Amoebic meningoencephalitis has claimed yet another victim in Kerala, this time in the State capital. Four more cases have also been confirmed from the same locality, Nellimoodu, in Neyyattinkara taluk, all of whom are admitted at the Government Medical College Hospital (MCH), according to the Additional Director of Health Services (Public Health).
Health authorities have confirmed that Akhil, a 27-year-old man who had been admitted at the MCH with fever and encephalitis and who breathed his last on July 23, had died of primary amoebic meningoencephalitis (PAM). The cerebrospinal fluid samples of four more youth from the same locality as the deceased, who were admitted with fever, headache and delirium to the MCH later, have also tested positive for PAM now.
All of the young people have a similar history of entering a mossy green pond with stagnant water. Water samples from the pond have been collected for analysis and the Health Department has also put up a notice board at the location, warning people not to enter the water.
While primary amoebic meningoencephalitis (PAM) is considered to be a rare disease, Kerala has had 10 or more cases of the same in the past three months. Cases have been reported from Malappuram, Kozhikode, Kannur, Thrissur, apart from Thiruvananthapuram.
At a meeting of the State Rapid Response Team of the Health department convened on Monday, August 5, 2024, officials reiterated the health warning that members of the public should not enter any water bodies that contain stagnant water. People who enter such water bodies to wash or to bathe cattle should be extremely cautious not to splash the water on their face or forcefully scrub their face with water.
Free-living amoebae (FLA) are found in freshwater, ponds, lakes, and rivers. These organisms, primarily, the Naegleria fowleri, a microscopic amoeba commonly called the “brain-eating amoeba”, enter through the nasal channels and destroy brain tissue, causing severe brain swelling and death in most cases. The mortality rate is 97%.
Health Department warning
People who bathe or swim in surface waterbodies should ensure that they do not dive into the water and stir up the sediments. They should also take care that this water is not forcefully drawn into the nose while swimming or even washing their face. They should immediately seek medical care if they develop a headache, fever, nausea or have difficulty in turning their heads. Symptoms usually develop in one to nine days.
Public health officials maintain that PAM is indeed a rare disease and that if more cases of PAM are being reported from Kerala now, it is only an indication of the diligence with which the State has been investigating and diagnosing all cases of acute encephalitis syndrome (AES) with unknown etiology in recent times.
Awareness campaigns
At the RRT meeting, it was directed that massive public awareness campaigns be organised on PAM and that stringent warnings be issued on avoiding bathing in stagnant water pools.
The Health Department has also issued a directive that swimming pools and pools in water theme parks are to be meticulously cleaned and chlorinated on a regular basis. Those going swimming should use nasal clips to prevent water entering the nose, because the amoeba attaches itself to the mucosal membrane of the nasal cavity.
The State RRT team also observed that there is a dip in dengue cases in the State. However, leptospirosis prevention and control should be strengthened.
