Kerala reports 19 deaths from brain-eating amoeba Naegleria fowleri in 2025. Know how PAM infection spreads, its symptoms, treatment, and safety tips.
Thiruvananthapuram:
Kerala is battling a public health emergency after 19 people died from Primary Amoebic Meningoencephalitis (PAM) this year, a rare but deadly brain infection caused by the so-called “brain-eating amoeba” Naegleria fowleri.
The state has recorded 61 confirmed cases in 2025, with patients ranging in age from a three-month-old infant to a 91-year-old. Health officials say the infection is appearing sporadically across districts, complicating tracing and prevention efforts.
What Is PAM?
PAM is a rare brain infection caused by Naegleria fowleri, an amoeba found in warm, stagnant freshwater sources such as ponds, lakes, and poorly maintained water tanks. The amoeba enters the body through the nose when contaminated water is inhaled during swimming, diving, or bathing.
Doctors stress that drinking contaminated water does not cause infection. Once inside, the amoeba travels via the nasal passages to the brain, destroying brain tissue and causing rapid swelling.
Symptoms and Risks
The disease is difficult to diagnose because its symptoms mimic bacterial meningitis. Common early signs include:
- Severe headache
- Fever
- Nausea and vomiting
- Stiff neck and confusion
Symptoms typically appear within 1–9 days of exposure, and the disease can progress fatally within days.
Why Kerala Is Vulnerable
State Health Minister Veena George said climate change may be exacerbating the problem. Rising water temperatures and an increase in recreational water use create ideal conditions for the amoeba to thrive.
Unlike previous years, infections are no longer confined to clusters linked to a single water source but are emerging as isolated cases across multiple districts, making containment harder.
Treatment Challenges
PAM has a very high mortality rate. Worldwide, very few patients have survived since the disease was first identified. Survival is linked to early diagnosis and rapid treatment with an aggressive antimicrobial drug cocktail that can cross the blood-brain barrier.
Kerala health officials are urging immediate medical attention for anyone showing meningitis-like symptoms after swimming or bathing in freshwater.
Safety Measures for the Public
The Kerala government has issued guidelines to reduce risks:
- Avoid swimming or bathing in stagnant freshwater bodies.
- Use nose clips when entering lakes, ponds, or rivers.
- Ensure proper chlorination of wells and water tanks.
- Maintain clean household water storage systems.
The state, in collaboration with the National Centre for Disease Control (NCDC), has begun environmental sampling to identify contaminated water bodies.
The Bigger Picture
Kerala reported its first PAM case in 2016. Until 2023, there were only eight confirmed cases. But numbers have surged: 36 cases and 9 deaths in 2024, and now 61 cases with 19 deaths in 2025, showing a sharp upward trend.
Health authorities warn that with rising global temperatures, the risk of Naegleria fowleri infections could grow in other parts of India as well.
