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Last week, a North Carolina man became a notorious microbial killer’s first confirmed victim this year. Fifty-nine-year-old Eddie Gray had unknowingly come across a brain-eating amoeba while swimming in a man-made lake near Fayetteville in mid-July; 10 days later, he was dead.

Since the brain-eating amoeba was first recognized and named, in 1970, grisly reports of its disastrous attacks have made headlines nearly every year. About 97 percent of confirmed cases in the United States have been fatal. But the infection is also incredibly rare, and the small sample size leaves the epidemiologists who study it and the doctors who encounter it with their hands tied. It may be one of nature’s most perfect crimes.

Despite their gruesome moniker, most brain-eating amoebas never eat a single brain. The single-celled swimmer, formally known as Naegleria fowleri, passes its time resting in a dormant state or, when it’s warm enough, splashing around and munching on bacteria. Unlike most waterborne pathogens, it’s utterly benign if you drink it. It becomes dangerous only when, thanks to a person enjoying a day at a water park or a quick rinse in a stream, the amoeba is yanked from its bacterial buffet and swept into the dark recesses of the human nose.

If the amoeba isn’t already in dining mode at this point, the intense burst of human body heat can help it shape-shift out of dormancy. Like anyone else waking up somewhere unfamiliar, the brain-eating amoeba is desperate for a food source, so it slithers its way up the olfactory nerve until it spies a tasty-looking tangle of neurons and digs in. The host’s immune system, sensing an unwelcome visitor, sends an onslaught of white blood cells to take down the feasting parasite. That commotion leads to a swollen—and, eventually, irreparably damaged—brain.

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