KOCHI: The death of a 15-year-old boy in Alappuzha infected with a brain-eating amoeba after he took a dip in the canal has raised questions about water safety. Gurudath was infected with primary amoebic meningoencephalitis (PAM) caused by Naegleria fowleri. While there are preventive steps for common communicable diseases such as dengue and tuberculosis, PAM is so rare that it is not even known whether it can be prevented.
Dr Dipu T S, associate professor of the division of infectious diseases at Amrita Hospital, Kochi, said that PAM is a rare, severe brain infection. “The initial symptoms that appear one to nine days after infection include headache, fever, nausea, and a stiff neck. As PAM progresses, confusion, loss of balance, seizures, and hallucinations can occur, typically leading to death within a couple of days to a couple of weeks from the onset of symptoms,” Dr Dipu said.
Dr Rajeev Jayadevan, a member of the Public Health Advisory Panel, Kerala State IMA, said that some precautions can only help. “If we allow water to get deep inside our nose, multiple organisms can enter the sinuses easily and stay there for a long time. Some sinuses are located close to the brain. Thus it is important to avoid letting excessive amounts of water into the nose while swimming,” he said.
Naegleria fowleri and other organisms could lurk in mud and sediments found at the bottom of water bodies. “Diving deep in the water is best avoided. Also, if the water appears dirty, better not get into it,” Dr Rajeev added.
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Dr Dipu, too, said that prevention of PAM involves avoiding exposure to the amoeba. “PAM can be prevented by limiting activities in warm, freshwater bodies during hot weather and low water levels. Use nose clips during water activities, and avoid stirring up sediment like mud in shallow water areas,” said Dr Dipu. He also recommended using only sterile, distilled, or lukewarm boiled water for nasal irrigation.
When asked about the significance of chlorination, Dr Rajeev said that chlorination of canals wouldn’t be effective against this amoeba, especially in the presence of abundant organic material and due to water flow.