Anaya, Government Lower Primary School, Class IV student at Koranngad, near Thamraseri in Kozhikode district, was tired of returning home on 13 August evening. His father KV Sanup and mother NP Rambesa thought that the child might feel tired as she had attended the dance rehearsal session for an Independence Day program.
As the night progressed, Anaya felt fever and vomited. “My brother initially suspected that he had a leptospirosis, gave Anaya a tablet, and the next day asked him to take him to Thamaraseri Taluk Hospital,” Says Soumya, Sister, Says, says KV Soumya. Although he was admitted to the hospital on 14 August, Anaya’s condition deteriorated by noon. He died in the evening while attending the Government Medical College Hospital (MCH), Kozhikode.
The results of the latter laboratory showed that she was infected with amybic meningo encephalitis, a rare but malignant brain infection, which is caused by the free-lived amoeba found in freshwater, lakes and rivers. In the next two weeks, at least nine people conducted positive tests for infections from the round of treatment for fever in MCH. Four of them, including Anaya’s seven -year -old brother and a three -month -old child, are from Kozhikode, three are from Malappuram, while two are from Wayanad.
The well in the complex of Abdusmad, from where the family of a three -month -old child infected was drawing water for his domestic use. , Photo Credit: K Ragesh
Doctors say that two types of malignant amybic encephalitis infections are usually found: Primary Amibic MeningoCencephilitis (PAM) and Granulomatus amobic encephalitis (GAE).
Is caused by pam Naglaria fouli The species, usually called the “brain-eating amoeba” because it destroys brain tissue that leads to the death of the patient. Children, teenage and young adults are sensitive to it. Delayed diagnosis and rapid onset cause high deadly rates in infection. Some of the initial symptoms of Pam are similar to bacterial meningitis, while GAE people may be similar to encephalitis, meningitis or brain boils.
Anaya’s partially from the full house of Anaya in Anaparpoy, a narrow, infallible, rock -covered rocky path leads to a small pond in their neighbor’s complex. Saysya says, “She bathed in deep knee water with her two brothers, however the source of infection remains to be identified. Taluk Hospital officials have tied a band around the pond with a notice, which announced a ban on entering water.
About 12 km from Anaya’s house, Abdusmad of Kolathkara near Omaseri, pays attention that his neighbor’s three-month-old baby has revealed amybic encephalitis and a lab test showed the presence of free-living amoeba in his well. He says, “They used to pump water from here for their domestic use. Health officials are now chlorine every three days.”
TS Anish, Professor of Community Medicine, and Kozhikode-based Kerala Nodal Officer One Health Center for Nipa Research and Regiles, say that climate change is one of the main reasons for the acceleration of amybic encephalitis in Kerala in recent years. “Due to increase in atmospheric temperature, microorganisms like amoeba Naglaria fouli Flowing into a high -temperature environment has gained a prominence in the environment in the last decade, ”he says.
“Like species Naglaria fouli Mainly feed on bacteria and algae. The contamination caused by coliform bacteria is usually found in stool, high in our water sources such as wells, ponds and rivers, ”they say.
C. Shubin, Malappuram District Monitoring Officer, notes that a combination of specific factors comes together to cause the disease. “These include the optimal temperature and a significant amybic increase in stable water with biomass, followed by water entering the nasal cavity, often through pre -existing deformity or opening,” they say.
Head of Infectious Disease Department, Government Medical College, Thiruvananthapuram R. According to Arvind, there are more than 400 species of amoeba, free in the environment. “However, only Naegleria Fowlelli, Acanthamoeba Sp., Vermamoeba Vermiformis, Balmuthiya Mandrilaris, Parvhalkampfeia FranceinaAnd Sapinia It is considered highly harmful to humans. Kerala has reported amybic infections Neglaria Faulary, Vermamoeba vermiforis as well as AcanthmibaMost recent infections are due to Naglaria fouli And SolitudeWhereas Naglaria fouli The most dangerous of these pathogens is considered, SolitudeThe most wide is also recovered from an soil, ”they say.
The local community is alert with 14 cases and four deaths from Malappuram district so far this year.
