Kerala on High Alert After Tragic Death of 9-Year-Old Due to Brain-Eating Amoeba

Kerala has been thrust into the spotlight again for an unsettling reason: a rare but deadly infection caused by the so-called “brain-eating amoeba.” Kozhikode district recently reported three back-to-back cases of primary amoebic meningoencephalitis (PAM), a disease so rare that most people may not even have heard of it. Tragically, one of the victims—a nine-year-old girl—has passed away, while a three-month-old infant and another patient continue to battle for their lives.

What exactly is this “brain-eating amoeba”?

PAM is caused by Naegleria fowleri, a free-living amoeba that thrives in warm freshwater, such as lakes, ponds, and even untreated water supplies. It can also be found in soil and dust. Infection occurs when contaminated water—or particles—enter through the nose, giving the amoeba direct access to the brain. It does not spread from person to person, yet it is often devastating—globally, it kills 97% of its victims.

Kerala has seen rising numbers in recent years. Since January, the state has recorded eight confirmed cases and two deaths, including this one in Kozhikode.

No common thread, big questions

According to health officials, these latest cases have emerged from different villages with no single link between them. That makes the outbreak harder to track and prevent. Doctors are particularly puzzled about how a three-month-old baby could have contracted the infection. Theories suggest possible exposure during bathing, but experts note that soil and dust may also serve as carriers—meaning water contact isn’t always necessary.

To complicate things further, scientists now say that PAM isn’t limited to Naegleria fowleri. Another organism, Acanthamoeba, can trigger similar brain infections without requiring water exposure, and it has a much longer incubation period, stretching from days to months.

Kerala’s changing disease landscape

source : A 3D illustration of the brain-eating infectious amoeba Naegleria fowleri.(iStock)

The first Indian case of PAM was reported in 1971, and Kerala saw its first only in 2016. For years, cases were extremely rare. But 2024 was a turning point: the state logged 36 infections and 9 deaths in a span of months, a sudden spike compared to previous years.

Behind this surge are better testing, particularly for acute encephalitis syndrome (AES), and broader factors like climate change and environmental pollution that create more favorable conditions for the amoeba to survive and spread.

A small ray of hope

While PAM is one of the deadliest infections known—with barely a handful of survivors worldwide—Kerala has made unprecedented progress. Thanks to specialized treatment protocols and SOPs introduced last year, the state has managed to reduce the fatality rate from 97% globally to around 25% locally.

In July 2024, a 14-year-old boy in Kozhikode became India’s first ever survivor of PAM, and only the 11th survivor in the world.

What this means for all of us

Cases like these remind us how quickly public health challenges can shift. Rare pathogens that most of us would never worry about are suddenly on the radar—pushed into the limelight by climate shifts, lifestyle changes, and improved screening practices.

For now, health experts advise caution when using untreated or stagnant water sources, especially for children. Avoid letting water enter the nose while swimming or bathing, and stay alert to symptoms of severe headache, fever, nausea, and confusion—early medical attention can be life-saving.

Kerala’s story is more than just tragic headlines. It’s also a lesson in how vigilance, medical preparedness, and timely treatment can make the difference between another grim statistic and a remarkable survival story.

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