What is this rare infection? – Firstpost

Kerala has reported at least 19 fatalities from primary amoebic meningoencephalitis (PAM), a rare brain infection. The southern state has seen 69 confirmed cases of the rare disease this year.

According to Kerala Health Minister Veena George, the cases are occurring sporadically across the state. “Unlike last year, we are not seeing clusters linked to a single water source. These are single, isolated cases, and this has complicated our epidemiological investigations,” she said.

We take a look at what’s going on.

What’s PAM?

Primary amoebic meningoencephalitis (PAM) is a rare brain infection which causes inflammation of the brain. It is caused by Naegleria fowleri or “brain-eating amoeba”.

This free-living amoeba, or a single-celled living organism, is found in warm freshwater and soil. It can be found in lakes, rivers, swimming pools, splash pads, or other water-based recreational venues.

People do not get infected by drinking water infested with the amoeba. They cannot contract the disease from an infected person either.

The amoeba enters the body through the nose, usually while swimming, according to the United States Centers for Disease Control and Prevention (CDC).

“This infection destroys brain tissue, causing severe brain swelling and death in most cases. PAM is rare and usually occurs in otherwise healthy children, teens and young adults,” says a document by the Kerala government.

It warned that “warm, especially stagnant, fresh water” can carry the “brain-eating amoeba”.

Symptoms of PAM

The initial symptoms of PAM include headache, high fever, nausea and vomiting. These are usually experienced about five days after infection.

Later, the patient could develop a stiff neck, confusion, loss of balance, seizures and hallucinations. The infected person may also slip into a coma.

“By the time other more common causes of meningitis are ruled out and the diagnosis of PAM is considered, it is often too late to save the patient from the cerebral edema that quickly develops and causes death,” as per the Kerala government document.

“Most patients present to medical care with signs or symptoms indicative of central nervous system involvement,” it added.

Can it be treated?

There are no standard treatments for the rare disease. Currently, doctors tackle it with a combination of drugs, including amphotericin B, rifampin, miltefosine, azithromycin, fluconazole and dexamethasone.

However, amoebic brain fever has a mortality rate of 97 per cent. As per the CDC, “Most people with PAM die within one to 18 days after symptoms begin. It usually leads to coma and death after five days.”

Nearly all survivors of PAM in the past six decades were diagnosed at a pre-cerebral stage. “This shows that early diagnosis of PAM and timely initiation of an antimicrobial cocktail might be lifesaving,” as per the Kerala government’s document.

Kerala reports dozens of cases

Kerala has reported Primary Amoebic Meningoencephalitis cases across districts, with infections ranging from three-month-old to 91-year-old people. Of these, 33 cases are in males and 19 are in females.

The infections have surged in Kerala; however, the mortality rate for amoebic meningoencephalitis in the state is 24 per cent, which is significantly lower than the global figure of 97 per cent, The New Indian Express reported, citing health officials.

Amoebic meningoencephalitis cases have been recorded in Kerala since 2016.

The National Centre for Disease Control (NCDC) and Kerala’s health department are conducting epidemiological investigations, including environmental sampling and testing of water sources.

Hospitals are on alert and awareness drives are underway to warn people about the risks associated with untreated freshwater.

With inputs from agencies