Every year, we’re more than happy to welcome back summer and all the fun that goes with it. But with those warm-weather activities also comes an unfortunate but important safety reminder: don’t let warm, fresh water go up your nose, lest a brain-eating amoeba swims up there with it.

The brain-eating amobea, known as Naegleria fowleri in the scientific community, is the suspect in another death this week, killing an 18-year-old Ohio girl who’d gone swimming in North Carolina during a church trip, reports WCMH-TV Columbus.

It’s still unclear exactly she encountered the amoeba, but a senior pastor at her church told the news station the group went whitewater rafting in North Carolina during the trip, which was the only time she was in the water. North Carolina’s Department of Health and Human Services also said the U.S. Centers for Disease Control and Prevention suspects the amoeba was the culprit.

The amoeba causes a rare yet devastating infection called primary amoebic meningoencephalitis, which is almost always fatal, according to the CDC. It enters the body through the nose and makes its way to the brain to feed, and is usually the result of swimming in bodies of warm freshwater — often found in southern states — though it can exist in fresh waters in the north as well.

It can’t get into your brain by drinking water, only if you sniff or inhale fresh water directly into your nose. Though it’s not a common infection, just the words “brain-eating amoeba” provide a great reason to wear nose plugs while swimming in fresh water, or to keep your head above water.

Symptoms like headache, fever, nausea, vomiting and a stiff neck can show up anywhere between one and seven days after the infection occurs, says the CDC.

“Later symptoms include confusion, lack of attention to people and surroundings, loss of balance, seizures and hallucinations,” the CDC notes. “After the start of symptoms, the disease progresses rapidly and usually causes death within one to 12 days.”

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