For years, neti pots have been used to clear the sinuses and ease nasal congestion. The vessels, which look like a genie’s lamp, are used to pour sterile, salt water into one nostril.
You allow it to drain out the other, by tilting your head sideways. This is said to flush out congested mucus that is clogging up the sinuses.
Neti pots have also been embraced by most NHS ear, nose and throat (ENT) departments as a safe and effective way to tackle blockages. Even the respected Cochrane research group has said nasal irrigation is a ‘cheap, safe and acceptable’ alternative to nasal sprays containing steroids or antihistamines.
The devices, available from High Street chemists for as little as £5, are usually made from plastic, steel or ceramic, and are recommended for those with a consistently runny or blocked nose.
But are they as safe as we might think? Last year, a woman in Seattle, in the U.S., died after contracting a very rare condition, amoebic meningitis, from using a neti pot incorrectly.
For years, neti pots have been used to clear the sinuses and ease nasal congestion. The vessels, which look like a genie’s lamp, are used to pour sterile, salt water into one nostril
Doctors had prescribed the pot to the 69-year-old to combat a persistent sinus infection. But she failed to follow instructions to use only cooled, boiled water to rinse, instead opting for tap water.
Unfortunately, the water contained Naegleria fowleri, a tiny amoeba less than 1mm in diameter, which thrives in water.
The amoeba travelled through her sinuses and crossed into the brain, where it started to consume healthy brain cells. Symptoms of amoebic meningitis strike within days, and include headache, behavioural disturbances, fever, nausea and vomiting.
Antibiotics can help, but it is fatal in well over 90 per cent of cases. A post-mortem revealed much of her brain had been destroyed, which led to her death.
This follows two similar cases, also in the U.S., in 2011, where patients using tap water instead of sterile water died from the same rare form of meningitis.
The organism that caused all three deaths can be found in warm water that exceeds around 25c.
There have only been around 250 cases of meningitis caused by Naegleria fowleri around the world — most involving swimming in contaminated lakes or pools, where water is forced up the nostrils when someone jumps in. Drinking water containing the amoeba does no harm, as it gets killed by powerful stomach acid.
So how much of a threat is it in the UK? Here mains tap water is around 20c, but in the summer it can reach the temperature required for the amoeba to thrive.
However, our domestic water supplies are treated with chlorine, which has been shown to kill the organism.
But some research casts doubt on how effective the chlorine in tap water is at this task.
A study, published in 2015 in the Environmental Science and Technology journal, showed the amoeba survived longer in pipes with chlorinated water than laboratory tests suggested — 24 hours instead of just five minutes.
Neti pots have also been embraced by most NHS ear, nose and throat (ENT) departments as a safe and effective way to tackle blockages. Even the respected Cochrane research group has said nasal irrigation is a ‘cheap, safe and acceptable’ alternative to nasal sprays containing steroids or antihistamines.
It’s thought the film of material that forms on the inside of water pipes protects the amoeba from the chlorine.
The risks from neti pots, when they are used correctly, are clearly low. But millions of people do not follow the instructions properly.
A 2012 study by researchers from the University of Alberta in Canada found almost half of neti pot owners used tap water to rinse. They quizzed 100 patients who had blocked noses due to allergies and found 65 per cent found it too ‘inconvenient’ to use cooled boiled water, while 70 per cent rarely cleaned their neti pots — another infection risk.
The researchers warned: ‘The extremely rare, but typically fatal, risk of meningitis makes this a potential health hazard.’
There may be other risks from using neti pots long-term. Most patients are advised to rinse with them daily for one to three weeks at a time to banish congestion. But many use them for longer to prevent symptoms returning.
Research from Georgetown University School of Medicine in Washington in the U.S., suggests this can increase the risk of sinus infection by up to 60 per cent.
It’s thought this is because rinsing flushes out excess mucus but subsequent use means the solution also washes away the healthy layer of nasal mucus that acts as a first line of defence against allergens or bacteria.
Dr Tony Narula, former president of the professional body ENT UK, says neti pots are safe and effective if used correctly. ‘But bacteria and other organisms can fester in dirty water, so it’s important to clean them every time you use them,’ he says. ‘If not, you could breathe them in and put yourself at risk.’