# How likely is it that I'll die due to sinus rinse? **URL:** \ **Category:** Factual Questions\ **Created:** [January 30, 2019, 11:10pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697 "2019-01-30T23:10:14Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Stranger\_On\_A\_Train](https://avatars.discourse-cdn.com/v4/letter/s/13edae/32.png) [@Stranger\_On\_A\_Train](https://boards.straightdope.com/u/Stranger_On_A_Train)\ **Post date:** [January 31, 2019, 3:08pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/21 "2019-01-31T15:08:12Z")
> [@Qadgop\_the\_Mercotan](#): > > **Stranger** ’s 0.01% chance per use is, in my mind, far too high. I suspect the actual lifetime risk to be well lower than 0.01%, else we’d be seeing a LOT more brain abscesses clinically than we do. That figure wasn’t based on anything; I was just using it for illustration purposes to show that even a small percentage chance of infection can add up over a cummulation of events. Infection by _N. fowleri_ is extremely rare even by people who are exposed to it, but injecting warm, unsterilized water into the sinus cavity is essentially maximizing the potental for infection. > [@susan](#): > > I don’t know about your neti practices, but mine include salt, which I assume may not be that great for brain-eating critters. The low concentration of salt necessary to make an isotonic saline solution (~1%) will not harm most microorganisms, and higher concentrations would irritate your mucous membranes. > [@am77494](#): > > I read the linked news story and related reports on google search. I did not find how the doctors established that the Neti was culprit as opposed to tap water/spray getting in her nose during a shower or bath. Is there any information available on this ? An incidental spray of water in a shower or splashing in a bath is unlikely to deliver enough organisms deep enough into the sinus cavity to result in infection, and the sinuses are normally protected by a layer of mucous that is continually renewed and expelled. The use of a neti pot or other sinus wash temporarily removes this layer (presumably because it has become encrusted or congested) and leaves the bare sinuses exposed to infection, and the flooding of the sinus cavity with warm, potentially microorganism-rich water maximizes the potential for infection. The odds of an actual infection are low—people have been using neti pots for hundreds of years with untreated water—but distilled water can be purchased at any large pharmacy or grocery store for under a dollar, and will remain essentially sterile as long as it is capped and not infused with any other substance. Even if the incidence of infection by using water that is not distilled or boiled is very low, the consequence of an infection (even if not _N. fowleri_, as anyone who has suffered a sinus infection and attendant symptoms can tell you) is severe, so the risk is high by default. Stranger ---
**Author:** ![bob\_2](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bob_2/32/3341_2.png) [@bob\_2](https://boards.straightdope.com/u/bob_2)\ **Post date:** [January 31, 2019, 3:20pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/22 "2019-01-31T15:20:07Z")
> [@Qadgop\_the\_Mercotan](#): > > I’m completely ruined for private practice now, I tell patients exactly what I think they need to know; complete and unvarnished truth about their situation. Fortunately I don’t have to face patient satisfaction surveys. Though most of my patients do seem to appreciate this direct approach. I take it that you are a Dock Martin fan then [https://www.youtube.com/watch?v=sbSeqGjftHI](https://www.youtube.com/watch?v=sbSeqGjftHI) ---
**Author:** ![bump](https://avatars.discourse-cdn.com/v4/letter/b/7c8e57/32.png) [@bump](https://boards.straightdope.com/u/bump)\ **Post date:** [January 31, 2019, 3:34pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/23 "2019-01-31T15:34:47Z")
> [@Qadgop\_the\_Mercotan](#): > > How likely? Not very. The otolaryngology and Infectious disease experts all report that the risk is ‘extremely low’ and that it’s a ‘rare’ complication. And that generally the risk is more for the elderly or immunocompromised. But the available data is just not good enough to to really give precise numbers. Even if you don’t get the brain-eating amoebas, is getting a more mundane infection possible or likely from using unfiltered/unboiled water? ---
**Author:** ![Yeah](https://avatars.discourse-cdn.com/v4/letter/y/dbc845/32.png) [@Yeah](https://boards.straightdope.com/u/Yeah)\ **Post date:** [January 31, 2019, 5:20pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/24 "2019-01-31T17:20:10Z")
> [@bump](#): > > Even if you don’t get the brain-eating amoebas, is getting a more mundane infection possible or likely from using unfiltered/unboiled water? I don’t know, but I doubt it. Most sinus infections are caused by microbes that like to live in mammalian uppper respiratory tracts, not in water. Do you have any particular mundane pathogenic microbes in mind? ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [January 31, 2019, 7:08pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/25 "2019-01-31T19:08:31Z")
