Kerala’s health authorities have issued a high alert after a significant spike in cases of Primary Amoebic Meningoencephalitis (PAM), a deadly brain infection caused by the “brain-eating amoeba” (Naegleria fowleri).
The state has recorded 69 confirmed cases and 19 deaths this year, with a concerning number of deaths occurring in recent weeks.
According to a statement from Health Minister Veena George, the state is grappling with a serious public health challenge. The infections, which were previously linked to specific clusters in districts like Kozhikode and Malappuram, are now appearing sporadically across the state, with patients ranging from a three-month-old infant to a 91-year-old.
“Unlike last year, we are not seeing clusters linked to a single water source,” Ms George told reporters. “These are single, isolated cases, which has complicated our epidemiological investigations.”
The minister stressed that the health department has stepped up surveillance, with strict instructions to hospitals to investigate every case of meningoencephalitis.
“Early detection is key,” she said, highlighting that Kerala’s survival rate of 24% is significantly higher than the global average of less than 3%, a success attributed to timely diagnosis and the use of the anti-parasitic drug miltefosine.
The infection, which is not transmitted from person to person, occurs when the amoeba enters the body through the nose, typically from contaminated water. It then travels to the brain, causing severe inflammation. Symptoms include severe headache, fever, nausea, and vomiting, which can rapidly progress to seizures and loss of consciousness.
The public has been advised to take a number of preventative measures like to avoid swimming or bathing in untreated or stagnant freshwater sources like ponds and lakes.
They are asked to use nose clips or hold the nose shut when entering freshwater, ensure proper chlorination and cleaning of community wells and water tanks.
The directive is to seek immediate medical attention if symptoms appear after exposure to stagnant water.
The health department, in collaboration with the National Centre for Disease Control (NCDC), is carrying out extensive environmental sampling to pinpoint potential sources of contamination.
Experts are also investigating the possibility of new transmission routes, as some recent cases have no history of exposure to open water bodies, raising questions about contaminated well water.