The Consulate General of Maldives to the State of Kerala in India has cautioned Maldivian nationals residing in Kerala and those visiting the state about the spread of primary amoebic meningoencephalitis (PAM), a rare brain infection. The condition is spread by Naegleria fowleri, commonly known as the “brain-eating amoeba.”

According to health authorities in Kerala, Naegleria fowleri is found in warm freshwater environments such as lakes, ponds, and rivers. In rare cases, it can also inhabit poorly maintained swimming pools.

The United States Centers for Disease Control and Prevention (CDC) describe Naegleria fowleri as a one-celled organism that thrives in warm freshwater, including lakes, rivers, and hot springs. Unfortunately, brain infections caused by this amoeba are nearly always fatal, making them a severe risk to those exposed to contaminated water.

Recent media reports from India highlight four cases of amoebic meningoencephalitis in Kerala since May. All the affected patients are children, with three fatalities. A 14-year-old receiving treatment for the disease passed away recently, following the earlier deaths of a five-year-old in May and a 13-year-old in June.

Naegleria fowleri infections primarily occur when individuals swim in warm freshwater bodies where the amoeba is present. Although rare, infections can also happen when contaminated water enters the nose from other sources.

The amoeba enters the body through the nasal passages, particularly when water is forced into the nose under pressure (such as during diving). Importantly, swallowing contaminated water does not cause infection, and person-to-person transmission of Naegleria fowleri does not occur.

Symptoms of amoebic meningoencephalitis include fever, headache, vomiting, and seizures. Later stages may involve a stiff neck, confusion, loss of attention, balance issues, and hallucinations.