Rare brain-eating disease claims two more lives in Kerala

Two more people have died in Kerala due to amoebic encephalitis, a rare brain-eating disease. The deceased were identified as Aryamol (26) and Binu Varghese (55), both from Alappuzha district.

Aryamol, a nurse from Bengaluru, resigned two months ago to go abroad and recently returned home. She developed symptoms a month ago. It is suspected she contracted the disease while in Bengaluru.

Varghese, a contract employee, was hospitalised on Wednesday night due to a severe headache. Tests on Saturday confirmed the illness after his condition did not improve. Health officials collected water samples from his home and a nearby rest house.

Health authorities urged the public to remain vigilant as it has recently emerged as one of the most fatal communicable diseases in the state, with a risk of increasing during the summer season.

Last year, primary amoebic meningoencephalitis (PAM) caused 42 deaths among 170 cases. This year, it has resulted in 43 fatalities so far, highlighting the persistently low survival rates for this severe infection.

Naegleria fowleri, or the brain-eating amoeba, is contracted through the nose during water activities in contaminated freshwater.

Kerala has seen sporadic cases, but a recent surge indicates a rising public health concern. This rare infection often goes unnoticed by medical professionals.

Amoebic meningoencephalitis has two main forms: primary amoebic meningoencephalitis (PAM) and granulomatous amoebic encephalitis (GAE).

Naegleria fowleri lives in warm freshwater environments, such as lakes and hot springs, and is not contagious.

Symptoms of PAM usually appear within nine days of exposure and can mimic viral infections.

As the disease advances, severe symptoms like a stiff neck, confusion, and seizures may occur, leading to rapid brain swelling and life-threatening complications.

Most victims do not survive beyond a week, and recent cases suggest exposure can occur in both home baths and resort pools, not just natural water bodies.

The amoeba has a shorter incubation period and is usually associated with recent exposure to water. In contrast, Acanthamoeba's incubation can last from days to nearly a year, making its source less clear.

Authorities have issued guidelines on required chlorine levels in water and the need to maintain a daily record of chlorine levels at public water sources.

In response to the public health crisis, they have also expanded the definition of cases to include all instances of amoebic meningoencephalitis.

Diagnosing PAM can be difficult as its symptoms resemble other illnesses. Clinicians use cerebrospinal fluid analysis and advanced imaging to confirm the presence of the amoeba. Many cases are discovered when patients seek help for headaches, vision problems, or seizures. Early detection and treatment are vital, especially for those without immunocompromising conditions.

Public health authorities stress the importance of strict swimming pool management in rural areas due to contamination risks.

They recommend daily chlorination at a minimum of 0.5 mg/L chlorine and detailed compliance logs, subject to inspection. These regulations apply to all recreational facilities, which face weekly health inspections.

Health Minister Veena George said that warm temperatures and stagnant water pose risks of spreading waterborne diseases.

She urged public awareness to prevent outbreaks and advised avoiding contaminated water for bathing and maintaining clean water sources. Regular chlorination of wells and proper sanitation of swimming facilities are essential.

People should also refrain from swimming in stagnant water, use nose clips, and avoid untreated water for nasal rinsing. Additionally, waste should not be discharged into water bodies, and water storage tanks should be cleaned every three months.

Local authorities must regularly check water quality in public areas, and anyone exhibiting symptoms should seek immediate medical attention.

Amoebic meningoencephalitis is caused by organisms such as Naegleria fowleri and Acanthamoeba, which are found in warm, polluted waters. Weakened immune systems increase risk, especially from Acanthamoeba infections.

The disease spreads through contaminated water but can be treated with antibiotics like doxycycline. Ongoing cases raise concerns about environmental pollution as a major factor.

Its spread is also linked to environmental pollution, as Kerala's water bodies are often used as garbage dumps. The state struggles with liquid waste management, treating only 16% of it properly, leading to contamination of wells and water bodies with harmful pathogens.