AUSTIN (KXAN) — Swimmers and water skiers in Texas are being reminded to take precautions to avoid a brain-eating amoeba.

PAM, or primary amoebic meningoencephalitis, is present in nearly all rivers, lakes, ponds and streams.

The Texas Department of State Health Services says even though the infection is extremely rare, it is almost always deadly.

Nine cases have been reported in the state since 2005, resulting in eight deaths, including a recent cases of a teen in Harris County.

DSHS says you can take these precautions to reduce the already low risk of infection:

• Do not swim, ski, dive or jump into stagnant water.

• Hold your nose or use nose clips when jumping, skiing, diving or wakeboarding in any fresh water.

• Avoid putting your head underwater in hot springs and other warm fresh water bodies.

• If you use a Neti-Pot or syringe for nasal irrigation or participate in ritual nasal rinsing be sure to use only sterile, distilled, or lukewarm previously boiled water.

• Avoid digging in, or stirring up mud and scum while taking part in water-related activities in shallow, warm freshwater areas.

The amoeba thrives in warm, stagnant water but may be present in any body of fresh water, the agency says. A combination of lower water levels, high temperatures and stagnant or slow-moving water may produce higher concentrations of the amoeba.

Infection can occur when water containing the amoeba is forced up the nose when participating in water-related activities. The organism has also been found in tap water and can be introduced to the brain when tap water is used for nasal irrigation or sinus flushes. Symptoms may include severe headache, high fever, stiff neck, nausea and vomiting.

The amoeba does not live in salt water or in swimming pools and hot tubs that are properly cleaned, maintained and treated with chlorine.

Closing lakes or other bodies of water is not a standard public health protection measure against PAM given that the amoebas are ubiquitous, naturally occurring microorganisms and infections are extremely rare.