What Experts Say On "Biggest Challenge" In Dealing With Brain-Eating Amoeba That Killed 19 In Kerala
Naegleria fowleri is a thermophilic amoeba found in warm and stagnant freshwater.
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Kerala is currently battling an outbreak of Naegleria fowleri, commonly referred to as the 'brain-eating amoeba', which causes Primary Amoebic Meningoencephalitis (PAM). The state's health ministry reports 61 confirmed cases and 19 fatalities this year from this deadly infection, prompting health experts to highlight critical challenges in managing the disease.
"PAM is a rare but extremely serious infection," explained Dr Manisha Arora, Director of Internal Medicine at CK Birla Hospital in Delhi, in an interview with NDTV.
The infection has affected individuals across a wide age range, from a three-month-old infant to a 91-year-old person. Health authorities have raised alerts following cases reported from Kozhikode, Malappuram, and Kannur districts during June-July 2024.
Naegleria fowleri is a thermophilic amoeba that thrives in warm, stagnant freshwater environments. The pathogen enters the human body through the nasal passage and migrates to the brain, causing severe inflammation.
Dr Arora further noted, "This is not a routine occurrence, but the amoeba is a free-living organism found in warm freshwater sources such as lakes, rivers, hot springs and poorly maintained swimming pools."
Dr Manjari Tripathi, Head of Neurology at AIIMS Delhi, warned NDTV, "If we swim in unclean water and there are amoebic organisms in it, you could get brain-eating amoeba. This is very dangerous and many people have little chance of survival. Therefore, people should avoid stagnant water."
The symptoms of PAM progress from early signs including headache, fever, nausea, and vomiting to more severe manifestations such as stiff neck, confusion, seizures, and coma. Experts indicate that the disease typically proves fatal within 5-18 days of onset.
Dr Subhajit Pal, Neurologist at CMRI Kolkata, identified the primary concern: "The biggest challenge with brain-eating amoeba infections is timely diagnosis. Since the condition is extremely rare, its initial symptoms often mimic those of viral meningitis, such as fever, headache, or neck stiffness. Patients and even clinicians may not immediately suspect this deadly parasite. This can lead to delays in initiating specific therapy, and unfortunately, in such rapidly progressive infections, every hour counts."
Dr Anshu Rohatgi, Vice Chairperson of Neurology at Sir Ganga Ram Hospital, emphasized the importance of early detection: "If the disease is diagnosed early, and its diagnosis is through a CSF test, if the amoeba is detected during the test, it can be treated promptly."
"Previously, people said the mortality rate was 100%, but this is not true. In Kerala, where the highest number of cases are being reported, there was a high index of suspicion. Early diagnosis and treatment were implemented. This has significantly reduced the mortality rate," Dr Rohatgi added.
Increased awareness among medical professionals and the general public is crucial to ensure that high-risk exposures, particularly swimming in potentially contaminated water, are taken seriously and suspected cases receive urgent medical attention.