Kerala is grappling with a sudden rise in amoebic meningoencephalitis, a rare but often fatal brain infection caused by the so-called “brain-eating amoeba.” Health officials report over 40 suspected cases this year, with multiple confirmed deaths, including children. The majority of infections have been linked to exposure to untreated water bodies such as ponds and wells, where stagnant, warm water provides an ideal environment for the organism to thrive. The state government has declared the situation a public health priority, urging citizens to take precautions while bathing or swimming in natural water sources.
Global mortality ranges from 95% to 98%. India has historically recorded very few cases.
Globally, amoebic meningoencephalitis has a case-fatality rate of over 95%, with very few survivors reported. Cases in India have been sporadic in the past, but Kerala has emerged as a hotspot in recent years, partly due to improved diagnostic surveillance. While earlier infections often went undetected or misdiagnosed, laboratories in Kerala now use real-time PCR and genomic sequencing to confirm cases. The heightened detection capacity explains part of the apparent surge. Nevertheless, experts caution that climate change and rising water temperatures may also be expanding the habitats of such dangerous pathogens.
The main culprit is Naegleria fowleri, a free-living amoeba found in warm freshwater and soil. It enters the human body through the nasal passages when contaminated water is inhaled, traveling up the olfactory nerve to the brain. Once inside, it causes severe inflammation leading to primary amoebic meningoencephalitis (PAM). Early symptoms resemble common infections — headache, fever, nausea — but rapidly progress to seizures, hallucinations, and coma. The rapid progression, coupled with delayed recognition, makes treatment extremely challenging.
Kerala’s Health Department has launched the “Jalamanu Jeevan” (Water is Life) campaign, focusing on chlorination of wells and tanks, public education, and urging people to avoid submerging heads in unsafe water. Hospitals now stock Miltefosine, one of the few drugs shown to improve survival. Surveillance has been scaled up, with Institute of Advanced Virology (Thonnakkal) and the State Public Health Lab (Pattoor) taking the lead in testing. Authorities stress that the increased numbers reflect better diagnosis, but the outbreak highlights the urgent need for climate-resilient health systems and stronger community awareness to prevent future tragedies.
