Kerala is currently experiencing an alarming rise in cases of Primary Amoebic Meningoencephalitis (PAM), a rare but highly fatal brain infection. An 11-year-old girl in Malappuram recently tested positive for this severe condition. Concerns are mounting as a 67-year-old woman’s death on August 9 is also suspected to be caused by the disease. Doctors at Kozhikode Medical College are treating three patients for PAM, including a three-month-old infant and a 40-year-old man. Tragically, a nine-year-old girl from Thamarassery succumbed to the illness on August 14. This situation highlights the critical need for public awareness. Naegleria fowleri, often called the “brain-eating amoeba,” causes these infections.
Understanding Naegleria fowleri Infection
Naegleria fowleri is a free-living amoeba, a single-celled organism. It is found globally in warm freshwater bodies like lakes, rivers, and poorly maintained swimming pools. The amoeba thrives in temperatures around 25°C to 40°C. Infection occurs when contaminated water enters the nose, usually during swimming, diving, or nasal rinsing. The amoeba then travels to the brain via the olfactory nerve, causing devastating inflammation and tissue destruction. Notably, drinking contaminated water does not transmit the disease. Also, PAM is not communicable from person to person. This explains why authorities are investigating local water sources.
Symptoms and Progression of PAM
Initial symptoms of Primary Amoebic Meningoencephalitis often mimic bacterial meningitis, making early diagnosis challenging. Patients typically experience severe headaches, fever, nausea, and vomiting. As the disease progresses, more severe neurological symptoms may develop. These include neck stiffness, disorientation, seizures, hallucinations, and altered consciousness. Most individuals affected by PAM unfortunately progress to a coma, often leading to death within 1 to 18 days of symptom onset. Therefore, prompt recognition and treatment prove absolutely vital.
Prevention and Public Health Measures
Preventing Naegleria fowleri infections is crucial given the high mortality rate. Health authorities in affected regions are advising people to avoid bathing or swimming in natural freshwater bodies. This is especially important during warmer months. Furthermore, individuals should pinch their noses or use nose clips when engaging in water activities. Authorities also recommend avoiding diving or jumping into stagnant freshwater. In areas with identified cases, like near the 11-year-old girl’s home, authorities have erected warning boards. These urge the public not to use specific streams. Regular chlorination of public water bodies and wells is a key preventive measure. Public health departments are actively surveying homes and collecting water samples to identify potential sources of contamination.
Recent Cases and Challenges in Kerala
Kerala has seen a worrying increase in suspected amoebic meningoencephalitis cases. Since the beginning of 2025, the state has recorded 20 suspected cases and six suspected deaths. This includes recent cases in Kozhikode and Malappuram districts. While globally the fatality rate for PAM is over 90%, Kerala has achieved a 25% survival rate through early detection and intervention. A 14-year-old boy became the first Indian survivor in July 2024. Despite these efforts, effective treatments for PAM remain limited, emphasizing the importance of prevention. Doctors currently use a combination of drugs, including amphotericin B and miltefosine, for treatment. Understanding the underlying neurological processes can be crucial for developing new treatment strategies. This is where specialized training in Neurology can be beneficial.
Frequently Asked Questions
Q1: What is Primary Amoebic Meningoencephalitis (PAM)?
PAM is a rare and severe brain infection caused by the free-living amoeba Naegleria fowleri, often referred to as the “brain-eating amoeba.” It leads to rapid and fatal inflammation of the brain.
Q2: How do people contract Naegleria fowleri infection?
Infection occurs when water containing Naegleria fowleri enters the nose, typically during swimming, diving, or nasal irrigation in warm freshwater bodies. The amoeba then travels to the brain. It is not transmitted by drinking contaminated water or from person to person.
Q3: What are the early symptoms of PAM?
Early symptoms often include severe headaches, high fever, nausea, and vomiting. These symptoms can quickly progress to neck stiffness, confusion, seizures, and ultimately coma. For professionals looking to deepen their understanding of neurological emergencies, the International Post Graduate Program In Emergency Medicine offers comprehensive training.
References
- 11-year-old tests positive for rare amoebic infection – ETHealthworld
- Cases of brain eating amoeba in India: Primary amoebic meningoencephalitis clinical features and pathogenesis – PubMed Central. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10300431/
- 3 new cases of ‘brain-eating amoeba’ in Kerala What you should know – The Indian Express. Available at: https://indianexpress.com/article/explained/explained-health/brain-eating-amoeba-kerala-cases-symptoms-9512140/
- 3 deadly ‘brain-eating amoeba’ cases reported in Kerala, what you need to know – The Week. Available at: https://www.theweek.in/news/india/2025/08/20/3-deadly-brain-eating-amoeba-cases-reported-in-kerala-what-you-need-to-know.html
- 9-year-old girl dies due to ‘brain-eating amoeba’ in Kerala, 4th death caused by contaminated water body: What is Amoebic meningoencephalitis? Signs and symptoms | – Times of India. Available at: https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/9-year-old-girl-dies-due-to-brain-eating-amoeba-in-kerala-4th-death-caused-by-contaminated-water-body-what-is-amoebic-meningoencephalitis-signs-and-symptoms/articleshow/112678007.cms
- Primary Amoebic Meningoencephalitis, Causes, Symptoms, Treatment, News. Available at: https://www.upsc.gov.in/sites/default/files/Primary%20Amoebic%20Meningoencephalitis.pdf
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