Eleven days later, she was dead.
An extremely rare and usually fatal brain infection caused by Naegleria fowleri, an amoeba that destroys brain tissue, claimed the life of a teenage girl with big dreams and a vibrant personality.
“I’m still in shock,” said Megan’s mother, Christina Ebenroth, in an interview with The Atlanta Journal-Constitution on Monday. “But I can’t keep silent about her. She was extraordinary.”
Naegleria fowleri is an amoeba, a single-celled organism that lives in soil and warm, freshwater lakes, rivers, ponds, and hot springs. The organism is commonly called the “brain-eating amoeba” because it causes a brain infection — primary amebic meningoencephalitis (PAM) — when water containing the amoeba goes up the nose. The amoeba is not found in salt water and is not found in properly treated drinking water and swimming pools.
Paul Johnson, the coroner for McDuffie County, told the AJC he was contacted about Megan’s death by the Children’s Hospital of Georgia at Augusta University Health. He confirmed she died from the rare brain infection.
Georgia public health officials announced Friday that an unidentified Georgia resident had died of the rare brain infection but would not disclose details of where the person was exposed. DPH spokeswoman Nancy Nydam said in an e-mail, “If we say it was in a specific body of water, it may not be there today. Additionally, we run the risk of giving a false sense of security that it is only that particular body of water, when it could be anywhere.”
Ebenroth also declined to name the place where her daughter went swimming. What happened to her daughter was a horrible fluke. None of her friends who went swimming were sickened. And the place, she said, is a place where families bond and she doesn’t want what happened to her daughter to end that for others.
Several agencies contacted by the AJC including the Department of Natural Resources and the U.S. Army Corps of Engineers said they did not know the location.
Dennis Kyle, director of the University of Georgia’s Center for Tropical and Emerging Global Diseases, said it’s highly unusual for authorities to not share the location of a place where someone was infected by Naegleria fowleri. He said believes authorities should name the place but put it into context — Naegleria fowleri can exist in any body of freshwater, anywhere in the United States, and the presence one day doesn’t necessarily mean it will be there the next, or that someone else would get infected by swimming in the same place.
The CDC says Naegleria fowleri infections are rare, with about three cases every year in the U.S. There were 157 cases reported between 1962 and 2022. Only four people with confirmed cases have survived, according to the CDC.
Prior to Megan’s death, there had been five other cases reported in Georgia since 1962.
A 2-year-old boy died earlier this month in Nevada from a Naegleria fowleri brain infection. Officials with Nevada’s Division of Public and Behavioral Health said they believe the boy was exposed at Ash Springs, natural hot springs in Lincoln County. In February, a man in Florida died after becoming infected through sinus rinsing, according to the Centers for Disease Control and Prevention.
The signs of a Naegleria fowleri infection usually begin with severe headache, fever, nausea and vomiting and progress to stiff neck, seizures, and coma. Symptoms usually begin about five days after infection but can start anytime within 1 to 12 days. Once symptoms start, the disease progresses rapidly and usually causes death within about five days.
Kyle said one reason Naegleria fowleri is so deadly is because symptoms of the infection resemble those of viral meningitis, a much more common and more treatable disease. While current drugs to treat this brain infection are not very effective, delays in diagnosis often mean it’s too late for the person “to even have a chance” of surviving, he said.
His lab is working on a simple urine test to speed the diagnosis so patients can start treatment as soon as possible. According to the CDC, primary amebic meningoencephalitis (PAM) is treated with a combination of antibiotics and antifungal drugs. Two children separately infected in the summer of 2013 and 2016 survived PAM — and the CDC credits their early diagnosis and treatment for their survival.
Kyle said scientists don’t know why some people become infected by the amoeba, while others — swimming in the same water, at the same time — don’t.
Megan woke up with a bad headache four days after that July 11 swim. Her mother took her to an urgent care clinic and she was treated for a migraine. As the day wore on, Megan’s head continued to hurt badly. Her mom said she then took her to a local emergency room where her daughter was treated for sinusitis, prescribed an antibiotic, and sent home.
Megan rested at home on Monday and that night, her mother slept by her side. By Tuesday morning, Ebenroth could feel her daughter’s high fever.
Megan’s parents then drove her to the emergency room at Doctors Hospital of Augusta. Megan underwent a series of blood tests and was given IV fluids, but her condition continued to worsen. She was transferred to Children’s Hospital of Georgia, where she was intubated for several days. At one point, Ebenroth said doctors opened up her daughter’s skull to relieve her brain swelling.
It wasn’t until Friday, July 21, that she heard any suggestion that her daughter might have been attacked by the brain-eating amoeba. Megan died the next day.
A spokesperson for Children’s Hospital of Georgia at Augusta University Health declined to comment and said they couldn’t confirm that Megan had received care at their hospital, citing federal HIPAA privacy regulations.
“They were so caring, I had the best doctors and nurses. I don’t blame anyone,” said Ebenroth. “This was an act of God. Right now, I’ve got to figure out why.”
Ebenroth said she was her daughter’s class mom every year, drove her to school every morning, and picked her up every day after school.
“She was my world,” said Ebenroth.
Kyle, who is also at the helm of UGA’s Kyle Lab, which focuses on the development of anti-parasitic drugs, said he was deeply saddened by Megan’s death. The amebic infection, he said, is very serious and “something I worry about all the time,” especially during the summer months, when unusually warm weather raises water temperatures, creating ripe conditions for the deadly amoebaes.
DPH said there are no routine tests to check pond or lake waters for the amoebae, which are naturally occurring. The location and number of amoebae in the water can vary over time within the same body of water.
DPH said the amoebae cannot cause infection if they are swallowed. The infection is not spread from person to person.
DPH also said those swimming in warm, fresh recreational waters should always assume there is a risk of infection, even a low risk. Swimmers can reduce risk by limiting the amount of water that goes up the nose.
Besides her mother, Megan is survived by her father, Steve Ebenroth, and an older brother, Matt.
Ebenroth said she and her daughter were extremely close, even “best friends.”
“She would tell people I was her best friend, and I would say ‘Honey, I can’t be your best friend’ and about three weeks ago, she said ‘come on, Mom, you know I’m your best friend, and I said, ‘Yes baby, you are.’