Federal health officials confirmed Friday that a Nebraska child died of a rare infection caused by a brain-eating amoeba after swimming in a river near Omaha. The Centers for Disease Control and Prevention confirmed the presence of the amoeba naegleria fowleri in the child, according to the Douglas County Health Department in Omaha. Health officials believe the child became infected while swimming Sunday in the Elkhorn River, a few miles west of Omaha. Authorities have not released the child’s name. People usually become infected when water containing the amoeba enters the body through the nose while swimming or diving in lakes and rivers. Other sources have been documented, including contaminated tap water in a Houston-area city in 2020. It is the second death in the Midwest this summer from primary meningoencephalitis, an infection caused by the amoeba that has proven fatal in 97 percent of reported cases. A Missouri resident died of the contamination in July after swimming in the Lake of Three Fires in southwest Iowa, health officials said. Symptoms of infection include fever, headache, nausea or vomiting, progression to a stiff neck, loss of balance, hallucinations and seizures. The CDC says naegleria fowleri infections are rare, with about three cases in the United States each year. There were 154 cases reported between 1962 and 2021 in the US, with only four survivors. Only about 430 cases have ever been recorded worldwide. In the US, amoeba infections usually occur in the southern states because the amoeba thrives in water warmer than 86 degrees Fahrenheit (30 Celsius). But infections have migrated north in recent years, including two cases in Minnesota since 2010.