The brain-eating amoeba: A rare but deadly threat in warm freshwater
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Brain-eating amoeba in Kerala: Primary Amoebic Meningoencephalitis (PAM)
1. What is it?
• Causative agent: Naegleria fowleri — a free-living amoeba found in warm freshwater (lakes, rivers, hot springs, poorly maintained swimming pools).
• Disease: It causes Primary Amoebic Meningoencephalitis (PAM), commonly called “brain-eating amoebic infection”.
• Occurrence in Kerala: Kerala has reported multiple cases in recent years, often linked with children swimming in ponds or rivers during summer.
2. Mode of transmission
• Amoeba enters the body through the nose (while swimming/diving in contaminated water).
• It travels via the olfactory nerve → reaches the brain.
• Not spread person-to-person.
• Ingestion (drinking water) is not harmful – only nasal entry causes disease.
3. Symptoms
Incubation: 2-7 days after exposure.
Early symptoms resemble meningitis:
• Severe headache
• Fever
• Nausea, vomiting
• Stiff neck
Rapidly progressing neurological symptoms:
• Confusion, hallucinations
• Seizures
• Loss of balance
• Coma
• Usually leads to death within 7-14 days.
4. Damage caused
• Extremely high fatality rate (>95%).
• Causes inflammation and destruction of brain tissue.
• Only a handful of survivors globally reported.
5. Treatment
• No single effective cure.
• Early diagnosis critical.
• Treatment approaches:
• Amphotericin B (antifungal, IV intrathecal administration)
• Miltefosine (antiprotozoal, given orally, repurposed drug)
• Combination with other drugs: azithromycin, rifampicin, fluconazole
• Supportive therapy (reduce intracranial pressure, manage seizures).
• Survival possible only with very early aggressive treatment.
6. Preventive measures
• Avoid swimming in warm freshwater bodies in summers.
• Use nose clips while swimming.
• Avoid diving in stagnant ponds.
• Ensure chlorination of pools.
• Public awareness (esp. in Kerala villages where children swim in ponds).
UPSC relevance
• Disease ecology: Climate change and warming water bodies → increased risk.
• Public health: Rare but highly fatal disease, important for epidemiology.
• Science & tech: Miltefosine as a repurposed drug.
• GS Paper II (Governance & Health): India’s response to emerging infectious diseases.
• GS Paper III (Science & Environment): Link between rising global temperatures and emergence of unusual pathogens.
Quick fact box for prelims:
• Pathogen: Naegleria fowleri (amoeba)
• Disease: Primary Amoebic Meningoencephalitis (PAM)
• Fatality rate: Rs 95%
• Transmission: Nose → brain (not water ingestion, not person-to-person)
• Treatment: Amphotericin B Miltefosine (limited success)
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