PAM Cases Rise In Kerala Caused By A Brain-Eating Amoeba

Brain-eating amoeba in Kerala, what next?…

The current increase in Primary Amoebic Meningoencephalitis (PAM) in Kerala, which poses a significant threat to humans caused by a brain-eating amoeba, has raised considerable public health concerns.  In this part of India, PAM exemplifies a growing public health-related threat  that requires immediate global attention to limit the spread of this amoeba. As of 2024, around 29 PAM cases have been reported in Kerala, and till now, five people have lost life due to this disease. PAM is correlated with an extremely high mortality rate, and many studies have reported a case fatality rate of high as 99 percent.

The onset of symptoms of PAM to death was found to be around 5.3 days. The mean time from exposure to death was around 9.9 days. In Kerala, four cases were reported over two months. On the other hand, a 14-year-old boy recovered from this illness caused by  Naegleria fowleri, confronting a nearly 99 percent mortality rate.  It has been seen that unhygienic and contaminated water sources and high temperatures are identified to be one of the major risk factors in terms of getting PAM, and the hot climate of Kerala could be a factor that contributes to the rising PAM cases.

Why are PAM cases rising in Kerala?

There are various factors that may be a reason behind the rising cases of PAM in Kerala, India, including climate change, alterations in rainfall patterns, and many others.  It is worth pointing out that due to global warming, the temperature across different coastal regions, and tropical and subtropical regions have increased dramatically. Therefore increase in temperature may provide favorable conditions for the growth and reproduction of Naegleria fowleri, which is found in warmer waters. This may be one of the key reasons behind the rising cases of PAM in Kerala, India.   

Brief information about Primary Amoebic Meningoencephalitis (PAM)

Naegleria fowleri is commonly found in warm freshwater, rivers, lakes, ponds, and soil in different parts of the globe.  The CDC report also indicates that  Naegleria fowleri, on rare occasions found in splash pads and poorly maintained swimming pools.  The amoeba is also found in tap water, which may increase the risk of illness that is caused by Naegleria fowleri.  The inflection occurs when ameba accidentally enters through the nose and goes into the brain. That may lead to inflection that is known as Primary Amoebic Meningoencephalitis (PAM), which is also regarded as a brain-eating amoeba that currently occurs in Kerala, India. In “The United States,” US fewer than 10 cases are reported yearly and always countered as fetal infection.

Epidemiology of PAM  

PAM is counted as an extremely rare disease, with only 3.7 reported cases per year globally. The  Naegleria fowleri, which is the main causative agent of PAM, is particularly found in warmer regions like the southern part of the US and specifically occurs in warmer months and summer, mainly because of the higher possibility of partaking in waterborne activities. The majority of the infection occurs among people who fall under 12 years of age which is considered as a mean age of acquiring this disease. Many reports suggest that PAM generally occurs among healthy individuals who are exposed to warm freshwater. 

 Naegleria fowleri, on the other hand, infects susceptible individuals when contaminated water enters their bodies via the nose.  Hence, amoeba penetrates olfactory mucosa and, therefore, crosses the cribriform plates and eventually reaches the olfactory bulb. It further leads to inflammatory reactions and causes damage correlated with PAM. In addition, the amoebacan invade the central nervous system which stimulates abscess along with focal granuloma formation.

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