the facility’s water system from the City’s water distribution system. This device passed an annual inspection in April 2021 and again on Sept. 7, 2021. Backflow is the reversal of flow of any substance into the safe drinking water distribution system. State law requires that public water features be equipped with a form of backflow prevention, such as the one at Don Misenhimer Park. These devices are tested each year by a qualified private company and inspection records are filed with the water department.
Click here to review backflow inspection records from the Don Misenhimer splash pad from April and September 2021.
For more information about Naegleria Fowleri, please visit Centers for Disease Control and Prevention website, https://www.cdc.gov/.
Media Contacts
Susan Schrock, City of Arlington Office of Communication, 817-459-6405, [email protected]
Brian Murnahan, Tarrant County Public Health Information Officer, 817-321-5306, [email protected]
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