The rare but nearly always fatal brain-eating amoeba has struck again, killing a 19-year-old college student and Kingston, NY resident named Kerry Stoutenburgh late this past August.

As reported by the Daily Freeman, Stoutenburgh had recently visited the state of Maryland with her family and boyfriend. On August 20, she decided to take a dip in several of the state’s sources of warm fresh water. Unknown to her, the water likely contained Naegleria fowleri, which likely infected her as she inhaled water through her nose. A week later, Stoutenburgh was hospitalized with vomiting and chronic headaches. Though she initially recovered, her condition quickly deteriorated and she finally died on August 31. State lab testing confirmed the presence of Naegleria fowleri in her system earlier this September.

“It is a catastrophic type of infection,” Dr. Carol Smith, Ulster County health commissioner, told the Daily Freeman. “It really progresses to fatality quite quickly.”

Since 1968, there have been 139 people in the United States confirmed to have been infected by Naegleria fowleri — with only four surviving — according to the Centers for Disease Control and Prevention. In recent years, however, there’s been an increase in cases, with Stoutenburgh’s infection being the 38th to be reported since 2006. Worryingly, it’s also become more widespread. While the majority of earlier cases were seen in the southernmost states, particularly Texas and Florida, more recent victims have been seen in states as far north as Minnesota. Stoutenburgh’s tragic death would be the first documented case from Maryland.

Though N. fowleri is content to live its life in especially warm soil or water as a bacteria-eating protozoan, the chance encounters it has with people are invariably disastrous. Reaching our noggins through the olfactory bulb, it systemically eats away at the brain’s protective covering as well as the brain itself, triggering a condition known as primary amoebic meningoencephalitis. Ultimately, our immune system’s drastic response causes such severe swelling and hemorrhaging that the brain collapses in on itself, severing the connection between it and the spinal cord, killing us. Although most people catch it from swimming in contaminated fresh water, some have contracted N. fowleri by using contaminated tap water to irrigate their noses or by swimming in poorly chlorinated swimming pools.

There has been some encouraging hope in finding treatments for N. fowleri infection, or n aegleriasis, particularly with the antimicrobial drug miltefosine, which may have helped save two stateside victims in 2013 and most recently Florida resident Sebastian DeLeon, 16, earlier this August. Elsewhere, other scientists have created ways to broadly screen for new drugs from an extensive list of existing compounds, and research is ongoing to test out the most promising of these candidates.

For the time being, though, miltefosine is considered a last resort experimental treatment that may only slightly increase the chances of survival, and only if the infection is detected as early as possible. According to Smith, it’s unlikely that Stoutenburgh would have been benefited from the drug, especially since her symptoms were mistakenly diagnosed as bacterial meningitis at first.

While infection with N. fowleri is thankfully rare and hardly the most pressing danger from spending time in the water, the CDC recommends that people can lower their risk by limiting how much water gets in their noses while swimming, especially in freshwater, and by using boiled or bottled water to irrigate their noses.

A GoFundMe page has been set up by Stoutenburgh’s friends to help support her family through their ordeal. It is currently less than two thousand dollars away from its $15,000 goal. An upcoming junior at CUNY Brooklyn College studying cinematography, Stoutenburgh would have turned 20 later this October.