The U.S. Food and Drug Administration (FDA) released a consumer warning in late August regarding the safe use of Neti Pots and other nasal rinsing products (including bulb syringes, squeeze bottles and pulsed water devices), that are designed to rinse out the nasal passages in those who suffer from allergies, sinus congestion and colds.

The warning is related to two deaths in Louisiana in 2011 that may have been related to improper use of Neti Pots. In particular, both individuals contracted brain infections caused by the amoeba Naegleria fowleri, which is thought to have been in the tap water they used in their Neti Pots. This amoeba, which can travel from the nose to the brain, destroys brain tissue and causes primary amoebic meningoencephalitis. Primary amoebic meningoencephalitis infections are almost always fatal.

In their consumer release the FDA stressed that while nasal rinsing products are generally safe, they must be used and cleaned properly in order to prevent risk of infection. To use them safely the FDA makes recommendations regarding:

    1. Types of water that are safe to use in nasal rinsing products:
    Distilled or sterile water

  • Boiled and cooled tap water (boiled for 3-5 min before cooling).
  • Filtered water can be used as long as the filter has an absolute pore size of 1 micron or smaller.
  • 2. Care and use of the nasal rinsing device:

  • Wash hands thoroughly before using
  • Ensure that the device is clean and completely dry before using
  • Use an appropriate type of water (see above) and the recommended saline rinse
  • After using the device, wash it using distilled, sterile, or boiled and cooled tap water. Then dry the inside with paper towel or let air dry between uses
  • Do not share the device with other people
  • Follow the manufacturer’s directions regarding proper use

While the risk of infection by the amoeba Naegleria fowleri is rare (it is primarily found in the southern United States), it is important to follow the recommendations listed in the consumer warning because using unsafe water or improperly cleaning nasal irrigation devices increases the risk of chronic nasal/sinus irritation, infection and worsening of allergy symptoms.

Graham Beaton is a Naturopathic Doctor practicing at Commonn Ground Collaborative Care in downtown Ottawa. For an appointment or to find out more about services, please call 613-290-6115.