Could Using Neti Pots to Relieve Sinuses Be Dangerous?

Q. I use a neti pot to relieve my sinusitis and love it. But I just heard two people died from neti pot infections. Is this true? Should I stop using mine?
-- Megan, Hanover, MA

A. When one of us (Dr. Oz) showed Oprah on TV how neti pots work, they sold out everywhere and became a drugstore staple for treating sinuses. Neti pots -- they look like a genie’s lamp -- are used to pour a mild salt-water solution up alternating nostrils, which flushes out the other side, gunk and all. Countless sinus sufferers like you say they've breathed clearly afterward for the first time in years.

So we YOU Docs were stupefied to hear two deaths blamed on neti pot use. Turns out, make that neti pot misuse. The vital message here: “Use all medical devices as directed,” even the simplest. Here's the story.

The Dec. 6, 2011 announcement (condensed for space reasons) read, “The Louisiana Department of Health and Hospitals is warning residents about the dangers of the improper use of neti pots [our italics] after the state's second death this year caused by Naegleria fowleri, the so-called brain-eating amoeba. Both people died after using tap water in a neti pot to irrigate their sinuses and becoming infected with the deadly amoeba. Naegleria fowleri enters the body through the nose, causing primary amoebic meningoencephalitis (PAM), which destroys brain tissue.

"If you're rinsing your sinuses with a neti pot, use distilled, sterile or boiled water to make the solution,' said Louisiana State epidemiologist Dr. Raoult Ratard. 'Tap water is not safe for irrigating your nose.' It's also important to rinse the device after each use and let it air dry.

"Naegleria fowleri infection typically occurs from swimming in warm lakes and rivers. In very rare instances, infections also occur when contaminated water from other sources (such as inadequately chlorinated swimming pool water or tap water heated to less than 116.6 degrees Fahrenheit) enters the nose."

We consulted experts who told us that this amoeba can’t live in chlorinated water. Even weakly chlorinated water kills it. So how did tap water, which should be chlorinated for purification, do this? Think improper use.

We don't intend to give up our neti pots and don't think you need to either. But like so many drugstore purchases -- aspirin to ice packs -- misuse can cause big trouble. Here's the right way to use a neti pot:

1. Rinse and let it air dry after each use.
2. If your pot develops a crack, toss it.
3. Don't share your neti pot with anyone.
4. A few times a year, disinfect it with a dilute solution of laundry bleach and water, then repeatedly rinse and completely air dry.
5. Ideally, use distilled water and pre-made saline solution packs (about $5 for a 3 to 5 month supply). However, our experts say that as long as your tap water is chlorinated, it should be fine.
6. Immediately discard any unused saline solution. Leftover saline solution is a great growth media for bacteria, viruses -- and, yes, amoeba.

When it comes to sinus symptoms, it's smart to be a wimp. Find out why.

Here are other ways to tame the pain of a lurking sinus infection.