You may have read my earlier post about the Jala Neti. Here is an excerpt and some new information that should be considered if you are a neti user.

Basically, the neti pot allows a user to pour 8 to 16 ounces of warm saline into one nostril while letting the solution pour out the other nostril. Typically, in a kit, the packets contain 700mg of sodium bicarbonate and 2300mg of sodium chloride; however, a level teaspoonful of plain salt can suffice if your pot does not come with saline packets. Simply empty the packets into the neti pot and add warm water, give a little stir and you are ready to go.

The authors of a randomized trial published in the Journal of Family Practice in 2002 concluded “Daily hypertonic saline nasal irrigation improves sinus-related quality of life, decreases symptoms, and decreases medication use in patients with frequent sinusitis.” Another, more recent, article in that same journal again reiterated that recommendation for both adults and children with allergic rhinitis.

In some circles, the neti is called a nasal douche, or more urbanely, a nasal irrigation or lavage. This process has grown quite popular beyond India and I wondered if it is ever misused. Well, here’s a reason to be cautious:
A 20-year old man and a 51-year-old woman from suburbs of New Orleans died after using Neti pots containing tap water to flush their nasal passages. Both became infected with Naegleria fowleri, a parasite known as the brain-eating amoeba.
“If you are irrigating, flushing or rinsing your sinuses, for example, by using a Neti pot, use distilled, sterile or previously boiled water to make up the irrigation solution,” Louisiana State epidemiologist Dr. Raoult Ratard said in a statement. “Tap water is safe for drinking but not for irrigating your nose.”

The amoeba causes primary amebic meningoencephalitis (PAM), most often through getting water in the nose when swimming in water that carries the parasite. These little guys lke warm water. Sampling of lakes in the southern tier of the U.S. indicates that Naegleria fowleri is commonly present during the summer, but infections are beginning to occur in northern states. (Global warming?) Naegleria is not found in the ocean. In any case, these infections are quite rare, somewhere on the order of 1 in a million warm water swimmers. The CDC is a good place to learn more about this parasite.

Anytime you are allowing non-sterile substances to enter your body you are introducing microbes into your personal environment. Usually these are benign. However, at times they can be pathogens, as in the example above. For this reason it is important to be sure to use boiled water if you are getting it from a tap, or at least distilled water from the store, for your neti. It also would be wise to sterilize the neti pot itself every now and then. Infection control begins at home!