Kerala is confronting a new health crisis in 2025 due to an increase in infections caused by Naegleria fowleri. This microscopic amoeba, known as the ‘brain-eating amoeba’, causes a deadly brain infection called primary amoebic meningoencephalitis (PAM). The recent surge in cases across Kozhikode, Malappuram and Wayanad has alarmed health authorities and the public alike.
Emergence of Naegleria Fowleri in Kerala
Naegleria fowleri is a free-living amoeba found in warm freshwater bodies such as ponds, wells and rivers. It enters the body through the nose and rapidly destroys brain tissue. Kerala recorded its first death from this infection in 2016. Since then, cases remained rare until 2024 when 29 confirmed infections were reported, mainly in the southern districts. The amoeba’s presence in drinking water sources and ponds has raised concerns about water safety.
Symptoms and Fatality
PAM begins with sudden fever, headache, vomiting and progresses quickly to seizures and coma. The disease is almost always fatal worldwide, with death occurring within days. Kerala’s experience is unusual as aggressive treatment and use of the anti-parasitic drug miltefosine helped save 24 out of 29 patients in 2024. Early diagnosis and immediate treatment are crucial for survival.
Factors Driving the Surge
Several factors contribute to the rise in infections. Climate change has increased temperatures, creating favourable conditions for the amoeba to thrive. Contamination of water bodies with sewage and organic waste has worsened water quality. Traditional practices like bathing, swimming or sniffing untreated water expose people to infection. Unsafe water use in rural areas remains a persistent challenge.
Public Health Response
Kerala’s health system has adapted quickly. The state now has a public laboratory capable of identifying pathogenic amoebae, reducing diagnostic delays. Doctors have been trained to suspect PAM in meningitis cases with freshwater exposure. Aggressive treatment protocols and awareness campaigns are underway. However, the surge strains healthcare infrastructure, including intensive care units.
Broader Implications and Challenges
Naegleria fowleri is spreading beyond typical habitats, found in wells, tanks, soil and dust. This expansion is linked to rising atmospheric temperatures and changing microbial ecologies. Kerala’s healthcare success story faces new threats from emerging pathogens influenced by climate change. Alongside PAM, the state battles outbreaks of Nipah virus, dengue, leptospirosis, and antimicrobial resistance, signalling growing public health vulnerabilities.
Future Outlook
The rise of brain-eating amoeba infections marks the fragile balance between environment, human practices and health. Kerala’s experience shows that even robust healthcare systems can be challenged by evolving pathogens. Continued surveillance, improved water sanitation, public education and climate action are essential to control this and other emerging infections.
Questions for UPSC:
- Point out the impact of climate change on the emergence and spread of infectious diseases in tropical regions with suitable examples.
- Critically analyse the role of water sanitation and hygiene practices in preventing waterborne diseases in rural India.
- Estimate the challenges faced by public health systems in managing emerging zoonotic and microbial infections and suggest strategic interventions.
- Underline the significance of early diagnosis and treatment in controlling fatal infections like primary amoebic meningoencephalitis and discuss Kerala’s healthcare response model.
