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A Santa Rosa company that makes neti pots — small vessels that sinus sufferers use to rinse their nasal passages — is fighting fallout from a report that two people died after using them.

NeilMed Pharmaceuticals and government health experts said neti pots didn't cause the deaths of two people in Louisiana earlier this year. The victims died of a rare infection after they used contaminated tap water in their neti pots, exposing themselves to a brain-eating amoeba when they rinsed their noses.

"We are not saying in any way that people should not use neti pots," said Lisa Faust, spokeswoman for the Louisiana Department of Health and Hospitals. "We are saying that if you are going to use a neti pot, you should not be using tap water."

Neti pots are safe if used with distilled, sterilized, boiled or properly filtered water, according to the U.S. Centers for Disease Control and Prevention.

But the Louisiana deaths have prompted media reports and Internet speculation about their safety. So far, no retailers have pulled the company's neti pots from their store shelves, said Dr. Ketan Mehta, NeilMed's CEO.

But there's confusion in the marketplace because some brands don't list the proper precautions, he said. NeilMed's neti pots come with instructions calling for distilled, filtered or boiled water to be used. There's also a warning against using tap water that hasn't first been boiled and then cooled down.

"From day one, our instructions have been the same," Mehta said. "We are the gold standard." NeilMed also includes instructions about cleaning neti pots between each use.

A neti pot is an ancient Indian device for rinsing the sinuses. NeilMed's version, which looks like a small teapot, lets users pour a saltwater solution into one nostril at a time, clearing nasal passages.

NeilMed is the world's largest maker of neti pots, supplying giant retailers including Walgreens, CVS Pharmacy and Rite Aid. It employs more than 350 people, mostly at its Santa Rosa headquarters.

NeilMed was founded in 2000 in Mehta's Santa Rosa medical office, and its sales exploded in 2007 after a neti pot was demonstrated on Oprah Winfrey's TV show. The company now makes various sinus-cleaning products that are sold in the U.S., Europe, Canada, the United Kingdom, Australia and elsewhere.

It's too soon to say whether the Louisiana cases will hurt NeilMed's business, Mehta said.

The Louisiana health department issued a warning about improper use of neti pots on Dec. 6 after the state's second fatality caused by a deadly amoeba. In the most recent case, a 51-year-old woman died after using tap water in a neti pot to rinse her sinuses.

The department didn't identify the neti pot brand.

An investigation traced the cause to Naegleria fowleri, a so-called brain-eating amoeba that infects people by entering the body through the nose. The contaminated tap water was from a small rural utility that relies on surface water, Faust said.

In June, a 20-year-old man died under the same circumstances, the health department said.

The amoeba causes a rare disease called "primary amoebic meningoencephalitis," an infection that leads to destruction of brain tissue.

Early symptoms are similar to bacterial meningitis, including headache, fever, nausea, vomiting and stiff neck. Later symptoms are confusion, loss of balance, seizures and hallucinations. Most victims die within 12 days, according to the health department.

People can't get infected by simply drinking water that contains the amoeba. Infection usually happens when people go swimming or diving in warm freshwater lakes or rivers and get water up their noses, the health department said.

"If you are irrigating, flushing or rinsing your sinuses by using a neti pot, use distilled, sterile or previously boiled water to make up the irrigation solution," said state epidemiologist Dr. Raoult Ratard.

"Tap water is safe for drinking, but not for irrigating your nose," he said.

You can reach Staff Writer Steve Hart at 521-5205 or steve.hart@pressdemocrat.com.