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A form of meningitis, Primary Amoebic Meningoencephalitis is a fast-spreading infection that destroys brain tissue. Symptoms include headache, vomiting, hallucination, coma & death
Naegleria fowleri cannot infect people through drinking water. The danger arises only when contaminated water enters the nasal passages, giving the amoeba a pathway to the brain. (Getty Images)
Kerala is once again in the headlines, but this time not for a monsoon flood or a virus outbreak. The state is grappling with the terrifying reality of a microscopic killer: Naegleria fowleri, more commonly known as the “brain-eating amoeba.” Over the past months, this rare but deadly organism has claimed at least 19 lives across districts, sending shockwaves among health authorities and local communities.
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Earlier, the infections were reported in clusters in districts such as Kozhikode and Malappuram. But now cases are being reported sporadically across the state. Patients include a three-month-old infant to a 91-year-old.
The situation raises urgent questions: What exactly is this amoeba? Why is it thriving in Kerala now? And what can people do to stay safe? Here’s a deep dive into everything you need to know.
What is the ‘Brain-Eating Amoeba’?
Naegleria fowleri is a free-living amoeba typically found in warm freshwater—ponds, lakes, rivers, tanks, and poorly maintained swimming pools. Despite its nickname, the amoeba does not “eat brains” in the literal sense. Instead, once it enters through the nose, it travels up the olfactory nerve into the brain, where it triggers Primary Amoebic Meningoencephalitis (PAM)—a fast-spreading infection that destroys brain tissue.
The infection is almost always fatal. Globally, only a handful of people have survived PAM despite hundreds of cases over decades.
How Does It Infect Humans?
The key detail is this: Naegleria fowleri cannot infect people through drinking water. The danger arises only when contaminated water enters the nasal passages, giving the amoeba a pathway to the brain.
This usually happens when:
- People swim, dive, or play in stagnant freshwater bodies.
- Water from poorly cleaned tanks or wells is used for bathing.
- Nasal rinsing or religious cleansing rituals involve untreated water.
- Once inside, the amoeba multiplies rapidly, causing inflammation and destruction of brain tissue.
Why Is Kerala Seeing Cases Now?
- Climate conditions
Kerala’s tropical weather, with high humidity and rising temperatures, creates an ideal environment for the amoeba to thrive in water sources. Warm freshwater is its natural home, and Kerala’s monsoon season fills ponds, tanks, and rivers with just the right conditions.
- Stagnant water bodies
As rainfall fluctuates, small pools of stagnant water remain—often untreated or uncleaned. These are hotspots for microbial growth.
- Population practices
Daily bathing in rivers, ponds, and wells is still common in many parts of Kerala. With water sources shared by communities, exposure risk increases dramatically.
- Post-monsoon surge
Experts have noticed that cases often peak after heavy rains. Floodwaters recede, leaving behind warm, stagnant pools that become perfect breeding grounds for amoebae.
What Are The Symptoms Of Infection?
The tragedy of PAM lies in its speed. Symptoms appear within 2–7 days of exposure and worsen quickly:
- Stage 1 (early symptoms): headache, fever, nausea, vomiting.
- Stage 2 (progression): stiff neck, sensitivity to light, seizures, confusion.
- Advanced stage: hallucinations, coma, and death, usually within 7–10 days.
Because these resemble viral or bacterial meningitis, misdiagnosis is common. By the time PAM is correctly identified, it is often too late.
How Many Cases Have Been Reported?
This year, Kerala has seen a worrying rise:
Nearly 70 confirmed cases of PAM. At least 19 deaths, including children and young adults.
While the numbers may seem small compared to diseases like dengue or malaria, the near 100% fatality rate makes this outbreak deeply concerning.
How Deadly Is The Infection Globally?
The brain-eating amoeba is rare but almost always lethal.
- In the United States, between 1962 and 2021, there were 154 known cases—only 4 survivors.
- Cases are also reported in Pakistan, Vietnam, and Latin America, often linked to untreated water or hot springs.
- In India, reports have been sporadic over the years, but Kerala’s current surge is among the most severe.
This rarity is a double-edged sword: doctors rarely suspect it early, and health systems don’t have dedicated testing mechanisms in place.
Why Is It So Hard To Treat?
Three reasons make Naegleria fowleri especially difficult to fight:
Late diagnosis: It mimics meningitis, so doctors often begin with antibiotics that don’t work against amoebae.
Rapid progression: By the time symptoms escalate, brain damage is extensive.
Limited treatment options: A combination of antifungal and antimicrobial drugs is used, along with induced hypothermia (lowering body temperature to slow amoeba growth). Success is rare.
Even in advanced hospitals worldwide, survival rates are dismally low—less than 5–10%.
How Is Kerala Responding?
The outbreak has triggered a public health response:
- Chlorination drives in wells, tanks, and ponds across affected districts.
- Awareness campaigns urging people to avoid bathing in stagnant water.
- Testing water sources in high-risk areas.
- Rapid response teams deployed to monitor new cases.
Still, the challenge remains steep. With so many households dependent on community water sources, ensuring complete safety is nearly impossible.
According to a Kerala government document, PAM affects the central nervous system. “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,” it says.
How To Protect Yourself And Your Family
While there is no guaranteed cure, prevention is possible. Here’s what experts recommend:
- Avoid swimming or bathing in stagnant freshwater during warm months.
- If unavoidable, wear nose clips or keep your head above water.
- Ensure pools and tanks are properly chlorinated and cleaned regularly.
- Use boiled, distilled, or filtered water for nasal rinses or religious cleansing.
If you develop sudden headaches, fever, or confusion after water exposure, seek medical help immediately.
Why This Outbreak Matters Beyond Kerala
The rise of Naegleria fowleri is not just a local issue—it is part of a bigger pattern. Climate change is warming freshwater bodies across the globe, expanding the amoeba’s natural habitat. Regions that never reported cases before are now beginning to see infections.
For India, where millions rely on untreated wells and ponds, this is a wake-up call. Public health planning will need to focus not just on common diseases like dengue and chikungunya, but also on rare but lethal infections made worse by climate shifts.
A Reminder About Lifestyle And Health
Kerala’s outbreak also highlights the intersection of tradition and modern health risks. Bathing in rivers and wells has been a cultural practice for centuries, but as microbial threats evolve, communities may need to adapt. Simple lifestyle changes—like using safe water and practicing better hygiene—could save lives.
What To Conclude
The brain-eating amoeba is not new, but its sudden surge in Kerala is a sobering reminder of how small organisms can cause outsized damage. Rare, deadly, and fast-moving, it leaves little room for error once infection sets in.
The only real protection lies in prevention and awareness. Avoid unsafe water, protect nasal passages, and act quickly if symptoms arise.
For Kerala, and for India at large, the challenge is not just containing this outbreak but building systems that can recognise and respond to such threats before they spiral into tragedy.
About the Author
Shilpy Bisht, Deputy News Editor at News18, writes and edits national, world and business stories. She started off as a print journalist, and then transitioned to online, in her 12 years of experience. Her prev…Read More
Shilpy Bisht, Deputy News Editor at News18, writes and edits national, world and business stories. She started off as a print journalist, and then transitioned to online, in her 12 years of experience. Her prev… Read More
September 18, 2025, 09:52 IST
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