A 15-year-old has died in Costa Rica of amebic meningitis after contracting the rare infection at a hot spring, the Health Ministry said Monday.

The Health Ministry first reported the case on Jan. 7 and confirmed the boy’s death Monday evening. An analysis from the University of Costa Rica (UCR) confirmed the presence of the Naegleria fowleri microscopic amoeba, which causes primary amebic meningoencephalitis (PAM), in the hot springs of Bagaces, Guanacaste.

Naegleria fowleri is “commonly found in warm freshwater (e.g. lakes, rivers, and hot springs) and soil,” according to the U.S. Centers for Disease Control (CDC), and “usually infects people when contaminated water enters the body through the nose.”

“Once the ameba enters the nose, it travels to the brain where it causes primary amebic meningoencephalitis (PAM), which is usually fatal,” the CDC says.

The infection is exceedingly rare. In the United States, “hundreds of millions of visits to swimming venues occur each year … result in 0-8 infections per year,” according to the CDC.

It marked the second such case ever recorded in Costa Rica, according to the Health Ministry. The first instance, in 2014, resulted in the death of an 11-year-old U.S. citizen.

You cannot get infected from swallowing water containing Naegleria, nor by person-to-person contact. The CDC says the risk of infection is “very low” even when swimming in water containing Naegleria fowleri.

“No method currently exists that accurately and reproducibly measures the numbers of amebae in the water,” the CDC says. “This makes it unclear how a standard might be set to protect human health and how public health officials would measure and enforce such a standard.”

The Health Ministry says the public can continue to visit hot springs but recommends the following: