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Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.
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On 5 December 2018, the Seattle Times published an article whose terrifying headline ensured its own virality: “Rare brain-eating amoebas killed Seattle woman who rinsed her sinuses with tap water. Doctor warns this could happen again.” Sadly for those who visited this page hoping to find that the reporting was exaggerated or made-up, this really happened. Though her anonymity was maintained, the story of a 69-year-old Seattle woman who used tap water in her Neti pot for over a year and then died from a Balamuthia mandrillaris brain infection was documented in a 20 September 2018 case study published in the International Journal of Infectious Diseases: We report the case of a 69-year-old female who presented with a chronic nasal skin rash, new onset focal seizure, and a cerebral ring-enhancing lesion after a year of improper nasal irrigation. Despite aggressive and novel anti-amoebic treatment, she died as a result of a Balamuthia mandrillaris brain infection. One year before developing the brain infection, the authors reported, the woman developed a chronic sinus infection whose symptoms were not relieved by medication. She turned to using a Neti pot to rinse her sinuses, but instead of using sterile or saline water as directed, she used tap water filtered with a Brita system. After a month of this practice, and without any relief of her sinus symptoms, “she developed a quarter-sized, red raised rash on the right side of the bridge of her nose and raw red skin at the nasal opening.” Though several misdiagnoses followed, no doctor correctly recognized the rash as a symptom of an amoebic infection. The report stated that a year after that initial rash developed, the woman developed a seizure that required hospitalization. At that time, the doctors identified a lesion on the right side of the brain which they decided to biopsy. Some 19 days later, after a continued decline in the patient’s health, scientists from Johns Hopkins University suggested the possibility that the cause of her malady was an amoebic infection, and the Centers for Disease Control rushed a novel drug for her treatment. Unfortunately, they were unable to halt the progression of the disease, and the patient’s family made the decision to remove her from life support. An autopsy determined the cause of death to be Granulomatous Amebic Encephalitis (GAE), which the CDC defines as “a serious infection of the brain and spinal cord that typically occurs in persons with a compromised immune system.” In this case, the causative agent was an extremely rare amoeba named Balamuthia mandrillaris, one of three forms of amoeba known to be capable of infecting and consuming the human brain. Amoebas are a broad group of taxonomically mixed unicellular organisms that consume surrounding cellular material through absorption, and that express an ability to take on a variety of shapes. Several different species are associated with disease, most notably Naegleria fowleri, commonly known as the “brain-eating amoeba” that can cause a different kind of brain infection called primary amebic meningoencephalitis (PAM). Balamuthia mandrillaris was discovered in 1986 in the brain of a mandrill monkey during an autopsy at the San Diego Zoo and is now recognized to be a cause of GAE in both humans, several primates, and other animals, with an estimated 200 cases of human infection ever documented. The amoebae are ubiquitous in soil and groundwater although their presence is not expected in city-treated water, according to Liz Coleman, a spokeswoman for the Environmental Public Health division of Washington State’s Department of Health, quoted in the Seattle Times’ reporting. Merely ingesting the thing will not lead to health problems, but in rare cases (usually instances involving people with weakened immune systems, or those who are young or old), the organisms can infect a host through skin breakage or via the respiratory system. If they infect the central nervous system, they “ingest bits and pieces of host tissue [and produce] enzymes that degrade the tissue.” Nasal irrigation involves rinsing one’s sinus cavity with distilled or sterile water (or water that has been filtered to remove potentially infectious organisms), and one such method of water delivery is a Neti pot. The need for sterility is explicitly stated due to the (extremely small) risk posed by another amoeba, Naegleria fowleri, and it is the reason the FDA requires (in the absence of sterile water) a specific kind of filter capable of removing the amoeba and similarly-sized organisms from water before it is pushed through fragile sinus tissue. While the authors of this case report could not state with absolute certainty that the Neti pot was to blame, it is far and away the most likely explanation given the fact that the patient had been rinsing her sinuses with tap water regularly for an extended period of time: While it is recommended that only sterile water or saline be used … the patient used tap water that was filtered with a Brita Water Purifier … Improper nasal irrigation has been reported as a method of infection for the comparably insidious amoeba, N. fowleri. This precedent led us to suspect the same route of entry for the Balamuthia amoeba in our case. Although this hypothesis is consistent with the patient’s history and ultimate diagnosis, the water supply to the patient’s home was not tested, hence our ability to definitively trace the patient’s infection to improper nasal lavage is limited. Other routes of exposure are possible, according to a 2013 review of amoebic infections: Epidemiology of Balamuthia GAE is not well understood. However, based on several case reports it can be hypothesized that gardening, playing with dirt, or exposure to dust while motorcycling may play significant roles in the acquisition of Balamuthia infection. It has been shown that Balamuthia is found in the soil and dust in air and the route of infection is probably via inhalation of Balamuthia either present in soil or carried by the wind or the amebae entering the body through a cut or puncture. Once it gains entry into the body it is likely to spread hematogenously to the brain. Additionally, there is some indication that water may serve as a vehicle for acquiring the infection. Although the water used in the Neti pot likely caused this infection, Dr. Cynthia Maree, a co-author of the report and a member of the team that treated the woman in question, told the Seattle Times that “the risk of infection to the brain is extremely low,” adding that “people who use neti pots or other nasal-irrigation devices can nearly eliminate [that risk] by following directions printed on the devices, including using only saline or sterilized water.”
