Amoebic meningoencephalitis: Another child with symptoms admitted for treatment in Kozhikode

Kozhikode: A four-year-old boy from Kozhikode is currently undergoing treatment for symptoms of amoebic meningoencephalitis, adding to the growing concerns over the disease in Kerala. The test results for the child are expected today (Wednesday). A three-year-old boy from Kannur is also receiving treatment for the same illness in critical condition.

Recently, there was a positive development when fourteen-year-old Afnan successfully recovered from amoebic meningoencephalitis, a condition with a 97% mortality rate. Globally, only eleven people have survived this rare disease.

Amoebic encephalitis, once rare in Kerala, has become a worrying issue. Within two months, the disease claimed the lives of three children, despite only six cases being reported in the past seven years. The victims included a five-year-old girl from Malappuram, a thirteen-year-old girl from Kannur and a twelve-year-old boy from Kozhikode. The five-year-old girl allegedly fell ill after bathing in Kadalundi river, while the other two are believed to have contracted the illness after bathing in ponds.

What is amoebic meningoencephalitis?

Amoebic meningoencephalitis is an extremely rare central nervous system (CNS) infection caused by a type of free-living amoeba called Naegleria fowleri, also known as ‘brain-eating amoeba’. This disease is not transmitted from human to human. 

The amoeba is found in soil and in ponds, rivers, streams, unchlorinated swimming pools and stagnant water. When the body is exposed to stagnant water, the amoeba enters the human body through the nose and causes encephalitis, seriously affecting the brain. 

Amoebic meningitis typically appears in two forms: primary amoebic meningoencephalitis (PAM) and granulomatous amoebic encephalitis (GAE).

PAM progresses rapidly when water containing the amoeba enters the nasal passage, allowing it to migrate to the brain, causing inflammation, cerebral edoema and potentially fatal complications within days. Initial symptoms include fever, headache, vomiting and sensitivity to light, primarily affecting healthy adolescent males during warm months.

In contrast, GAE, more common in adults, develops over a longer period, often through inhalation or skin contact, with symptoms such as fever, headache, altered mental status or seizures appearing over weeks to months.

Symptoms
Symptoms appear within one to nine days of the infection. The primary symptoms include:

• severe headache
• Fever
• Nausea and vomiting 
• Neck stiffness and pain
• Symptoms like epilepsy, loss of consciousness, and memory loss can be experienced in critical situations.

The infection is diagnosed by examining the fluid around the spinal cord.

Preventive measures

• Avoid bathing in unhygienic, stagnant water.
• Avoid nasal irrigation with unclean water.
• Only enter properly chlorinated swimming pools.