- Causative Agent:
- Caused by Naegleria fowleri (a free-living, thermophilic amoeba).
- Commonly found in warm freshwater (ponds, lakes, poorly maintained swimming pools, stagnant water).
- Mode of Transmission:
- Amoeba enters the human body through the nose while swimming, bathing, or diving in contaminated water.
- Reaches the brain through the olfactory nerve (cribriform plate).
- Not transmitted person-to-person.
- Pathophysiology:
- Amoeba invades the central nervous system → acute inflammation of brain and meninges.
- Causes Primary Amoebic Meningoencephalitis (PAM) → often fatal.
Relevance : GS 2(Health), GS 3(Science and Technology)
Symptoms & Clinical Course
- Incubation period: 5–10 days after exposure.
- Early Symptoms:
- Severe headache, fever, nausea, vomiting.
- Stiff neck, photophobia (light sensitivity).
- Children: refusal to eat, irritability, lethargy.
- Progressive Symptoms:
- Confusion, altered behavior.
- Seizures, epilepsy.
- Memory loss, fainting.
- Coma → death (usually within 1–2 weeks of symptom onset).
- Mortality: Extremely high (95–99%), with very few survivors globally.
Risk Factors
- Swimming or bathing in stagnant or warm freshwater (especially during summer).
- Children at higher risk (due to thinner cribriform plate → easier entry to brain).
- Ear/nose surgeries or injuries may increase susceptibility.
- No risk from drinking contaminated water (infection occurs only through nose).
Recent Outbreak in Kerala
- Kozhikode (2024): 3 cases detected, 1 death reported.
- Previous local outbreaks in Kerala had led to warning boards near ponds to alert public.
- Current alert: Issued by Kerala Health Department to raise awareness and encourage precaution.
Preventive Measures
- Avoid swimming or bathing in stagnant/unclean ponds, lakes, and warm water bodies.
- Use nose clips while swimming to prevent water entry.
- Ensure chlorination and cleaning of public water sources and swimming pools.
- People with nasal/ear surgeries should avoid exposure to stagnant water.
- Public awareness campaigns: leaflets, boards near ponds, media outreach.
Treatment Challenges
- No single guaranteed cure.
- Drugs used (in combinations):
- Amphotericin B, Miltefosine, Azoles (Fluconazole, Ketoconazole).
- Treatment effective only if started very early.
- Supportive care (ICU, ventilator support) often required.
Broader Public Health Concerns
- Rarity but Deadliness: Cases are rare, but nearly always fatal → high fear factor.
- Climate Change Link: Rising temperatures and water stagnation may increase risk.
- Surveillance & Rapid Diagnosis:
- Need early identification at hospitals.
- Train health workers to recognize neurological symptoms after water exposure.
Bottom Line:
- PAM is a rare but almost always fatal brain infection caused by Naegleria fowleri.
- Kerala’s alert in Kozhikode is precautionary due to recent cases and a death.
- Preventive steps (avoiding stagnant water, using nose clips, awareness campaigns) are critical, as treatment options are limited and survival rates are very low.