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A woman who rinsed her nasal passages using a neti pot filled with tap water contracted a fatal “brain-eating” amoeba infection.


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When the Mercyhurst team arrives at a crime scene, members are tasked with telling the story of how human remains arrived there, how long they were in place, and whether the remains were affected by weather, animals or other humans. “It’s all about reconstructing past events,” said Dennis Dirkmaat, department chairman of the Mercyhurst University forensic science program. Dirkmaat, a forensic anthropologist, has led his students to scenes across Pennsylvania and beyond to help coroners and medical examiners answer questions crucial to each case. With forensic anthropology, he said, investigators don’t bring bones to a lab to be identified, at least not at first. Vital information exists at the scene where a body is found, including the origin and spatial distribution of the remains. “Each particular case is a new scenario,” he said. DNA can easily provide the identity of human remains, Dirkmaat said. But his students are educated in identifying trauma in bone and gathering information at each scene that could show whether the individual died from homicide, suicide, accidental or natural causes, as well as whether remains were moved or scattered by animals, gravity, water, wind or human activity. “We always search for where the body was originally,” Dirkmaat said, and look at whether remains are still articulated - together in the proper order or pattern - or if there are signs of decomposition. “The police or coroners, when they call us in, they have some idea of who this might be and how long ago it occurred, and so we start with that hypothesis and we try to prove or disprove it from the evidence.” Dirkmaat said he’s seen an average of 100 cases each year in the nearly two decades that he and his students have assisted police and coroners at outdoor crime scenes. “In an academic setting, I don’t think anyone’s come close to that number,” he said. ‘Processing the scene’ Cambria County Coroner Jeff Lees called Dirkmaat in May concerning human remains discovered near a Johnstown trail. The Mercyhurst team helped local officials identify the remains of Nancy Giles, who had gone missing in October. “Dealing with the remains is one process, but the entire scene has to be cleared methodically,” Lees said. “It’s a diligent and slow process, but one that must be done. (Dirkmaat) and his team are second to none. Processing the scene will have a long-term impact on the investigation.” Somerset County Coroner Wallace Miller said Dirkmaat was the first person he called last September, when the remains of two homicide victims were found along Ligonier Pike in Conemaugh Township. “Anytime you have skeletal remains, you have to have (the Mercyhurst University team),” Miller said. “They’re qualified as experts in court. (Dennis) is well-known and well-respected.” Rusty Styer, Bedford County coroner, has called in Dirkmaat and his students several times. The latest instance was last October, when remains were located by a hunter near Route 30 in Snake Spring Township. The recovery and mapping capabilities are “top notch,” Styer said, and the Mercyhurst team accurately captures the location of every bone and piece of evidence, which he said is vital to the work of coroners and the police. “It’s essential to have it,” he said. “They turn over every leaf and every rock.” ‘Practical experience’ Dirkmaat said he enjoys his work for a variety of reasons: including seeing his students graduate from the program and earn their own success in the field, while navigating the challenges each case brings. He arrived at Mercyhurst University in 1991 with a doctoral degree from the University of Pittsburgh. One of his first assignments was to help then-Cambria County Coroner John Barron with a case involving human remains, coincidentally found near the site off Roosevelt Boulevard where Giles’ remains were found in May. From there, “it just expanded,” Dirkmaat said, as coroners spoke with each other about these types of cases they were working through, and the resources he and his team could provide. Dirkmaat said he and his students have worked on cases all over Pennsylvania and in parts of New York and Ohio. “It’s a pretty big territory,” he said. “And I attribute it to the fact that we can do the forensic archaeology. We can process a scene for the police and for the coroner’s office.” The hands-on experience has given the program its good reputation, Dirkmaat said. “The students that I’ve produced are well-trained forensic anthropologists,” he said. “There are really very few, if any, programs that give as much hands-on practical experience as we do. Some of the graduate students that just recently graduated have 15 to 20 forensic cases under their belts.” Dirkmaat recalled getting a call about a plane crash in Westmoreland County the day before that year’s classes started, before he’d even met his new students. On the first day of the semester, he took the students to the scene of that crash. “The first day of classes, they were working a scene,” he said, “right off the bat.” Career opportunities Dr. Erin Chapman, forensic anthropologist with the Erie County Medical Examiner’s Office, is one of Dirkmaat’s former students. During a recent lecture at Mercyhurst, Chapman said she is assigned 40 to 50 cases each year, 60 percent of which are trauma-related. Chapman said real-world scenarios encountered at Mercyhurst make that master’s degree program in forensic anthropology stand above similar options at other schools. “I think it’s the difference between having a job and not,” she said. Mercyhurst’s program is an attractive commodity, Dirkmaat said, due to the hands-on experience his students receive in assisting with cases. The approach involves applied learning, because there’s only so much forensic anthropologists can gain from a textbook, Chapman said. Over the past five years, Dirkmaat has seen more of his students explore careers in investigation, he said. About half graduate from the Mercyhurst program and get their doctorate degrees, he said, while the other half go into investigatory positions with coroners’ and medical examiners’ offices. “There’s a lot they can do,” he said of his students. Dirkmaat envisions a day when police will be able to collect DNA from human remains at outdoor scenes with the click of a device. Although the capabilities of forensic anthropology continue to expand - almost daily - through technology and research, Dirkmaat said bone identification will continue to be the tip of the iceberg when it comes to processing a scene. “If you just say, ‘I only work with bones,’ you’ll become extinct,” he said. ?