Primary Amoebic Meningoencephalitis

What is this disease?

Amoebic meningoencephalitis, also called Primary Amoebic Meningoencephalitis (PAM), is a very rare but extremely serious infection of the brain and the protective layers around it. It is caused by an amoeba called Naegleria fowleri, commonly known as the “brain eating amoeba”. This organism naturally lives in warm fresh water such as ponds, lakes, rivers, streams, hot springs and poorly chlorinated swimming pools. It enters the human body through the nose, travels along the olfactory nerves and reaches the brain, where it causes severe inflammation.

Symptoms

Early symptoms look exactly like common viral or bacterial meningitis:

• Severe headache

• Fever

• Vomiting

• Nausea

Very soon, more dangerous symptoms may appear, such as:

• Neck stiffness

• Confusion or reduced alertness

• Seizures

• Loss of balance

• Sensitivity to light

  
  

  The disease progresses very rapidly, often within a few days, which makes early recognition extremely important.

Treatment

There is no guaranteed cure for this infection. Even with treatment, survival is very rare worldwide. Doctors usually use a combination of medicines including Amphotericin B and Miltefosine, along with intensive ICU support. The only effective protection is early detection and prevention.

How patients can protect themselves

• Avoid swimming or diving in warm fresh water sources during hot seasons.

• If swimming is unavoidable, prevent water from entering the nose.

• Use only boiled or sterile water for nasal rinsing (neti pot etc).

• Make sure swimming pools are properly chlorinated.

• If you develop fever, headache or vomiting within a week after fresh water exposure, visit a hospital immediately.

Current situation in Kerala

Kerala has recently reported a rise in amoebic meningoencephalitis cases. As per recent public health updates, the state recorded multiple cases with several deaths this year, prompting the health department to release special water-safety guidelines. Health authorities have advised the public to avoid bathing in untested fresh water bodies and to ensure proper water treatment practices.

Advice for Ayyappa devotees going to Sabarimala

Since many devotees take holy dips in rivers and streams during the pilgrimage, it is important to be cautious:

• Avoid swimming or immersing the head in slow moving or stagnant warm fresh water.

• Do not allow water to enter the nose while taking a dip.

• Prefer flowing water and avoid ponds.

• Use only boiled or bottled water for nasal cleansing.

• If any fever or headache starts during or after the trip, seek medical care immediately.

Staying alert and following these simple precautions can make your pilgrimage safer and protect you from this rare but dangerous infection.

Dr. Karuturi Subrahmanyam, MD, FRCP (London), FACP (USA)

Internal Medicine Specialist

Kify Hospital

Danavaipeta

Rajahmundry

Phone : 85000 23456

www.KifyHospital.com