> [@dougrb](#): > > How low would that need to be before you decided to risk it? Is it _“I probably shouldn’t drive because I just drank six beers”_ risky or is it _“I better never go outdoors because I might get eaten by a bear”_ risky? Both of these are things which have killed some people. And both of these are things which some people have done and survived. But I think most people would agree that one is a sensible precaution and one isn’t. Which one is rinsing your nose with tap water closer to? ---
**Author:** ![aruvqan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aruvqan/32/2891_2.png) [@aruvqan](https://boards.straightdope.com/u/aruvqan)\ **Post date:** [January 31, 2019, 9:15pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/26 "2019-01-31T21:15:28Z")
neti pot user daily except for the week i recently spent in hospital [totally unrelated, was due to a chemo and radiation side effect] and i have an electric tea kettle in the bathroom that every morning i fill with well water and boil. Let it cool to body temp, rinse out the neti then refill and add the saline packet and use and finish by washing and rinsing out the pot after use. if i have a sinus issue, i may flush my sinuses several times a day, and will boil fresh kettles as needed. been doing this for what, like 5 or so years now? love the neti pot, have had so many fewer sinus incidents since starting - maybe down to a couple colds a year. ocd cleanliness and person avoidance this past 10 months kept me from getting anything til i picked up pneumonia in the freaking hospital, stupid opportunistic bugs! ---
**Author:** ![Hermitian](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hermitian/32/470_2.png) [@Hermitian](https://boards.straightdope.com/u/Hermitian)\ **Post date:** [January 31, 2019, 9:36pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/27 "2019-01-31T21:36:05Z")
> [@Stranger\_On\_A\_Train](#): > > Given the unknowns, it makes little sense to risk infection compared to spending a few dollars per year to purchase distilled water. > Stranger Its not the cost of the distilled water, it is the trouble of heating it up every single day. Between getting ready for work and getting the kids ready, mornings are chaos. If this neti pot operation take more than about 25 seconds or more than 10% of my mental capacity, it isn’t going to happen. As the wise oracle once said, “Ain’t nobody got time for that!” So yea, I take the risk. ---
**Author:** ![bump](https://avatars.discourse-cdn.com/v4/letter/b/7c8e57/32.png) [@bump](https://boards.straightdope.com/u/bump)\ **Post date:** [January 31, 2019, 10:10pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/28 "2019-01-31T22:10:51Z")
> [@Yeah](#): > > I don’t know, but I doubt it. Most sinus infections are caused by microbes that like to live in mammalian uppper respiratory tracts, not in water. Do you have any particular mundane pathogenic microbes in mind? No, I was just wondering- the media and people tend to make a lot of noise about relatively uncommon stuff, while ignoring the everyday things, so I wondered if that was the case here as well- they’re making noise about the amoebas, but ignoring the thousands of other infections caused by using unsanitary water. ---
**Author:** ![am77494](https://avatars.discourse-cdn.com/v4/letter/a/d2c977/32.png) [@am77494](https://boards.straightdope.com/u/am77494)\ **Post date:** [February 1, 2019, 11:52am UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/29 "2019-02-01T11:52:13Z")
> [@Stranger\_On\_A\_Train](#): > > …An incidental spray of water in a shower or splashing in a bath is unlikely to deliver enough organisms deep enough into the sinus cavity to result in infection, and the sinuses are normally protected by a layer of mucous that is continually renewed and expelled… > > Stranger Thank you Stranger. In the US media, yoga is often portrayed as something done predominantly by females or by hippy kind of people. But Neti is also yoga, and has found wide acceptance amongst Americans of different ideologies. As an Indian, it warms my heart to see this and I wish meditation gains more popularity too. ---
**Author:** ![DesertDog](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desertdog/32/11503_2.png) [@DesertDog](https://boards.straightdope.com/u/DesertDog)\ **Post date:** [February 1, 2019, 1:28pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/30 "2019-02-01T13:28:12Z")
> [@Qadgop\_the\_Mercotan](#): > > Just like we use distilled water for our patients with CPAP machines. Not using one, I didn’t realize you needed to use water with a CPAP machine. On reflection, it would be better to blow moist air up your upper respiratory tract. ---
