A rare but deadly brain infection is spreading in Kerala, prompting urgent concern among health experts and communities alike. The disease, called amoebic meningoencephalitis, is caused by tiny organisms called amoebae that live in warm, untreated freshwater such as ponds, lakes, rivers, and even household wells. These infections are extremely dangerous, but with the right knowledge and precautions, they can be prevented.
What is happening in Kerala?
In 2025 alone, Kerala has reported 69 confirmed cases and 19 deaths from this infection. That is a sharp rise from fewer than 10 cases reported over the past six years. While the global death rate from this disease is around 97%, Kerala’s rate is currently 24%, thanks to quicker diagnosis and better treatment. Encouragingly, two children, siblings of an eight-year-old who sadly died from the same disease in August, recently recovered.
Why is this happening now?
Experts believe that rising temperatures and poor water sanitation are making the problem worse. These amoebae thrive in warm water and feed on bacteria and algae. Many of Kerala's water sources, like wells and ponds, have high levels of coliform bacteria, which come from sewage and waste. This rich source of food and warm waters create the perfect environment for the amoebae to grow.
Two types of brain infection
There are two main forms of this disease:
Primary Amoebic Meningoencephalitis (PAM): Caused by Naegleria fowleri, often called the “brain-eating amoeba.” Symptoms like headache, fever, vomiting, stiff neck, and seizures, usually appear within 1 to 9 days, and the illness progresses very quickly.
Granulomatous Amoebic Encephalitis (GAE): Caused by Acanthamoeba and Balamuthia. Symptoms such as headache, fever, seizures may take several weeks or months to appear.
While PAM progresses rapidly, often within days, GAE develops slowly over weeks or months resulting in delayed or wrong diagnosis.
How does the infection spread?
In the case of PAM, the amoeba usually enters the body when contaminated water gets into the nose, often while swimming or bathing in ponds, lakes, or poorly treated swimming pools. Once inside, it travels up the nose to the brain, where it eats up the brain cells and causes severe damage. In GAE, the amoebae usually enter the body through the lungs (via inhaled dust or aerosols), broken skin, or even eye infections, especially in people with weakened immune systems. Once inside, they slowly travel through the bloodstream and eventually reach the brain, where they cause gradual damage over time.
Is it contagious?
No. The disease does not spread from person to person, and drinking contaminated water is not usually dangerous, because stomach acids kill the amoebae. The real risk is when water is forcefully inhaled into the nose in the case of PAM.GAE is also non-transmissible between people.
How can you stay safe?
Here are some simple steps to protect yourself and your family:
· Avoid swimming or bathing in untreated freshwater, especially in ponds, lakes, and poorly maintained swimming pools.
· Don't let water enter your nose while bathing or swimming. Use nose clips if needed.
· Make sure wells, tanks and swimming pools are properly maintained and chlorinated.
· Boil water used for nasal rinsing or religious rituals like jal neti or snanam.
· Protect open wounds and skin lesions: Avoid exposing cuts, scrapes, or ulcers to soil, untreated water, or dust. Use waterproof bandages when bathing or gardening.
· Use sterile solutions for eye care: Acanthamoeba is known to cause serious eye infections. Always use sterile, commercially prepared solutions for contact lenses.
· Increase public awareness and help them make informed decisions about recreational water activities.
· See a doctor immediately if one develops fever, headache, or confusion after water exposure.
This is not a time for panic, but it is a time for vigilance. The threat may be microscopic, but the consequences are monumental. By taking simple precautions and staying informed, we can prevent further tragedy and protect our communities from this invisible killer.