Kerala has reported its fifth case of amoebic meningoencephalitis infection, a rare disease caused by a dangerous amoeba called Naegleria fowleri.

The 12-year-old boy from Padoor, Thrissur district, who is currently in class 7, had been on ventilator support for several days in June but has reportedly shown progress in recent days. According to the District Medical Officer (DMO), the boy had contracted a less severe strain of the brain-eating amoeba, called Vermamoeba vermiformis. This was established after testing his cerebrospinal fluid in Puducherry.

While the exact source of infection in the young boy currently remains unknown, it is important to note that the brain-eating amoeba usually occurs through exposure to contaminated water and can be prevented with proper measures.

What Is the Brain-Eating Amoeba?

Naegleria fowleri, also known as brain-eating amoeba, is an amoeba that typically occurs in freshwater habitats such as lakes, rivers, and hot springs, says Dr Sneha, Consultant - Internal Medicine, CARE Hospitals, Banjara Hills, Hyderabad.

“It invades people when they come into contact with the nose and go to contaminated water while indulging in some activities like swimming and diving,” she tells the OnlyMyHealth team, adding that after entering the brain, it gets into the olfactory nerve and causes the Primary Amoebic Meningoencephalitis (PAM), which is a rare but nearly always fatal brain infection.

According to the Centers for Disease Control and Prevention (CDC), fewer than ten people a year in the United States contract PAM. Nearly everyone who gets PAM dies from it.

What Makes It So Concerning?

The most concerning fact about the brain-eating amoeba is that it can be life-threatening.

According to Dr Sneha, the symptoms typically manifest within 1–9 days after exposure and progress rapidly. These include:

• Severe frontal headache
• Fever
• Nausea and vomiting

“As the infection advances, patients may experience a stiff neck, seizures, altered mental state (confusion, hallucinations), loss of balance, sensitivity to light, and coma. These severe symptoms result from the amoeba's destruction of brain tissue, leading to inflammation and swelling of the brain,” the doctor adds.

Do's And Don'ts To Prevent Infection

Before we delve into the do's and don'ts of preventing infection from Naegleria fowleri, it is important to understand the source of infection.

Dr Sneha shares that the deadly amoeba thrives in warm environments, particularly in freshwater bodies that are warm and stagnant. She says, "As temperatures rise, the amoeba multiplies, increasing the likelihood of human exposure. The infection typically occurs during hot weather, when people are more likely to engage in recreational water activities like swimming and diving."

The CDC also mentions that, in rare cases, Naegleria fowleri can also grow in poorly maintained swimming pools, splash pads, and even in tap water. Therefore, when it comes to preventing the brain-eating amoebic infection, here are the important do's and don'ts to follow:

Do's

• If swimming in freshwater, choose cooler bodies of water, especially during peak summer months.
• Use nose clips or hold the nose shut when participating in water-related activities to prevent water from entering the nasal passages.
• Use sterile or properly treated water for nasal irrigation.
• Educate yourself and others about the risks associated with Naegleria fowleri infection and the preventive measures that can be taken to reduce these risks.

Don'ts

• Swim in warm lakes, rivers, and hot springs, particularly during hot weather.
• Forget to use a nose clip or hold your nose shut while swimming.
• Dive headfirst in freshwater; avoid getting water up your nose.
• Use untreated water or tap water for nasal irrigation.

Dr Sneha lists a proper advisory for swimming pools to prevent the spread of the brain-eating amoebic infection. These include:

• Maintaining proper chlorine levels between 1.0 and 3.0 parts per million (ppm) and pH levels between 7.2 and 7.8, as chlorine effectively kills the amoeba
• Regular testing of chlorine and pH levels occurs multiple times daily, especially during peak usage periods.
• Adequate filtration and circulation systems are needed to ensure water quality by removing debris and maintaining chlorine distribution.
• Regular cleaning of pool surfaces is necessary to prevent organic material buildup.
• Educating pool users about infection risks and promoting safe swimming practices, such as avoiding water inhalation through the nose and using nose clips.

Diagnosis And Treatment

Diagnosing PAM involves a combination of factors, says Dr Sneha. Besides looking at a patient's symptoms and recent exposure to warm freshwater, laboratory tests examine the cerebrospinal fluid for the presence of the amoeba using techniques like microscopy and Polymerase Chain Reaction (PCR). Brain scans may also be used. Early detection is critical because the disease progresses rapidly.

According to the doctor, treatment for PAM is challenging and often unsuccessful. She shares that doctors use a combination of antifungal drugs, antibiotics, and sometimes experimental medications to fight the amoeba and manage symptoms. Supportive care, like reducing brain swelling and controlling seizures, is also crucial.

Unfortunately, due to the rapid destruction of brain tissue, PAM often leads to severe brain damage and death, even with early treatment. This highlights the importance of preventing infection by avoiding warm freshwater activities.

Reference Link

https://www.onlymyhealth.com/dos-and-donts-to-prevent-brain-eating-amoeba-or-naegleria-fowleri-1720764119