An 8-year-old Louisiana girl has died after contracting a rare and almost always fatal brain infection caused by Naegleria fowleri, a microscopic organism commonly known as the “brain-eating amoeba.”
Lillian Smart of Ruston died over the weekend after being hospitalized with primary amebic meningoencephalitis (PAM), the severe brain infection associated with Naegleria fowleri. Her family said she had been fighting the infection since being hospitalized on August 15.
The Louisiana Department of Health confirmed that a Louisiana resident had contracted Naegleria fowleri and said the infection was most likely acquired while swimming in Lake Claiborne, a freshwater lake in northern Louisiana. Officials did not publicly identify the patient, but the family later confirmed Lillian’s death.
Her death came just one day after her eighth birthday, according to reports.
What happened to Lillian Smart?
According to the Associated Press, Lillian was diagnosed with an infection caused by Naegleria fowleri, which can enter the body when contaminated water travels up the nose.
Once inside the nasal passages, the amoeba can move toward the brain and cause PAM, a rapidly progressing infection that destroys brain tissue. The infection is not spread from person to person.
The Louisiana Department of Health said this was the state’s first confirmed Naegleria fowleri infection since 2013. CDC data show that Louisiana has recorded four PAM cases associated with exposure in the state through 2025, although case totals can vary depending on the surveillance period and classification used.
Why is the amoeba so dangerous?
Naegleria fowleri is naturally found in warm freshwater environments, including lakes, rivers, ponds and hot springs.
The organism thrives particularly well when water temperatures rise. According to the CDC, infections in the United States remain extremely rare, with typically fewer than 10 cases occurring each year. Despite their rarity, PAM infections are almost always fatal.
CDC surveillance recorded 180 U.S. PAM cases from 1937 through 2025, with most cases occurring during the warmer months. The data show that July and August account for the largest number of reported illnesses, coinciding with increased exposure to warm freshwater.
That means the risk is extraordinarily small—but the consequences can be devastating when infection occurs.
How does ‘brain-eating amoeba’ infection happen?
The nickname can make the organism sound as though it attacks people simply by entering the water or being swallowed. That is not how infection typically occurs.
The critical route is through the nose.
When contaminated freshwater is forced or splashed into the nasal passages—such as during swimming, diving or other water activities—the amoeba can travel through the nose toward the brain. Simply swallowing water containing Naegleria fowleri does not cause PAM.
The CDC says properly maintained and disinfected swimming pools are not considered a typical source of infection, while warm natural freshwater such as lakes and ponds presents the primary recreational exposure risk.
The symptoms can progress rapidly
One of the most concerning aspects of PAM is how quickly the illness can worsen.
Early symptoms can include:
- Headache
- Fever
- Nausea
- Vomiting
As the infection progresses, patients can develop a stiff neck, confusion, seizures, hallucinations and coma. The CDC says symptoms generally begin around five days after exposure, although they can appear anywhere from one to 12 days afterward.
Once symptoms begin, the disease can progress rapidly, making early medical attention critical.
How can swimmers reduce the risk?
Health experts stress that Naegleria fowleri infections are exceptionally uncommon, but people can take precautions when entering warm freshwater.
The CDC recommends:
- Keeping your head above water when possible.
- Holding your nose shut or wearing a nose clip when jumping or diving.
- Avoiding activities in warm freshwater during particularly hot periods.
- Avoiding stirring up sediment in shallow freshwater, where the amoeba may be more likely to be present.
- Using only safe, distilled or appropriately treated water for nasal rinsing.
There is currently no practical way to completely eliminate Naegleria fowleri from natural lakes and rivers.
A rare tragedy that has renewed attention on freshwater safety
Lillian Smart’s death has brought renewed attention to an infection that most people will never encounter but that public-health officials continue to monitor because of its severity.
The Louisiana case also comes amid continuing U.S. surveillance of Naegleria fowleri. While the organism is traditionally associated with warm southern states, CDC information shows that infections have also occurred farther north, making awareness of freshwater exposure important beyond the regions where cases are most common.
For Lillian’s family, however, the statistics offer little comfort.
What began as a seemingly ordinary freshwater outing ended in an extraordinarily rare medical emergency—and ultimately the loss of an 8-year-old child.
The warning from health experts is not to panic around freshwater, but to understand the risk, recognize the symptoms quickly and take simple precautions to keep potentially contaminated water out of the nose.
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