NEWS – Kerala’s health department has issued an alert in Kozhikode district after three cases of Primary Amoebic Meningoencephalitis (PAM) were reported. A nine-year-old girl died, while a three-month-old baby and another child are critically ill. This comes amid rising cases of Naegleria fowleri, the so-called “brain-eating amoeba.”

HIGHLIGHTS

What is Naegleria fowleri?

• A free-living amoeba found in warm freshwater and soil.
• Enters the human body through the nose, usually during swimming or bathing, and travels to the brain.
• Causes Primary Amoebic Meningoencephalitis (PAM), a rare but highly fatal disease.

Symptoms and Risks

• Early: fever, headache, nausea, vomiting.
• Advanced: stiff neck, confusion, seizures, hallucinations, coma.
• Fatality rate is 97% globally, though Kerala has managed to lower it to ~25% through early detection and protocols.

Kerala’s Experience

• First PAM case in Kerala: 2016.
• From 2016–2023: 8 cases reported.
• In 2023 alone: 36 cases, 9 deaths.
• Kerala became the first Indian state to issue a treatment protocol for PAM.
• In July 2024, a 14-year-old boy survived, becoming India’s first and the 11th global survivor.

Broader Context: AES and Climate Change

• PAM is part of the Acute Encephalitis Syndrome (AES) spectrum.
• Climate change and pollution have expanded the habitat of Naegleria fowleri.
• Warmer freshwater bodies (up to 46°C) increase infection risk.

Government Response

• Kerala has developed a special treatment protocol & SOP for PAM — first in India.
• Treatment involves multiple drugs: Amphotericin B, Miltefosine, Azithromycin, etc., though no definitive cure exists.

Policy & Science Solutions

• Biotechnology: PCR-based rapid diagnostics, drug discovery via genomics, CRISPR research.
• Genomic and proteomic studies of the amoeba can identify unique metabolic pathways or proteins that can be targeted with new drugs.
• Nanomedicine: Drug delivery across the blood-brain barrier, nanoparticle-based formulations, futuristic nanobots.
• Targeted Drug Delivery: The blood-brain barrier is a major obstacle for many drugs. Nanoparticles can be engineered to carry drugs like Amphotericin B directly across this barrier and deliver them to the site of infection in the brain.
• Public Health: Awareness on safe water use, surveillance, SOP-driven treatment.