Primary Amoebic Meningoencephalitis (PAM) is a rare but deadly brain infection caused by Naegleria fowleri, commonly known as the “brain-eating amoeba.” The infection occurs when contaminated water enters the body through the nose, allowing the amoeba to reach the brain and cause severe inflammation. Recent reports of PAM cases in Kerala, India, have raised concerns about its prevalence and seasonal patterns. In this article, we will explore the commonality of PAM and whether its occurrence is influenced by the monsoon season.
The Rarity of Primary Amoebic Meningoencephalitis
PAM is an extremely rare infection. According to Dr. Bharat Subramanya, a Brain and Spine Surgeon, PAM is a fatal brain infection with a mortality rate of nearly 100%. The amoeba responsible for PAM, Naegleria fowleri, thrives in poorly maintained or unhygienic water bodies such as ponds, wells, swimming pools, and marshlands. While the infection can affect individuals of all ages, it is more commonly seen in children and young adults.
Sources of Naegleria fowleri
Naegleria fowleri can be found in various warm water sources, including lakes, rivers, hot springs, and warm water discharge from industrial or power plants. Additionally, poorly maintained or minimally chlorinated recreational venues like swimming pools and tap water can also harbor the amoeba. It’s important to note that swallowing contaminated water does not lead to infection, as the amoeba must enter the body through the nasal passage.
Prevalence and Seasonal Patterns
Primary Amoebic Meningoencephalitis can occur globally, and cases have been reported worldwide. Although it is a rare infection, its fatality rates are alarmingly high, reaching approximately 98%. The infection tends to occur during the warmer months, with an increased likelihood in the summer season. In India, the months of April, May, and June are mentioned as a period when people tend to engage in activities like swimming in pools and other water bodies, which may be potential sources of the amoeba.
Prevention and Treatment
Preventing PAM requires avoiding water bodies that are not regularly tested or maintained. While avoiding direct contact with contaminated water is recommended, it is not foolproof protection. Swimmers should exercise caution and consider using nose clips to minimize the risk of amoeba entry.
In terms of treatment, a combination of drugs, including amphotericin B, azithromycin, fluconazole, rifampin, miltefosine, and dexamethasone, is often administered. These drugs have shown activity against Naegleria fowleri and have been used in treating patients who have survived the infection.
Primary Amoebic Meningoencephalitis caused by Naegleria fowleri is a rare but highly fatal brain infection. The infection occurs when contaminated water enters the body through the nose, allowing the amoeba to reach the brain. While PAM is rare, it can be found worldwide and is more likely to occur during the warmer months, particularly in regions where people engage in water activities. Prevention involves avoiding poorly maintained water bodies, while treatment includes a combination of specific drugs. It is crucial to raise awareness about the infection, its prevention, and timely medical intervention to minimize the risk of PAM.
