A recent incident in Kerala’s Alappuzha district has highlighted the danger of a rare infection caused by Naegleria fowleri, commonly known as the “brain-eating amoeba.” A 15-year-old boy lost his life after contracting the infection, which is primarily associated with warm freshwater environments.
Understanding Naegleria Fowleri:
- Habitat and Infection: Naegleria fowleri is a species of amoeba that can infect humans. It is commonly found in warm freshwater bodies such as hot springs, rivers, and lakes. The amoeba enters the human body through the nose and migrates to the brain, causing a dangerous infection known as Primary Amebic Meningoencephalitis (PAM). This infection destroys brain tissues and has a high mortality rate.
- Risk Factors and Seasonal Variations: The amoeba thrives in natural environments, particularly in warm water habitats. It does not survive in saline conditions, and hence, it is not found in seawater. During hot summer months when water temperatures are higher, the risk of infection from Naegleria fowleri in warm freshwater bodies increases. Activities such as swimming, diving, or even dipping the head in freshwater bodies can lead to infection.
Infection and Treatment:
- Mode of Infection: Naegleria fowleri enters the human body through the nose and then migrates to the brain. It is commonly contracted during activities that involve contact with contaminated water. Cleaning the nostrils with contaminated water has also been identified as a potential route of infection. However, there is no evidence to suggest that the amoeba spreads through water vapor or aerosol droplets.
- Treatment Options: Treatment for PAM caused by Naegleria fowleri is challenging, and early diagnosis is crucial. The US-based Centers for Disease Control (CDC) recommends a combination of drugs for treatment, including amphotericin B, azithromycin, fluconazole, rifampin, miltefosine, and dexamethasone. Miltefosine, the newest addition to these drugs, has shown promising results in killing Naegleria fowleri in laboratory tests and has been used successfully in treating a small number of survivors.
Preventive Measures:
- Limiting Activities in Warm Freshwater Bodies: To minimize the risk of infection, it is advisable to limit activities in warm freshwater bodies, including lakes, hot springs, and ponds, unless they are disinfected with chlorine.
- Nose Protection and Hygiene Practices: When engaging in swimming or diving activities in freshwater, using nose protection, such as nose clips, can help prevent the entry of Naegleria fowleri. Maintaining clean swimming pools and following proper hygiene, including thorough handwashing with soap and water before and after water activities, as well as before eating, is essential.
- Nasal Cleaning: It is recommended to use sterile water for nasal cleaning to avoid the introduction of contaminated water into the nasal passages.
