Teenager in Kerala Dies from Brain-Eating Amoeba: Learn About Symptoms, Treatment, and Prevention Measures

The tragic death of a 15-year-old boy in Kerala’s Alappuzha district highlights the dangers of primary amebic meningoencephalitis (PAM), a rare brain infection caused by the ‘brain-eating amoeba’ Naegleria fowleri. The boy had been suffering from high fever and experienced a rapid decline in his vital signs. It is believed that the amoeba entered his body when he bathed in a nearby stream. Naegleria fowleri thrives in natural settings, particularly in warm water habitats, where it feeds on bacteria in the silt of rivers and lakes.

Understanding Naegleria fowleri

Naegleria fowleri is a single-cell organism commonly referred to as a brain-eating amoeba. It is found in warm freshwater environments such as lakes, hot springs, and poorly maintained swimming pools. Due to its small size, only a microscope can detect it. Naegleria fowleri is the only species of Naegleria known to infect humans and has been occasionally detected in unclean or inadequately chlorinated recreational areas.

Primary amebic meningoencephalitis (PAM) is a severe and often fatal brain disease caused by the amoeba entering the body through the nose and reaching the brain. The amoeba is vulnerable during its trophozoite phase, but becomes more resistant in its cyst phase. It thrives in temperatures over 46 degrees Celsius and can survive in extremely cold temperatures as cysts. Its growth is facilitated by warm water environments, especially in the summer, and the risk of exposure increases in contaminated water sources and poorly maintained swimming pools. Activities like diving or jumping into warm freshwater lakes can provide an entry point for the amoeba by forcing water up the nose.

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It is important to recognize the signs and symptoms of a Naegleria infection. Early symptoms of PAM may resemble those of bacterial meningitis.

• PAM symptoms typically appear 1-12 days after infection, with an average onset around 5 days.
• Common symptoms include headache, fever, nausea, and vomiting. Severe symptoms may include seizures, hallucinations, stiff neck, confusion, and coma.
• The illness progresses rapidly and often results in death within 5 days, although the duration can vary from 1 to 18 days.

Treatment Options for Naegleria fowleri Infection

Due to the rarity and rapid spread of PAM, effective treatments have been challenging to develop. Various medications, including amphotericin B, azithromycin, fluconazole, rifampin, miltefosine, and dexamethasone, are currently used in combination to treat PAM. These medications have shown effectiveness in surviving patients and the most recent addition is meltefosine.

Preventing Naegleria fowleri Infection

Naegleria fowleri infection occurs when water containing the amoeba enters the body through the nose. The majority of infections happen during activities like swimming, diving, or submerging the head in warm freshwater environments. In rare cases, infections have been linked to rinsing the nose with contaminated tap water or performing nostril cleaning during religious rituals. Water systems, including public drinking water systems, hot water heaters, and pipes, can support the growth of Naegleria fowleri.

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The primary precaution to prevent Naegleria fowleri infection is to avoid water from entering the nose.