___ Glossary of terms . Forensic anthropology: The examination and excavation of human remains to assist law enforcement with identification, signs of trauma, estimated time of death and historical context of a crime scene. . Forensic taphonomy: The study of postmortem changes to human remains, including decomposition of soft tissue, animal activity, bone modification or human interference. . Forensic pathology: The examination of corpses through autopsy to determine a medical cause of death, collect medical evidence, order further laboratory tests such as X-rays, toxicology screens and samples of tissues or organs. . Total Station: A surveying instrument used to map and reconstruct accidents or crime scenes to preserve the locations of evidence and the context in which a death or accident occurred. ___ Local scenes worked by Mercyhurst team . 2010: An unmarked cemetery near site of 1800s location of Somerset Hospital, where an addition to SCI-Laurel Highlands was planned. Tribune-Democrat archives show workers realized they were uncovering rows of coffins during excavation, and officials with the Pennsylvania Department of Corrections postponed work while Mercyhurst graduate students conducted research on each coffin’s contents. The remains were later relocated to a burial place away from the construction site. . November 2011: Dirkmaat and several of his students responded to Bedford Township near the Midway Travel Plaza of the Pennsylvania Turnpike, where skeletal remains were found by hunters in a wooded area. The remains were later identified as 30-year-old Audrey Rock Phoenix, of Portland, Oregon, who was entered as an endangered missing person by the Portland Police Department six months prior. . November 2012: The discovery of human remains along the Great Allegheny Passage hiking trail in Larimer Township, Somerset County, were quickly identified by Dirkmaat and his team as 19-year-old Justine Jackson and led to the arrest of her boyfriend, Jonathan Beal. Beal eventually admitted to strangling and killing Jackson, then burying her, and was sentenced in 2013 to serve 10 to 24 years in state prison for voluntary manslaughter. . December 2015: Mercyhurst University students helped investigate the scene of a fatal fire in Shade Township, Somerset County. Investigators and Dirkmaat’s students determined that Helen Kalanish, 56, died from smoke inhalation and her death was ruled accidental. . September 2017: Human remains found along Ligonier Pike in Conemaugh Township, Somerset County; later identified as homicide victims Damian Michael Staniszewski, 19, of Duncansville, and James Edward Smith, 32, of Portage, who were both reported missing in March 2017. State police then charged two Ohio men in the murder and allege it was retaliation for allegedly stealing drugs from a “stash house” in Johnstown. Devon Lee Wyrick and Samson Ezekiel Washington are both being held without bond at the Somerset County Jail awaiting trial. . October 2018: Human remains discovered near Route 30 in Bedford County, later identified as Robert E. Cochran, 27, of Canajoharie, New York, who had gone missing in 2013. Investigators said Cochran’s cause of death and the details of why he was in the area may never be determined, but the information from his family and Dirkmaat’s team did not include evidence of anything suspicious. . May 2019: Human remains found in shallow grave near the James Wolfe Sculpture Trail in Johnstown, later determined to be those of 40-year-old Nancy Giles, a city woman who had gone missing in October. According to Cambria County Coroner Jeff Lees, Giles’ body was found “approximately two feet off the trail and two feet down,” by a man who was searching for metal objects in the area. Dental records were used to identify the remains, and, to confirm the identification, investigators used the serial number of a medical device found with the remains that matched Giles’ medical records. Lees has called Giles’ death highly suspicious, but has not released her cause or manner of death. Police are still investigating and have not yet made any arrests in the case. ___ Online: https://bit.ly/31YjAC5 https://bit.ly/2NqbvTw ___ Information from: The Tribune-Democrat, http://www.tribune-democrat.com
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University forensic science team reveals stories of the dead.


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KTWO-AM reports Carbon County School District No. 2 canceled classes Thursday at the elementary schools in Hanna, Elk Mountain and Medicine Bow, as well as the high school in Hanna. Classes will resume Monday after the campuses are disinfected. Kim Deti, a spokeswoman for the Wyoming Department of Health, says meningitis has not yet been confirmed and there is no public health threat. Superintendent Jim Copeland says student involved attends Hanna Elementary, and the other schools were closed as a precaution. The child has since been hospitalized. Meningitis is an infection of the membranes surrounding the brain and spinal cord. ___ This story has been updated to correct that meningitis has not been confirmed. ___ Information from: KTWO-AM, http://www.k2radio.com/
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4 Wyoming schools close after possible meningitis case.