Three children die from brain-eating amoeba in Kerala: What is it?

So far, Kerala has witnessed the death of three children due to infection caused by the brain-eating amoeba, Naegleria fowleri.

In the last two months, four cases of primary amoebic meningoencephalitis (PAM) have been diagnosed, three of which were fatal, according to Dr Drishya Pillai, consultant physician, Meditrina Hospital, Palakkad, Kerala.

“These deaths are due to its fulminant progression, high mortality rate (around 90-95%) and lack of established or effective treatment. It is pertinent to raise awareness,” said Dr. Pillai.

A 14-year-old boy from Payyoli is currently receiving treatment at a private hospital after the condition was quickly identified.

Earlier, another 14-year-old boy died due to the infection. A five-year-old girl from Malappuram died on May 21 and a 13-year-old girl from Kannur also succumbed to the disease on June 25.


PAM, or primary amebic meningoencephalitis, is a rare but serious infection caused by Naegleria fowleri, a free-living amoeba that thrives in warm freshwater environments such as lakes, ponds, and poorly maintained swimming pools.

The amoeba enters the body through the nasal passages, usually when people swim or dive in contaminated water. Once inside, it travels to the brain, where it causes serious damage.

Primary amoebic meningoencephalitis is a rare but serious infection caused by Naegleria fowleri, a free-living amoeba that thrives in warm freshwater environments. (Photo: Getty Images)

“The high affinity for the brain and the rapid damage it subsequently causes earned Naegleria the name ‘brain-eating amoeba’,” Dr Pillai explained. Initial symptoms typically include fever, nausea, vomiting, headache and neck stiffness.

As the infection progresses, patients may experience confusion, altered behavior, seizures, and eventually coma and death.


Diagnosing PAM can be challenging due to its rarity and the similarity of its symptoms to other conditions, such as bacterial meningitis.

“Early diagnosis can be achieved by high clinical suspicion and PCR testing of cerebrospinal fluid or CSF, analysis of CSF for motile trophozoites, in addition to routine testing,” said Dr. Pillai.

Although there is no established treatment for PAM, some success has been seen with the administration of intravenous and intrathecal amphotericin B, together with azithromycin, miltefosine, and dexamethasone.

However, the effectiveness of the treatment remains uncertain.


Given the high mortality rate and lack of definitive treatment, prevention is crucial.

Dr Prameela Radhakrishnan from Neuberg Diagnostics stressed the importance of raising awareness among parents: “Children eagerly look forward to swimming in lakes, rivers and pools; it is critical that parents are aware of a rare but potentially life-threatening risk – the brain-eating amoeba.”

Parents are advised to take the following preventive measures:

  • Prevent children from swimming in warm bodies of freshwater such as lakes, ponds, and poorly maintained swimming pools.
  • Make sure children use nose clips to prevent water from entering their nostrils.
  • Clean children’s nose with warm water after swimming.
  • Keep a close eye on water activities.

“If you suspect your child may have developed symptoms of PAM, seek medical attention immediately,” Dr. Radhakrishnan advised. “Tell the doctor about your child’s recent water activities, as this information can help with quick diagnosis and treatment.”

Dr CS Narayanan, Chairman, Manipal Institute of Neurosciences, Manipal Hospital Dwarka, further highlighted preventive measures.

“Prevention of Naegleria fowleri infection primarily involves avoiding activities that allow water to enter the nose. Public health recommendations include avoiding swimming in warm freshwater during peak temperatures, using nose clips or holding the nose closed when underwater, and avoiding stirring up sediment in warm freshwater.”

While the risk of infection with Naegleria fowleri remains low, the potential consequences are devastating.

Awareness and preventative measures are essential to protect against this rare but deadly threat.

By understanding the risks and taking proper precautions, families can safely enjoy water activities and minimize the danger of encountering this deadly amoeba.

Published by:

Daphne Clarance

Published in:

July 10, 2024