Kerala doctors are warning of a rise in cases of the rare but deadly brain infection caused by the so-called “brain-eating amoeba,” with 72 infections and 19 deaths reported so far this year.
The toll has already doubled last year’s figures, when 36 infections were recorded, nine of them fatal.
“First of all, meningoencephalitis means any infection happening to the brain and its covering called the meninges,” explained Dr. Anoop Kumar AS, Director, Critical Care Medicine at Aster IMMS, Calicut.
“Usually we get infection because of bacteria and viruses, and rarely by fungus or amoeba. When it is caused by a particular amoeba called Naegleria fowleri, it is called primary amoebic meningoencephalitis, or PAM. This is also called the brain-eating amoeba because it produces severe damage to the brain. Once infected, the mortality is more than 90 per cent”, he told PTI.
The infection progresses fast and is almost always fatal.
Prof (Dr) Kameshwar Prasad, Principal Director, Department of Neurology, Fortis Hospital (Vasant Kunj), in an interview with PTI said, “This enters the brain and causes inflammation, leading to several symptoms such as headache, vomiting, fever, sore throat, and bacterial infections. The patient may faint within a few days. Medicines are not very effective, which is why patients often die within a short period. The microbes responsible include bacteria, viruses, fungi, and parasites. Amoeba is one type of parasite, and a species called Naegleria fowleri causes this disease. It is not a virus but an amoeba. The infection spreads through freshwater.”
Health officials say the amoeba is present in warm freshwater such as ponds, lakes, rivers and poorly maintained swimming pools. It does not cause illness when swallowed, but if water enters the nose the parasite can migrate to the brain.
“What starts as a fever, headache, nausea and stiff neck soon leads to confusion, seizures and coma. Death usually occurs within one to two weeks,” a health official noted.
For families, the deaths have been devastating.
Speaking to PTI, the mother of a nine-year-old girl from Kozhikode who died after contracting the amoeba said she was still struggling to comprehend the loss.
“I cannot believe my daughter is gone,” the sobbing mother said, adding there was no clear information from health authorities on how the child became infected.
Kerala first reported PAM in 2016, usually one or two cases a year, almost all fatal.
Globally, only 488 cases have been reported since 1962, mostly in the US, Pakistan and Australia, with 95 per cent proving fatal, according to a BBC report.
Kerala Health Minister Veena George told the State Assembly on Wednesday that amoebae exist in most water sources, though only some types are dangerous.
She noted that the state had established its own diagnostic facilities after earlier relying on laboratories in Chandigarh and Puducherry.
Hospitals have been instructed to suspect PAM in patients with sudden meningitis-like symptoms and a history of freshwater exposure. Microbiologists are alerted immediately to test cerebrospinal fluid samples by microscope or PCR.
Still, treatment remains extremely difficult.
There is no single cure.
Survivors worldwide are rare and were treated with combinations of drugs such as amphotericin B, miltefosine and rifampicin, along with therapies to reduce brain swelling.
Residents are advised to avoid swimming in stagnant or poorly maintained freshwater, use nose clips if necessary, and ensure proper chlorination of pools.
Children should not play with hoses or sprinklers that push water up the nose, and only boiled or filtered water should be used for nasal rinsing.
After the Nipah virus outbreak in Kozhikode in 2023, Kerala mandated reporting and investigation of all cases of brain fever, including rare infections like PAM.