This year, the state has reported 61 confirmed cases and 19 deaths, many of them in recent weeks
Kerala health authorities are on alert after a spike in cases of Primary Amoebic Meningoencephalitis (PAM), a rare but highly fatal brain infection caused by Naegleria fowleri, commonly known as the “brain-eating amoeba.”
This year, the state has reported 61 confirmed cases and 19 deaths, many of them in recent weeks.
State Health Minister Veena George said Kerala is grappling with a serious public health challenge. Earlier, infections were largely linked to clusters in districts like Kozhikode and Malappuram. Now, however, sporadic cases are being detected across the state, ranging from a three-month-old infant to a 91-year-old.
“Unlike last year, we are not seeing clusters tied to a single water source. These are isolated cases, and this has complicated our epidemiological investigations,” she said.
According to a state health department document, PAM attacks the central nervous system by destroying brain tissue, leading to severe swelling and usually death. Though rare, it mostly affects otherwise healthy children, teenagers, and young adults.
The amoeba thrives in warm, often stagnant, freshwater. It infects people when contaminated water enters through the nose, traveling via the olfactory mucosa and cribriform plate to the brain. Drinking such water does not cause the disease.
Swimming, diving, or bathing in contaminated water bodies puts individuals at high risk. Experts warn that climate change, which raises water temperatures and increases recreational water use, may heighten exposure. The infection is not transmitted from person to person.
PAM is difficult to diagnose as its early symptoms resemble bacterial meningitis—headache, fever, nausea, and vomiting. By the time it is recognised, cerebral swelling often proves fatal.
The illness typically appears between one and nine days after exposure, with symptoms worsening rapidly within hours to a couple of days. “The neuro-olfactory route provides N fowleri quick access to the brain and results in impaired immune response, causing a very rapid disease course,” the health advisory warns.
