How Pakistan’s study shed light on Kerala’s rare brain-eating amoeba case in infant
Pakistan study links nasal rinsing to rare amoeba infection in Kerala infant
Kerala health authorities are investigating a rare case of primary amoebic meningoencephalitis (PAM) in a three-month-old infant in Kozhikode — the youngest reported in the state so far.
The infection, caused by free-living amoebae, is usually linked to contaminated ponds, lakes, or swimming pools. But in this case, doctors suspect nasal rinsing as the source.
Tests revealed that the infant’s cerebrospinal fluid contained a different amoeba type from the one detected in the family’s well water. Investigators later confirmed the child’s nose had been rinsed with well water, which tested positive for amoebic contamination.
Why Pakistan’s study matters
A Pakistan-Cambridge study tracking Karachi cases over 14 years found most infections weren’t linked to swimming. Instead, they were associated with nasal rinsing and sinus cleansing with unsafe water — mirroring Kerala’s latest case.
Expert caution
“Without PCR or sequencing, there is no conclusive proof of the exact amoeba type,” senior officials told Manorama News. “Both well water and holy water used by the child tested positive. Treatment is the same regardless of species. What matters is awareness against nasal rinsing with contaminated water.”
Kerala’s infectious disease specialists have since updated guidelines, advising that nasal rinsing should only be done with sterile, distilled, or filtered water.
The baby, who is immunosuppressed, remains on ventilator support. Doctors noted that holy water stored over time may be prone to contamination. Authorities are considering a sensitisation campaign to warn against non-traditional sources of infection.
What is the brain-eating amoeba?
Naegleria fowleri and related amoebae live in warm freshwater and soil.
Infection occurs when contaminated water enters through the nose.
The amoeba travels to the brain, destroying tissue and causing swelling.
How the amoeba spreads
Found in ponds, lakes, and stagnant water bodies.
Spreads through the nasal passage, not by drinking contaminated water (CDC).
Children may be more vulnerable due to nasal cavity structure.
How deadly is it?
Symptoms: fever, headache, vomiting, confusion, seizures.
Progression: extremely rapid; death often occurs within 5 days.
Fatality rate: 97% worldwide, with only a handful of survivors.
What happened in Kerala?
The baby was admitted with fever, deteriorated quickly, and is now on ventilator support.
Doctors suspect holy water used for nasal rinsing as the likely source.
Tests showed a different amoeba strain from the family’s well water.
Rising cases in Kerala
Since 2016: 45 PAM cases reported, mainly in Kozhikode and Malappuram.
In 2023 alone: 36 infections and 9 deaths.
Other detected species include Acanthamoeba and Vermamoeba.
Currently: 8 patients under treatment, including the infant.
Doctors warn climate change and poor water hygiene may be fuelling the surge.
Safety advice for the public
Avoid swimming or bathing in stagnant freshwater, especially after rain.
Use only sterile, boiled, or filtered water for nasal cleansing.
Seek medical help immediately if symptoms occur after water exposure.
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