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Serologic survey for exposure following fatal Balamuthia mandrillaris infection


Granulomatous amebic encephalitis (GAE) from Balamuthia mandrillaris, a free-living ameba, has a case fatality rate exceeding 90 % among recognized cases in the USA. In August 2010, a GAE cluster occurred following transplantation of infected organs from a previously healthy landscaper in Tucson, AZ, USA, who died from a suspected stroke. As B. mandrillaris is thought to be transmitted through soil, a serologic survey of landscapers and a comparison group of blood donors in southern Arizona was performed. Three (3.6 %) of 83 serum samples from landscapers and 11 (2.5 %) of 441 serum samples from blood donors were seropositive (p = 0.47). On multivariable analysis, county of residence was associated with seropositivity, whereas age, sex, and ethnicity were not. Exposure to B. mandrillaris, previously unexamined in North America, appears to be far more common than GAE in Southern Arizona. Risk factors for disease progression and the ameba’s geographic range should be examined.

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We thank the landscapers for their participation and Chukwuma Mbaeyi, Eileen Farnon, Matthew Kuehnert, Brad McKinney, Michelle McDonald, Sherry Daniels, Ken Komatsu, Myrna Seiter, Orion McCotter, Michael Arrowood, and Anna Yaffee for contributing to this investigation.


The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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The investigation described in this manuscript complied with the laws of the USA.

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Correspondence to Brendan R. Jackson.

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Jackson, B.R., Kucerova, Z., Roy, S.L. et al. Serologic survey for exposure following fatal Balamuthia mandrillaris infection. Parasitol Res 113, 1305–1311 (2014).

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  • Blood Donor
  • Serum Specimen
  • Cysticercosis
  • Serologic Survey
  • Soil Exposure