Deaths From Neti Pot Infections Prompt FDA Warnings

Deaths from Neti Pot infections have prompted warnings by the U.S. Food & Drug Administration (FDA).

Neti pots are popularly suggested by physicians for patients who suffer from chronic sinus infections or allergies, said The Boston Globe. The small teapot-like devices rinse clogged nasal passages, loosening mucus and removing debris, dust, pollen, and dirt; however, the agency suggests some precautions and steps.

Last year, two Louisiana deaths were linked to improper use of neti pots. Both died from a rare brain infection, according to the agency, which cited tap water contaminated with an amoeba organism that infected the brain, said The Boston Globe. The agency suggested neti pot users only utilize the pots with distilled or filtered water. Experts also warn that neti pots be appropriately cleaned to remove mold and other bacteria, said The Boston Globe.

The FDA explained that neti pots are typically used to rinse nasal passages with a saline (salt-based) solution, warning that other nasal rinsing devices, such as bulb syringes, squeeze bottles, and battery-operated pulsed water devices be cleaned and used properly. The devices are generally safe and useful products, said Steven Osborne, M.D., a medical officer in FDA’s Center for Devices and Radiological Health (CDRH), noting that the water source is critical and that tap water that is not filtered, treated, or processed in specific ways is not safe for use as a nasal rinse.

While some tap water contains low levels of organisms—bacteria and protozoa, including amoebas—that may be safe to swallow because stomach acid kills them, the germs can remain alive in nasal passages, causing potentially serious infections, the U.S. Centers for Disease Control and Prevention (CDC), explained. The contaminated tap water that killed two in Louisiana contained the amoeba Naegleria fowleri.

FDA staff said it found that some manufacturers’ instructions provide misleading or contradictory information, or lack any guidelines on the proper use of the nasal rinsing devices. Some manufacturers recommend using plain tap water; others warn against using it in printed directions, but show its use in pictures or videos. Some devices are provided with no instructions, such as custom-made neti pots.

The FDA urges that users of these nasal devices only use distilled or sterile water, which can be purchased in stores and which indicate “distilled” or “sterile.” Boiled and cooled tap water–boiled for 3-5 minutes, then cooled until lukewarm—can also be used. Previously boiled water, which is stored in a clean, closed container, can be used within 24 hours. Also, water that has passed through a filter with an absolute pore size of 1 micron or smaller, which traps potentially infectious organisms, can be used. The FDA noted that the CDC has information on selecting these filters, which can be purchased from some hardware and discount stores, or online.

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