**Author:** ![puddleglum](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puddleglum/32/137_2.png) [@puddleglum](https://boards.straightdope.com/u/puddleglum)\ **Post date:** [February 1, 2019, 3:36pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/31 "2019-02-01T15:36:28Z")
> [@Little\_Nemo](#): > > Is it _“I probably shouldn’t drive because I just drank six beers”_ risky or is it _“I better never go outdoors because I might get eaten by a bear”_ risky? Both of these are things which have killed some people. And both of these are things which some people have done and survived. But I think most people would agree that one is a sensible precaution and one isn’t. Which one is rinsing your nose with tap water closer to? From a risk management perspective there are three concerns. Potential cost, likelihood, and cost of mitigation. The potential cost is huge, your life. The likelihood is vanishingly small, and the cost of mitigation is a couple of dollars a year for distilled water. For this reason I use distilled water but everyone has a different risk tolerance. ---
**Author:** ![muldoonthief](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/muldoonthief/32/3188_2.png) [@muldoonthief](https://boards.straightdope.com/u/muldoonthief)\ **Post date:** [February 1, 2019, 4:27pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/32 "2019-02-01T16:27:05Z")
> [@puddleglum](#): > > From a risk management perspective there are three concerns. Potential cost, likelihood, and cost of mitigation. The potential cost is huge, your life. The likelihood is vanishingly small, and the cost of mitigation is a couple of dollars a year for distilled water. For this reason I use distilled water but everyone has a different risk tolerance. As **Hermitian** alluded to above, there’s also a time/convenience cost in using distilled water. I can walk to the sink and adjust tap water to the exact temperature I want in about 5 seconds. How long does it take for a container of distilled water? ---
**Author:** ![robby](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/robby/32/11048_2.png) [@robby](https://boards.straightdope.com/u/robby)\ **Post date:** [February 1, 2019, 5:02pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/33 "2019-02-01T17:02:33Z")
> [@muldoonthief](#): > > As **Hermitian** alluded to above, there’s also a time/convenience cost in using distilled water. I can walk to the sink and adjust tap water to the exact temperature I want in about 5 seconds. How long does it take for a container of distilled water? You could probably heat it in the microwave in under a minute. If you do it regularly, you could pretty easily figure the exact amount of seconds needed to heat a given volume to the desired temperature. ---
**Author:** ![joe.russell](https://avatars.discourse-cdn.com/v4/letter/j/ecb155/32.png) [@joe.russell](https://boards.straightdope.com/u/joe.russell)\ **Post date:** [February 2, 2019, 3:20am UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/34 "2019-02-02T03:20:27Z")
Exactly right. Microwave for 32 seconds with the neil med sinus rinse. ---
**Author:** ![Yeah](https://avatars.discourse-cdn.com/v4/letter/y/dbc845/32.png) [@Yeah](https://boards.straightdope.com/u/Yeah)\ **Post date:** [February 2, 2019, 4:08am UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/35 "2019-02-02T04:08:23Z")
> [@joe.russell](#): > > Exactly right. Microwave for 32 seconds with the neil med sinus rinse. Or 45-50 seconds if you warm two squeeze bottles at once. ---
**Author:** ![Ike\_Witt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ike_witt/32/283_2.png) [@Ike\_Witt](https://boards.straightdope.com/u/Ike_Witt)\ **Post date:** [February 2, 2019, 4:40am UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/36 "2019-02-02T04:40:00Z")
> [@joe.russell](#): > > Exactly right. Microwave for 32 seconds with the neil med sinus rinse. > [@Yeah](#): > > Or 45-50 seconds if you warm two squeeze bottles at once. For what wattage microwave? ---
**Author:** ![SamuelA](https://avatars.discourse-cdn.com/v4/letter/s/c77e96/32.png) [@SamuelA](https://boards.straightdope.com/u/SamuelA)\ **Post date:** [February 2, 2019, 8:04am UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/37 "2019-02-02T08:04:49Z")
> [@Ike\_Witt](#): > > For what wattage microwave? Microwaves tend to be of similar wattage, between 1000 and 1500 watts. The reason is if they are too powerful or have too little power, the instructions for cooking on the back of frozen meals won’t be valid. Normal power level seems to be 1100 watts. ---
