Naegleria fowleri, an amoeba measuring mere 10-15 micrometres in diameter, poses a potentially deadly challenge to health authorities nationwide after having taken 17 lives in Kerala this year. The amoeba is known to enter through the nose and cause primary amoebic meningoencephalitis (PAM), an infection that destroys brain tissues. That’s the reason behind its common reference as the ‘brain-eating amoeba’. The symptoms start a few days after the infection, with early signs presenting fever, headache, nausea and vomiting, and advanced symptoms expressing in the form of stiffness in the neck, seizures, confusion, hallucination and coma. The PAM infection is rapidly progressive and very aggressive, with patients dying between five and 18 days after the onset of symptoms. The fatality rate is as high as 97 percent, according to the US Centers for Disease Control and Prevention.
Unfortunately, awareness about the infection is low given its limited incidence. However, the population’s vulnerability to Naegleria fowleri cannot be underestimated. This amoeba enters the body usually during swimming or diving, activities commonly indulged in across rural and urban India wherever wells, ponds, lakes and pools exist. Many of these hold contaminated warm water—which is ideal for this amoeba to thrive—and unsuspecting swimmers would remain exposed to the threat.
Treating PAM is a major challenge. Although a combination of medicines is used to treat this infection, it is seldom successful unless done in the very early stages of the infection. This is mainly because of the blood-brain barrier preventing the drug from reaching the affected areas—a protective barrier made of tightly-packed endothelial cells in the brain’s blood vessels that regulate the passage of substances. However, the Naegleria fowleri amoeba can be destroyed in the water itself with chlorination or ultraviolet light.
This puts the onus on prevention. But for that, the entire health machinery—at the Centre, across the states and at the taluk level—needs to be involved in systematic inspection of water bodies to test samples and treat the water, if needed, to eliminate the possible presence of the deadly amoeba. At the same time, the research for more effective drugs to treat the deadly PAM needs to be intensified. The time to act is now, in the season the threat increases.