By Shankar Raj*
Thiruvananthapuram: Northern districts in Kerala are in the grip of fear as a brain-eating bacteria has claimed the lives of two children while a 12-year-old boy hailing from Ramanattukara in Malappuram is battling for life for the past four days in a private hospital.
Many have stopped their kids from taking baths in ponds and rivers due to the fear of Amoebic meningoencephalitis (AM), a rare but usually fatal disease caused by Naegleria fowleri, a free-living amoeba found in warm freshwater.
Primary Amoebic Meningoencephalitis (PAM) is mostly linked to bathing or swimming in waters containing the amoeba, which enters the body through the nose. The amoeba then moves to the brain, where it destroys the brain tissue.
Children in Kerala are in the habit of taking baths in such waters, especially during monsoon season.
The boy currently undergoing treatment developed symptoms including fever, headache, and vomiting around 5-6 days after bathing in a pond near his house. On the seventh day, he lost consciousness and was brought to the hospital.
Earlier, a five-year-old girl from Malappuram died of PAM after she had taken a bath in a river in her locality.
Dr Rajeev Jayadevan, chairman of the research cell at IMA Kerala, was quoted in the media as saying there is no need for panic as amoebic meningoencephalitis is very rare. “People should take care not to take water into their nose while bathing and also not stir up the sludge in the bottom of the ponds,” he said.
Early symptoms may resemble flu-like illness that is rampant during monsoons in Kerala. But in later stages, it hits the central nervous system.
Cerebrospinal Fluid (CSF) analysis would show high opening pressures, elevated white blood cell counts (mostly neutrophils), low glucose levels, and elevated protein levels.
Research ways there is a diagnostic challenge in such cases as PAM is diagnosed in only 27% of patients before death. Only three patients in the United States have survived PAM.
In the case of a 13-year-old girl from Kannur, who died at a private hospital on June 12, she had amoebic meningoencephalitis caused by free-living amoeba Vermamoeba vermiformis. She is suspected to have got the infection after taking a bath in a swimming pool during a school trip to Munnar on January 28, 2024.
Unlike in PAM cases, where the symptoms crop up within five days of the amoeba entering the body, the disease progression was slow in her case.
Vermamoeba vermiformis, formerly known as Hartmannella vermiformis, is a free-living amoeba that is widely distributed in natural and man-made aquatic environments, including water systems.
It can be found in soil, water, and air and can support the multiplication of other microorganisms. It may harbor and potentially protect pathogenic bacteria or viruses.
Its presence in hospital water networks can raise health concerns and could indirectly contribute to healthcare-related infections.
Scientists study Vermamoeba vermiformis to understand its relationships with other microorganisms and is considered an etiological agent and a “trojan horse” in health contexts.
*Shankar Raj is a former editor of The New Indian Express, Karnataka and Kerala, and writes regularly on current affairs.
