Due to reported serious infections and two patient deaths in Louisiana, National Jewish Health is recommending that tap water is no longer used for performing nasal washes or sinus rinses. The recommendation is based on a recent alert from the Centers for Disease Control (CDC) and an update of their recommended practices regarding this procedure. The change in recommendation was based on a report of two recent cases of brain abscesses linked to nasal/sinus washes. The chlorinated tap water contamination with an amoeba, Naegleria fowleri, resulted in deaths of both patients infected through the use of the procedure. Earlier cases were linked to fresh water sports activities such as swimming especially in warm climates. These two cases are the first that were linked to nasal washes. The CDC has now recommended that tap water never be used for the procedure unless treated as outlined below.
Do not use tap water for the nasal wash (unless boiled or filtered as described below). Do not use well-water.
You may use:
- Distilled water,
- Sterilized water,
- Tap water that has been boiled for 1 minute (at elevations above 6,500 ft., boil for 3 minutes) and cooled or
- Tap water that is filtered using a filter with an absolute pore size of 1 micron or smaller.
Please talk with your health care provider if you have any questions or concerns about this recent change.
This information has been approved by Christopher A. Czaja, MD, MPH (February 2012).