Balamuthia mandrillaris
| Morphology | Free-living amoeba. | 
|---|---|
| Disease | A slowly progressive, insidious encephalitis that is almost always fatal. | 
| Zoonosis | None. | 
| Host Range | Soil, dust, water. Humans, dogs, horses, primates. | 
|---|---|
| Modes of Transmission | Skin contact with contaminated material and inhalation. | 
| Signs and Symptoms | Subacute to chronic with nonspecific neurologic symptoms; skin lesions. | 
| Infectious Dose | Unknown. | 
| Incubation Period | Unknown. | 
| Prophylaxis | None available. | 
|---|---|
| Vaccines | None available. | 
| Treatment | Treatment with pentamidine, fluconazole, flucytosine, sulfadiazine, azithromycin,
                                                      clarithromycin, and miltefosine. | 
| Surveillance | Monitor for symptoms. | 
| MSU Requirements | Report any exposures | 
| Laboratory Acquired Infections (LAIs) | None have been reported. | 
|---|---|
| Sources | Aquatic environments, soil, dust. Cultures, frozen stocks, other samples described
                                                            in IBC protocol. | 
| BMBL: | https://www.cdc.gov/labs/BMBL.html | 
|---|---|
| CDC: | |
| NIH Guidelines: | 
| Risk Group 2 | Agents that are associated with human disease which is rarely serious and for which preventive or therapeutic interventions are often available. | 
|---|---|
| BSL2 | For all procedures involving suspected or known infectious specimen or cultures. | 
| ABSL2 | For all procedures involving infected animals | 
| Small | Notify others working in the lab. Remove PPE and don new PPE. Cover area of the spill
                                                   with absorbent material and add fresh 1:10 bleach:water. Allow 20 munutes (or as directed)
                                                   of contact time. After 20 minutes, cleanup and dispose of materials. | 
|---|---|
| Large | 
 | 
| Mucous membrane  | Flush eyes, mouth, or nose for 5 minutes at eyewash station. | 
|---|---|
| Other Exposures  | Wash area with soap and water for 5 minutes.  | 
| Reporting | Immediately report incident to supervisor, complete a First Report of Injury form, and submit to Safety and Risk Management. | 
| Medical Follow-up  | During business hours: Bridger Occupational Health 3406 Laramie Drive. Weekdays 8am -6pm.  Weekends 9am-5pm After business hours: Bozeman Deaconess Hospital Emergency Room 915 Highland Blvd Bozeman, MT | 
| Disinfection | Susceptible to 1:10 bleach:water, 3% hydrogen peroxide | 
|---|---|
| Inactivation | Inactivated by moist heat (60 minutes at 121oC) and dry heat (1 hour at 160-170oC). | 
| Survival Outside Host | Survives in the environment for long periods of time. | 
| Minimum PPE Requirements | Lab coat, disposable gloves, safety glasses, closed toed shoes, long pants | 
|---|---|
| Additional Precautions | Additioanl PPE may be required depending on lab specific SOPs and IBC Protocol. | 
