Kerala health authorities have sounded alarm after a sharp increase in cases of Primary Amoebic Meningoencephalitis (PAM), a rare but fatal brain infection caused by Naegleria fowleri, also known as the “brain-eating amoeba”.
This year, the state has reported 61 confirmed cases and 19 deaths, with many fatalities occurring in recent weeks. Patients have ranged in age from a three-month-old infant to a 91-year-old.
State Health Minister Veena George described the situation as a serious public health challenge. “Unlike last year, we are not seeing clusters linked to a single water source. These are single, isolated cases, and this has complicated our epidemiological investigations,” she said.
How the Brain-Eating Amoeba Infects Humans
According to a Kerala government document, PAM primarily affects the central nervous system. “This infection destroys brain tissue, causing severe brain swelling and death in most cases. PAM is rare and usually occurs in otherwise healthy children, teens and young adults,” it states.
The amoeba enters the body through the nose when people swim, dive, or bathe in contaminated freshwater, particularly warm and stagnant water. The document clarifies that drinking such water does not cause the disease. It further notes, “Climate change raising the water temperature and the heat driving more people to recreational water use is likely to increase the encounters with this pathogen.”
ALSO READ: What is masturbation coaching? No, it’s not paid sex
The infection is not contagious and does not spread from person to person.
Symptoms, Treatment and Preventive Measures
PAM symptoms resemble bacterial meningitis, including headache, fever, nausea, and vomiting. “By the time other more common causes of meningitis are ruled out and the diagnosis of PAM is considered, it is often too late to save the patient from the cerebral edema that quickly develops and causes death,” the government document warns. Symptoms may appear within one to nine days of exposure, with rapid progression in one to two days.
Almost all survivors worldwide were diagnosed at an early stage. “This shows that early diagnosis of PAM and timely initiation of an antimicrobial cocktail might be lifesaving,” the document adds. Veena George stressed, “early detection is key.”
To prevent further cases, authorities have advised people to avoid swimming or bathing in stagnant freshwater sources such as ponds and lakes, use nose clips when entering freshwater, and ensure wells and tanks are properly cleaned and chlorinated. The health department, along with the National Centre for Disease Control, has also begun environmental sampling to trace contamination sources.
Sharp Rise Since 2023
Kerala reported its first PAM case in 2016. Until 2023, only eight cases were recorded. But the numbers spiked sharply with 36 cases and nine deaths last year. In 2025, the tally has already reached 61 cases and 19 deaths, marking a near 100 percent rise.
