Kerala has witnessed the deaths of three children till now due to an infection caused by the brain-eating amoeba, Naegleria fowleri.

Over the past two months, four cases of primary amoebic meningoencephalitis (PAM) have been diagnosed, three of which were fatal, according to Dr Drishya Pillai, a consultant physician at Meditrina Hospital, Palakkad, Kerala.

"These deaths are caused owing to its fulminant progression, high mortality rate (around 90-95%), and lack of established or effective treatment. It is pertinent to raise awareness," Dr Pillai stated.

A 14-year-old boy from Payyoli is currently receiving treatment at a private hospital after the condition was quickly identified.

Earlier, another 14-year-old boy died from the infection. A five-year-old girl from Malappuram died on May 21, and a 13-year-old girl from Kannur also succumbed to the condition on June 25.


PAM, or primary amoebic meningoencephalitis, is a rare but severe infection caused by Naegleria fowleri, a free-living amoeba that thrives in warm freshwater environments such as lakes, ponds, and poorly maintained swimming pools.

The amoeba enters the body through the nostrils, typically when individuals swim or dive in contaminated water. Once inside, it travels to the brain, causing severe damage.

"The high affinity to the brain and the rapid damage thereafter earned Naegleria the name 'brain-eating amoeba,'" Dr Pillai explained. Initial symptoms often include fever, nausea, vomiting, headache, and neck stiffness.

As the infection progresses, patients may experience confusion, altered behaviour, seizures, and eventually coma and death.


The diagnosis of PAM can be challenging due to its rarity and the similarity of its symptoms to other conditions, such as bacterial meningitis.

"A timely diagnosis can be ensured by a high clinical suspicion and spinal fluid or CSF PCR, CSF analysis for motile trophozoites, apart from the routine tests," Dr Pillai noted.

Although there is no established treatment for PAM, some success has been observed with the administration of amphotericin B intravenously and intrathecally, along with azithromycin, miltefosine, and dexamethasone.

However, the treatment's efficacy remains uncertain.


Given the high mortality rate and lack of definitive treatment, prevention is crucial.

Dr Prameela Radhakrishnan from Neuberg Diagnostics emphasised the importance of awareness among parents: "The children eagerly anticipate swimming in lakes, rivers, and pools, it is crucial for parents to be aware of a rare but potentially deadly risk of the brain-eating amoeba."

Parents are advised to take the following preventive measures:

  • Avoid allowing children to swim in warm freshwater bodies like lakes, ponds, and poorly maintained pools.
  • Ensure children wear nose clips to prevent water from entering their nasal passages.
  • Clean children's noses with hot water after swimming.
  • Monitor water activities closely.

"If you suspect that your child may have been exhibiting symptoms of PAM, seek medical attention immediately," Dr Radhakrishnan advised. "Inform the doctor about your child's recent water activities, as this information can aid in prompt diagnosis and treatment."

Dr CS Narayanan, Chairman of the Manipal Institute Of Neuro Sciences at Manipal Hospital Dwarka, further highlighted preventive measures.

"Preventing infection by Naegleria fowleri primarily involves avoiding activities that allow water to enter the nose. Public health recommendations include avoiding swimming in warm freshwater during peak temperatures, using nose clips or holding the nose shut when underwater, and avoiding disturbing sediment in warm freshwater."

While the risk of infection by Naegleria fowleri remains low, the potential consequences are devastating.

Awareness and preventive measures are essential to safeguard against this rare but deadly threat.

By understanding the risks and taking appropriate precautions, families can enjoy water activities safely while minimising the danger of encountering this deadly amoeba.

2024-07-10T07:12:55Z dg43tfdfdgfd