Naegleria fowleri & Primary Amoebic Meningoencephalitis (PAM)
Context:
- A 3-month-old child under treatment for Primary Amoebic Meningoencephalitis (PAM) at Kozhikode Medical College Hospital for 2+ weeks.
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A 9-year-old girl from Thamarassery recently died of PAM.
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Cause: Naegleria fowleri amoeba detected in the well water at the child’s residence.
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Testing: Water samples from homes of the other two patients also sent for analysis.
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Precautionary measures: Girl’s brother with fever kept under observation, but no PAM symptoms detected.
About Naegleria fowleri
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Commonly known as the “brain-eating amoeba.”
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Habitat: Found in warm freshwater (lakes, ponds, rivers, wells, poorly maintained swimming pools).
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Infection route: Enters through the nose (when contaminated water is inhaled); travels via olfactory nerves to the brain.
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Does not spread person-to-person.
About Primary Amoebic Meningoencephalitis (PAM)
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Nature: Rare but almost always fatal brain infection.
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Symptoms (appear within 1–9 days): Fever, headache, nausea, vomiting, stiff neck, seizures, altered mental status, coma.
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Fatality rate: >95%.
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Treatment: Limited success with drugs like amphotericin B, miltefosine; early detection critical.
Relevance for India
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Kerala has reported sporadic PAM cases in recent years (Thiruvananthapuram, Alappuzha, Malappuram earlier).
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Public health concern: unsafe water sources, unchlorinated wells, rising temperatures (favors amoeba growth).
Preventive Measures
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Avoid contaminated water exposure – don’t allow untreated water into nose during bathing/swimming.
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Ensure chlorination of wells, tanks, pools.
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Public health monitoring – testing of water sources in suspected areas.
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Early diagnosis awareness – doctors and public health workers need high suspicion in cases of meningoencephalitis with recent freshwater exposure.