Kerala Faces Surge in Brain-Eating Amoeba Infections: 61 Cases and 19 Deaths Reported

Kerala is facing a growing health crisis as infections caused by the “brain-eating amoeba” have claimed 19 lives this year. The disease, known as Primary Amoebic Meningoencephalitis (PAM), is caused by Naegleria fowleri, a rare but highly fatal pathogen. With 61 confirmed cases already reported in 2025, health authorities are urging people to take strict precautions when exposed to untreated freshwater sources.

What is Primary Amoebic Meningoencephalitis (PAM)?

According to official health documents, PAM affects the central nervous system and destroys brain tissue. “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,” the Kerala government has explained. The amoeba typically enters through the nasal passages when people swim, dive, or bathe in contaminated freshwater.

How the Amoeba Spreads

The disease-causing Naegleria fowleri thrives in warm, stagnant, untreated water bodies such as ponds and lakes. Once the amoeba enters through the nasal cavity, it travels via the olfactory nerve and cribriform plate to the brain. Importantly, drinking contaminated water does not cause infection. Health experts warn that “oral consumption of contaminated water is not associated with symptomatic disease.”

Rising Threat with Climate Change

Global warming is being seen as a contributing factor to the rise of these infections. Higher temperatures encourage the growth of the amoeba, while extreme heat drives more people to water bodies for recreation. A Kerala government document 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.”

Symptoms of PAM Infection

PAM has a very high mortality rate due to delayed diagnosis. Its early symptoms resemble bacterial meningitis and include headache, fever, nausea, and vomiting. As the disease progresses, patients develop signs of brain swelling such as confusion, seizures, and coma. The incubation period ranges from one to nine days, and the infection advances rapidly within hours to days. “The neuro-olfactory route provides N. fowleri quick access to the brain and results in impaired adaptive immune response, causing a very rapid disease course,” the document states.

Difficulties in Diagnosis

Doctors face major challenges in diagnosing PAM because its symptoms mimic more common conditions. “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,” the Kerala government notes. This delay in identification often leads to fatal outcomes.

Treatment Options and Challenges

Treatment for PAM remains limited. Almost all survivors in the past six decades were diagnosed at an early stage before the infection reached the brain. “This shows that early diagnosis of PAM and timely initiation of an antimicrobial cocktail might be lifesaving,” health authorities emphasise. However, there is no single established cure, and doctors rely on combinations of drugs capable of crossing the blood-brain barrier. State Health Minister Veena George has stressed that “early detection is key.”

PAM Cases in Kerala: A Growing Concern

Kerala reported its first PAM case in 2016, but until 2023, the state had only eight confirmed cases. Last year, infections surged to 36 cases and nine deaths. In 2025, the numbers have nearly doubled, with 61 cases and 19 deaths already recorded. Patients have ranged from infants as young as three months to the elderly as old as 91, showing that no age group is immune.

Preventive Measures for Public Safety

Authorities have urged the public to avoid swimming or bathing in untreated freshwater sources such as ponds, lakes, and poorly maintained wells. The health department advises swimmers to use nose clips to reduce the risk of infection. Proper cleaning and chlorination of water tanks and wells are also being encouraged. Environmental sampling is being conducted with the help of the National Centre for Disease Control to trace possible sources of contamination.