Since the death of a 16 -year -old boy in the third week of June, no one has taken a dip in the Plasid pond in Cholakkal near Malappuram. It is believed that he developed meningo encephalitis after bathing in the pond with crystal clean water. “Many others who used to bathe in the pond with Fasila Kolaktil, a resident of Kemmankadavu near Cholakkal, had fever due to fear.”
In September 2024, Nawaikulam Panchayat, about 37 km north of the city of Thiruvananthapuram, was in the grip of fear. Three plus two students took a bath in the Madankavu pond in the Maruthikkunu ward, one of which came to know of the infection. Navikulam Panchayat officials worked fast, putting people on the banks of almost all the 40 ponds and some canals, warning people against entering into them.
The message was done carefully to ensure that people take adequate care. A year later, intimidation seems to have been removed after cleaning the ponds, the warning boards have been removed. Panchayat member of Maruthikunu Ward H. Savad says, “No case has been reported from the area after cleaning and people now use some of these ponds.”
“My son spent 45 days in the hospital. Since we arrived at Government Medical College Hospital, Thiruvananthapuram, okay when we paid attention to some symptoms, their condition did not deteriorate. They really got good care there and recovered well,” the father of the Nawaikulam boy says that the disease was detected. The doctor examines it once at a time. “Now, he is fine and will soon join a professional course,” he says.
However, another 23-year-old who developed the symptoms around last year after coming to the water near Shabanikodi in Kollam, still sometimes faced difficulties. ,
In addition to the rural suburb Nawakalam, Athinaur, near Thiruvananthapuram, a group of cases were also seen in seven youths who conducted positive tests for all of the disease and later recovered. It was a rare case of a cluster, while all the rest are sporadic cases.
Health officials say the state started reporting cases of sporadic amibic encephalitis from 2016 and almost all patients died for infection by 2023. This was a challenge to identify motivational organisms as the samples were to be sent for Post Graduate Institute of Medical Education and Research, Chandigarh, Punya Diagnosis.
In 2024, the state government came out with a set of guidelines for diagnosis and management of infection in view of recurring matters and deaths. Patients with acute meningitis symptoms such as fever, hard neck and confusion are now asked if they have a history of nasal exposure to freshwater 14 days before the onset of symptoms. Children can become more weak as their cribriform plate that separates the nose cavity and the scalp has a more porous opening than adults. Cerebro-spinal fluid (CSF) of such patients are then sent for lab tests for free-living amoeba, including Naegleria FowLelli. Recommended multi-drug regimen and supportive therapy should begin on patients diagnosed with PAM via CSF microscopy.
Dr. Arvind says that the introduction of an anti-parsitic drug Miltaphocin, whose supply was earlier limited, was a major twist, in the antibiotic cocktail. Till then, only 11 living cases cases Naglaria fouli Palm was informed globally. However, until October 2024, a total of 14 of 19 infected persons survived in Kerala in the last five months.
Doctors say the test is now more aggressive, especially in the context of recurring nipa outbreaks in North Kerala districts, to detect the exact cause of any case of acute encephalitis syndrome (AES), to detect brain inflammation. “Even more than one rare case is considered a outbreak. Whenever AES matters are noted, doctors examine the presence of amoeba in CSF. Therefore, more cases are being reported more now. However, the source detection can be difficult to case of people affected. Acanthamoeba spp. As it is omnipresent, ”says Dr. Arvind.
He also throws light on the need for timely treatment to save the pathogen and to save life. The state in Thiruvananthapuram is capable of detecting five harmful species of public health lab free Amiba, Dr. Arvind says.
Dr. Anish says that keeping waterbody clean is one of the ways to reduce the cases of infection. The water should be chlorine -chlorinated at regular intervals and the overhead water tank should be cleaned. “Any opportunity of contaminated water entering the nose should be avoided. It should be taken care that hygiene water is used for religious rituals in which water drips into the nose of children,” he said.
The state government is planning an intensive hygiene campaign on August 30 and 31 by incorporating local bodies, Harita Kerala Mission and Water Resources Department. Health Minister Veena George has asked for chlorine and cleaning all the water tanks.
Ponds and other waterbodies may still appear to be invited. But under the plasid water sheath, there may be a lean pathogen.
,Abdul Lathef Naha’s input in Malappuram,
