In a tragic turn of events, a 14-year-old boy named EP Mridul from Kerala, India, succumbed to a rare and fatal infection known as primary amoebic meningoencephalitis (PAM) on July 3. Mridul, a class 7 student at Farook Higher Secondary School in Kozhikode, had been admitted to a private hospital with complaints of vomiting and headache. His condition deteriorated rapidly after doctors diagnosed him with PAM, an infection caused by the “brain-eating” amoeba, Naegleria fowleri. Mridul’s case is the third such incident reported in Kerala in the past two months, following the deaths of two other children from Malappuram and Kannur districts earlier this year. Health officials traced the infection to a pond where Mridul had been swimming, prompting immediate preventive measures and public warnings about the dangers of bathing in contaminated freshwater sources.
What is the Brain-Eating Amoeba?
Origin and Description
The brain-eating amoeba, scientifically known as Naegleria fowleri, is a single-celled organism that thrives in warm freshwater environments such as lakes, rivers, hot springs, and poorly maintained swimming pools. It can survive in temperatures up to 46 degrees Celsius, making it prevalent in warm climates. This amoeba typically infects individuals through the nose, from where it travels to the brain, causing severe damage and inflammation.
Symptoms
The infection caused by Naegleria fowleri is called primary amoebic meningoencephalitis (PAM). Symptoms usually appear 1-9 days after exposure and begin with headache, fever, nausea, and vomiting. As the disease progresses, patients may experience a stiff neck, confusion, seizures, hallucinations, and altered mental status. The infection advances rapidly, often resulting in death within 1-12 days after symptoms begin.
Treatment and Cure
Currently, there is no definitive cure for PAM. Treatment usually involves a combination of drugs, including amphotericin B, azithromycin, fluconazole, rifampin, miltefosine, and dexamethasone. Despite aggressive treatment, the prognosis remains poor, with most patients succumbing to the infection within a few days of symptom onset.
Precautions
To prevent infection, health authorities recommend avoiding swimming in warm freshwater bodies, especially during the hot summer months. If swimming in such waters is unavoidable, using nose clips or keeping the head above water can help reduce the risk of the amoeba entering the nasal passages. It is also advised to avoid stirring up sediment in shallow, warm freshwater areas.
International Reports of Brain-Eating Amoeba Infections
The occurrence of infections caused by Naegleria fowleri is rare but not confined to any single region. Cases have been reported globally, with the highest incidence in the United States, particularly in southern states. According to the US Centers for Disease Control and Prevention (CDC), there have been 148 known infections in the United States between 1962 and 2019, with only four survivors. The majority of these cases occurred in the southern states, where the climate provides an ideal environment for the amoeba.
In recent years, there have been several high-profile cases:
- United States: In July 2020, a 13-year-old boy in Florida died after contracting PAM while swimming in a lake. This incident prompted widespread media coverage and public health warnings.
- Pakistan: In 2012, there was a notable outbreak in Karachi, resulting in several deaths. The infections were linked to municipal water supplies contaminated with Naegleria fowleri.
- Australia: Australia has also reported cases, particularly in the Northern Territory. In 2000, a 4-year-old boy died from PAM after swimming in a warm spring.
The recent deaths in Kerala due to primary amoebic meningoencephalitis underscore the need for increased public awareness about the dangers of Naegleria fowleri, the brain-eating amoeba. This organism, though rare, poses a significant threat to those who come into contact with contaminated warm freshwater sources. Understanding the symptoms, prevention measures, and the severe nature of this infection is crucial for reducing future cases and saving lives. Public health officials must continue to educate communities and implement preventive measures to combat this deadly amoeba.
Disclaimer:
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