What is Naegleria fowleri? Rare brain-eating amoeba kills 14-year-old boy in Kerala

In the Kozhikode district of Kerala India a rare virus killed a fourteen-year-old boy, a type of amoeba species that lives in warm shallow freshwater environments such as lakes rivers and hot springs.

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Living in warm, shallow, freshwater environments like lakes, rivers, and hot springs Naegleria fowleri is a type of amoeba species found worldwide. In soil, it also thrives. Because it does not require a host to survive, it is regarded as a free-living organism.

A fourteen-year-old boy from Kerala, India, was killed by a rare brain-eating amoeba in the Kozhikode district. State health officials claim that the boys free-living amoeba infection was discovered in the tainted waters.

In the previous three months, the deadly infection has been the cause of three deaths. The boy was swimming in a small pond when he contracted the virus, according to the health department. Immediate preventive action has been taken in response to the incident.

Previously, on May 21 in Malappuramon, a five-year-old girl died from the virus, and on June 25 in Kannur, another thirteen-year-old girl perished.

The disease known as primary amoebic meningoencephalitis (PAM) affects those who are infected by this amoeba. The central nervous system is severely infected with PAM, which is nearly always lethal.

How do you get infected by brain-eating amoeba (Naegleria fowleri)?

The most typical way to contract this kind of amoeba is through the ingestion of contaminated water in the nasal cavity. The amoeba then travels to your brain. This typically occurs when engaging in aquatic sports like water skiing, diving, or swimming in contaminated water. In very rare instances, poorly chlorinated swimming pool water or heated tap water may contain bacteria.

Water contaminated by an infection cannot infect you.

How common is an infection due to a brain-eating amoeba (Naegleria fowleri)?

However, in more recent years, a few cases have occurred in northern states during extremely hot weather. The shifting geographic distribution of infections may be a result of climate change.

Research is being conducted to challenge the actual rarity of the Naegleria fowleri infection. Antibodies against the amoeba are present in certain individuals, suggesting that they have been infected and managed to survive. Certain cases of deaths previously linked to meningitis have now been reclassified as amoeba-caused brain deaths (Naegleria fowleri).

Symptoms and causes

The following are some of the abrupt and severe initial signs and symptoms of primary amoebic meningoencephalitis (PAM).

  • High fever.
  • Very painful headache.
  • Nausea and vomiting.
  • Trembling.
  • Symptoms like those of meningitis, including a stiff neck and extreme sensitivity to light (photophobia).
  • Mental confusion.
  • Coma.

The fatality rate is higher than 97%, even with treatment.

What causes infection with brain-eating amoeba (Naegleria fowleri)?

The Naegleria fowleri amoeba enters your brain through your nasal cavity, which is how the infection happens. If you breathe in any contaminated water, it could enter your body. A warm freshwater environment, such as hot springs or geothermal water, is typically home to amoeba life.

Inhaling contaminated dust can also spread the infection.

Other reported cases of brain-eating amoeba (Naegleria fowleri) infections have been linked to people using tap water to rinse their noses with neti pots or other devices instead of distilled or sterilized water.

How long is the incubation period for infection with brain-eating amoeba (Naegleria fowleri)?

Following amoeba exposure, symptoms take two to fifteen days to manifest.

Can I get infected with brain-eating amoeba (Naegleria fowleri) from being around someone who has it?

No. No cases of the infection spreading from person to person have been discovered. Studies are being conducted to determine whether organ or tissue donation can spread the infection.

Diagnosis and tests

A doctor may advise a spinal tap, also called a lumbar puncture, if they believe you may have been infected with a brain-eating amoeba (Naegleria fowleri). This procedure allows the doctor to check your cerebrospinal fluid (CSF) for the organism.

A brain biopsy may also be suggested by your physician. In order to detect the amoeba during this process, a tissue sample will be taken and examined under a microscope.

Management and Treatment

The antifungal amphotericin B is the preferred treatment for primary amoebic meningoencephalitis (PAM), which is caused by an infection with brain-eating amoeba (Naegleria fowleri). Fluconazole, rifampin, amphotericin B, and a medication known as miltefosine were among the medications used to treat some survivors in North America. Sandflies carry the parasitic disease leishmaniasis, which can be treated with the drug miltefosine.

When brain swelling is treated by cooling the body to below-normal temperature and receiving early diagnosis and treatment with the prescribed drugs, the best outcomes (in two children who recovered completely) are achieved.


Despite the extreme rarity of the condition, prevention can be crucial due to its extremely poor prognosis. Points to keep in mind are as follows:

  • In warm freshwater environments, especially still waters, avoid swimming, wading, or participating in water sports without wearing nose plugs. If there is a possibility that Naegleria fowleri will be present, do not enter the water at all.
  • To clean your nasal passages, never use tap water with a neti pot or any other device. Use only water that has been sterilized or distilled. Use boiled water for one minute, and then allow it to cool if you must use tap water. Boil the water for three minutes and allow it to cool if you live more than 6500 feet above sea level.
  • To get rid of bacteria in water, use filters. Make use of filters with the labels NSF 53, NSF 58, or an absolute pore size of 1 micron or less.
  • You can also disinfect your water to clean your sinuses and nose by using tablets or liquid chlorine bleach. An alternative amount of bleach is needed to disinfect water for nasal use compared to drinking water.

Tell your healthcare provider where you have been if you experience fever or headaches after entering warm freshwater.

Outlook and Prognosis

A person with a Naegleria fowleri infection has a very bad prognosis. The majority of those with this illness pass away even with treatment. Usually, a week or ten days after the onset of symptoms and signs, a coma is followed by death.

Living With

Consult a physician or head straight to the emergency room if you develop a fever or headache after irrigating your nasal passages with tap water or after engaging in physical activity in a warm body of freshwater. The brain-eating amoeba (Naegleria fowleri) infection must be identified and treated as soon as possible.