'Brain-Eating' Amoeba Kills Second Neti Pot User

Louisiana state health officials are warning patients about potential dangers of using tap water in the sinus-irrigating neti pot after two patients died of Naegleria fowleri infection.

N. fowleri is known as a "brain-eating" amoeba because it can enter a patient's nose, infect the brain, and cause primary amebic meningoencephalitis (PAM), a brain-tissue destroying condition.

The first Louisiana patient died of neti pot-induced infection in June. An additional two patientsdied of N. fowleri infection in August after swimming in warm, fresh water.

The amoeba usually infects patients that submerge their heads in freshwater lakes and rivers, though it can be transmitted through inadequately chlorinated pool water or underheated (less than 116°F) tap water that enters a patient's nose, a statement from the Louisiana Department of Health and Hospitals said.

Patients that irrigate their noses with a neti pot should use distilled, sterile, or previously boiled water, Raoult Ratard, MD, a Louisiana state epidemiologist, said in the statement. He noted that tap water was safe to drink, but may not be safe for nasal cleansing.

Symptoms of PAM include headache, fever, nausea, vomiting, and stiff neck, and may take one to seven days to start. Later symptoms include confusion, lack of attention to environment, loss of balance, seizures, hallucinations, and, in one to 12 days after infection, death. The disease progresses rapidly and symptoms may resemble bacterial meningitis, the statement warned.

N. fowleri infection is rare in the U.S. -- only 32 cases have been documented from 2001 to 2010, according to the CDC website. The agency also noted that patients should rinse devices like the neti pot after use and to allow it to air dry.

The CDC is actively working with Louisiana state health officials on the investigation, an agency representative told MedPage Today.

Long Island Beach Remains Identified as Shannan Gilbert

Skeletal remains found in an impassable tangle of swamp and thick brush on a Long Island, N.Y., barrier beach have been identified as Shannan Gilbert, the woman whose disappearance led to the discovery of what police say is a serial killer's burial ground.

The Suffolk County Medical Examiner's Office identified the remains today, and though the cause of death is still undetermined, police have said they believed it was accidental.

The body was found last week about a quarter of a mile from where the 24-year-old Gilbert's purse, identification and shoes were located last week, near Oak Beach."[The homicide squad] were on an amphibious machine edging forward into thick brush when the homicide squad detective spotted the skeletal remains lying on the surface of the ground," "Suffolk County Police Commissioner Richard Dormer said after the remains were found.Oak Beach is on a barrier island along the South Shore of Long Island, separating the Atlantic Ocean from South Oyster Bay. In the summer the ocean beaches are crowded, but in winter the beaches are largely deserted.Dormer called the area where the body was found a "very tough, desolate, tangled mess."He said that Gilbert could have likely been able to see the lights on a nearby parkway and attempted to go in that direction, but that she did not get very far in the marshy, tough ramble."If it is Shannan Gilbert, then her location is indicative of her trying to make it to the causeway, which is northeast of where her remains were found," Dormer said."There's no way Shannan Gilbert could have gotten through that brush to make it to the parkway," Dormer said. "If somebody is disoriented and anxious and running, it certainly would take a toll on you."Gilbert, 24, was last seen in May 2010 apparently running from someone near today's search area. On the night of her disappearance, witnesses told police Gilbert did not appear to be acting rationally."It appeared at first when they searched that there's no way anyone could get in there," Dormer said. "We went in with the idea that we were going to do this one last time to see if we can find anything and we did.""It is certainly a sad day for the Gilbert family and our condolences go out to that family on the death of their daughter," Dormer said.The search for Gilbert led to the discovery of 10 sets of dismembered bodies that are believed to have been the victims of a serial killer, but Gilbert's death is not believed to be linked to the other 10 deaths.Detectives believe a single killer is responsible for the dismembered bodies of young women, a male transvestite and a toddler found dumped along a pristine stretch of Long Island's south shore from 1996 to 2010.Police believe that all 10 of the victims were linked to the sex trade, with DNA indicating that the toddler was the likely daughter of one of the victims.It was the search for Craigslist escort Gilbert that yielded the grisly discoveries. Gilbert disappeared the previous May after meeting a client in nearby Oak Beach.

Britney Spears’s ‘Princess’ Engagement Ring: All the Details!

Courtesy Neil Lane; Inset: Kevin Mazur/WireImage

Britney Spears may be a pop-star diva to the rest of the world, but to beau Jason Trawick, “she’s his everyday princess,” says celebrity jeweler Neil Lane, who designed Spears’s dazzlingengagement ring to befit Trawick’s vision of the singer’s down-home regality. “Jason is a romantic and when I asked him to tell me about Britney and what the ring would represent to them so I could find inspiration, his response was always the same — she is his princess!”

With that theme in mind, Lane tells PEOPLE he designed from scratch a tiara-motif sparkler with a round, perfect white diamond in a handmade platinum setting that “looks like a mini crown,” the celebrated jeweler says. He also added 90 small round diamonds around the eternity band. “Jason didn’t want an over-the-top ring with a giant stone,” he adds.

Over the last month, Lane and Trawick clocked phone and email minutes as they collaborated while Trawick was traveling with Spears on her global tour. “Texts came from all over the world, from Abu Dhabi, Mexico and I don’t know where else!” says Lane.

But when Trawick stopped into Lane’s Los Angeles store to pick up the ring — less than one week before the proposal! — they both knew the hard work and scheming had paid off. “Oh my god, he loved it,” Lane shares, adding that he could tell Trawick had pre-proposal jitters. “The guy was so excited and nervous. At the end of the day, even with all the fame, he’s still a normal guy who was about to propose to the woman he loves.”

That said, Lane believes this couple is in it for the long haul. “He’s deeply in love with her. Britney is his princess and he is her knight in shining armor,” he says. “Jason’s protective of her. He adores her. Every good fairytale needs a princess, and now Britney has a ring fit for a princess!”