PRIMARY AMOEBIC MENINGOENCEPHALITIS (PAM)
1. Context
There have been four cases, including three deaths, of the rare, but fatal primary amoebic meningoencephalitis (PAM) in Kerala in the last two months. A 14-year-old boy from Thikkodi in Kozhikode district tested positive for the infection on July 5. He is undergoing medical treatment now and his condition is reported to be stable.
2.What is PAM?
- Primary amoebic meningoencephalitis (PAM) is an infection caused by Naegleria fowleri, an amoeba that thrives in warm freshwater environments like lakes, ponds, and rivers. It can also persist in poorly maintained swimming pools.
- This amoeba, known as the "brain-eating amoeba," can invade the brain and destroy its tissues.
- Though the infection is rare, it is almost always fatal, with a 97% mortality rate. The infection typically occurs during summer when people swim in warm freshwater bodies. High atmospheric temperatures and low water levels increase the risk.
- The amoeba enters the body through the nose and migrates to the brain, causing tissue destruction and swelling. Recent cases indicate that children are particularly vulnerable. The infection is not transmissible between people, and drinking contaminated water does not result in infection
3. Symptoms and diagnosis of PAM
3.1.Symptoms
- According to the U.S. Centers for Disease Control and Prevention (CDC), early symptoms of PAM include headache, fever, nausea, and vomiting. The disease progresses quickly, leading to later symptoms such as stiff neck, confusion, inattentiveness, loss of balance, and hallucinations.
- The CDC states that the disease typically results in coma and death within five days, with most patients dying between one to 18 days after symptoms begin.
- Experts suggest that rising atmospheric temperatures and stagnant, unhygienic water sources may contribute to the conditions that facilitate infection. The amoeba is more active in warm water
3.2. Diagnosis
- The infection can be diagnosed using PCR tests on cerebrospinal fluid. However, due to its rarity, PAM can be difficult to detect. In Kozhikode, doctors at the Government Medical College Hospital suspected PAM in a five-year-old girl from Malappuram after she showed symptoms resembling bacterial meningitis, which has become less common due to vaccination efforts. T
- here are no standard treatments for PAM, so the doctors are currently following CDC guidelines.
- The State Health Department has obtained miltefosine, a broad-spectrum antimicrobial drug, from Germany to treat infected individuals.
- Pediatricians note that other recommended medications, such as Azithromycin and Amphotericin B, are available
4. Way Forward
Holding the nose or wearing a nose clip while jumping or diving into fresh water are some of the steps suggested to avoid the infection. The head should be kept high while entering warm water. Steer clear from digging in shallow waters, say experts. Distilled or boiled water should be used for clearing nasal passages
Source: The Hindu
