Naegleria fowleri

Three cases of Primary Amoebic Meningoencephalitis (PAM), a rare and often fatal brain infection caused by the “brain-eating amoeba” Naegleria fowleri, have been reported in Kerala. This includes the recent death of a nine-year-old girl and the infection of a three-month-old baby.

The Disease and Its Spread

PAM is caused by Naegleria fowleri, a single-celled organism that thrives in warm, fresh water and soil. The amoeba infects humans when contaminated water enters the body through the nose, typically during activities like swimming, jumping, or diving. It then travels up the nasal passage to the brain, where it destroys brain tissue and causes swelling.

• Symptoms: Initial symptoms of the infection often include severe headache, fever, nausea, and vomiting. As the disease progresses, it can lead to a stiff neck, confusion, seizures, hallucinations, and coma. The disease has a rapid and aggressive progression, with a fatality rate exceeding 97% globally.
• Historical Context: While the first case of PAM in India was reported in 1971, the first case in Kerala was in 2016. The state recorded a significant surge in cases last year, with 36 infections and nine deaths. Until July 2024, every known case in India had resulted in death. The recent cases in Kerala’s Kozhikode district have prompted a public health alert.

Public Health Response in Kerala

The Kerala Health Department has implemented several measures to prevent the further spread of the infection.

• The government has issued public advisories urging people to avoid swimming or bathing in stagnant, untreated freshwater bodies such as ponds, lakes, and rivers.
• They are encouraging the use of nose clips during swimming and emphasizing the importance of proper chlorination and maintenance of swimming pools.
• The state has also issued Technical Guidelines on Prevention, Diagnosis and Treatment of the disease and is implementing fever surveillance in the affected areas to enable early detection and treatment.

(Source: IE)