Kerala’s health department has issued an alert in Kozhikode district after three consecutive cases of primary amoebic meningoencephalitis (PAM) were reported. One of the patients, a nine-year-old girl, died, while two others, including a three-month-old baby, are fighting for their lives.
Deadly Amoeba Behind the Outbreak
PAM is caused by Naegleria fowleri, often called the “brain-eating amoeba.” This free-living organism is commonly found in warm freshwater and soil. Infection occurs when the amoeba enters the body through the nose. Kerala has reported eight confirmed cases of PAM this year, with two deaths, including the most recent fatality in Thamarassery on August 14.
Cases Reported from Different Villages
Health officials noted that the three new cases in Kozhikode have no common source of infection. “We are unsure how the three-month-old baby contracted the disease. The amoeba might have entered the body during bathing. Although water is a common source, the organism is also found in soil and dust,” an official explained.
Other Amoeba Also Cause the Illness
Molecular testing revealed that another amoeba genus, Acanthamoeba, can also cause meningoencephalitis. Experts clarified that water exposure is a key factor only in infections caused by Naegleria fowleri. In contrast, Acanthamoeba-related illness may not be linked to water exposure and can take days to months to develop.
Kerala’s Rising Case Count
India reported its first PAM case in 1971, while Kerala’s first case surfaced in 2016. From then until 2023, the state recorded only eight cases. However, in 2023 alone, Kerala reported 36 cases and nine deaths. The global fatality rate of PAM is 97%, yet Kerala has reduced this to 25%. Until July 2024, all Indian cases were fatal. That changed when a 14-year-old boy from Kozhikode became India’s first PAM survivor—and only the 11th survivor worldwide.
Factors Driving the Increase
As reported by indianexpress, officials attribute the surge in cases to better testing for acute encephalitis syndrome (AES), which can be caused by various pathogens including amoebae. Climate change and environmental pollution have also contributed to the rise. Last year, after a sudden spike in infections, Kerala became the first state in India to release a special treatment protocol and standard operating procedure for managing amoebic meningoencephalitis.