**Author:** ![Zyada](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/zyada/32/3028_2.png) [@Zyada](https://boards.straightdope.com/u/Zyada)\ **Post date:** [February 3, 2019, 5:36pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/38 "2019-02-03T17:36:30Z")
What I haven’t seen in this discussion is the fact that N. fowleri prefers hot water. The first I ever heard of brain eating amoeba was from signs near hot springs in Nevada warning people to not submerge their heads to to n. fowleri. You don’t need those warnings in most lakes because the lakes are too cold for this organism to be infectious. From wikipedia: > [@](#): > > Naegleria fowleri is a thermophilic (heat-loving), free-living amoeba. It is found in warm and hot freshwater ponds, lakes and rivers, and in the very warm water of hot springs. As the water temperature rises, its numbers increase. > … > N. fowleri occurs in three forms – as a cyst, a trophozoite (ameboid), and a biflagellate > … > Cysts are naturally resistant to environmental factors, so as to increase the chances of survival until better conditions occur. Trophozoites encyst due to unfavorable conditions. Factors that induce cyst formation include a lack of food, overcrowding, desiccation, accumulation of waste products, and cold temperatures.[4] When conditions improve, the amoeba can escape through the pore, or ostiole, seen in the middle of the cyst. N. fowleri has been found to encyst at temperatures below 10 °C (50 °F). > … > The trophozoite is the feeding, dividing, and infective stage for humans. The trophozoite attaches to olfactory epithelium, where it follows the olfactory cell axon through the cribriform plate (in the nasal cavity) to the brain. This reproductive stage of the protozoan organism, which transforms near 25 °C (77 °F) and grows fastest around 42 °C (106.7 °F), proliferates by binary fission. > > … > This amoeba is able to grow best at moderately elevated temperatures making summer month cases more likely. N. fowleri is thermotolerant and able to survive 46 °C (115 °F) - [Naegleria fowleri](https://en.wikipedia.org/wiki/Naegleria_fowleri) IANA Microbiologist, but from this, I would guess the problem is that the normal residential water heater is a near ideal environment for the proliferation of n. fowleri. Especially with the relatively\* recent recommendation to lower your water heater setting to 120 F for safety reasons. So even using regular tap water strictly from the cold water side, and heating in the microwave is much lower risk that using water from the hot tap. What this article doesn’t really address (that I can tell), is how effective are normal water treatment processes are on the cyst form of the amoeba. Also, how do the new “hot water on demand” water heaters work - would the water not stay in one of those water heaters long enough for the amoeba to proliferate? - since I’m getting into the old fart age range, recently can be as much as before you were born, sonny. Get off my lawn! ---
**Author:** ![Bill\_Door](https://avatars.discourse-cdn.com/v4/letter/b/50afbb/32.png) [@Bill\_Door](https://boards.straightdope.com/u/Bill_Door)\ **Post date:** [February 3, 2019, 7:31pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/39 "2019-02-03T19:31:58Z")
> [@dougrb](#): > > How low would that need to be before you decided to risk it? Well, if the round trip to the retail establishment to obtain distilled water is 5 miles, you’ve got [one chance in 10.6 million](https://curiosity.com/topics/your-odds-of-dying-ranked-curiosity/) of dying in a motor vehicle crash on the way, so anything less than that is quite literally saving your life. Everything has a risk-reward ratio, **Anny Middon** just wants to know what it is. ---
**Author:** ![SamuelA](https://avatars.discourse-cdn.com/v4/letter/s/c77e96/32.png) [@SamuelA](https://boards.straightdope.com/u/SamuelA)\ **Post date:** [February 3, 2019, 8:47pm UTC](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697/40 "2019-02-03T20:47:03Z")
> [@Zyada](#): > > Also, how do the new “hot water on demand” water heaters work - would the water not stay in one of those water heaters long enough for the amoeba to proliferate? Correct. This is one way to avoid such problems. Another way is you use a conventional tank heater set to 140 Fahrenheit or higher, but, **critical step!** - you install a hot water mixing valve. This is a special valve that automatically mixes in cold water to bring the temperature leaving the heater assembly down to around 104-110 Fahrenheit, which is below the temperature that you get scalds or burns. > [@Bill\_Door](#): > > Well, if the round trip to the retail establishment to obtain distilled water is 5 miles, you’ve got [one chance in 10.6 million](https://curiosity.com/topics/your-odds-of-dying-ranked-curiosity/) of dying in a motor vehicle crash on the way, so anything less than that is quite literally saving your life. Everything has a risk-reward ratio, **Anny Middon** just wants to know what it is. Yes but you were going to make that trip anyways to purchase other supplies and groceries. No difference in the odds. Also, tap water can contain chlorine and other irritants. [Previous page](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697.md?page=1) [Next page](https://boards.straightdope.com/t/how-likely-is-it-that-ill-die-due-to-sinus-rinse/828697.md?page=3)