Brain-eating amoeba, scientifically known as Naegleria fowleri, is a microscopic organism found in warm freshwater that can cause a rare and almost universally fatal brain infection called Primary Amoebic Meningoencephalitis (PAM).
Kerala, the picturesque southern state of India often referred to as “God’s Own Country,” is currently grappling with a terrifying public health crisis. A rare and almost universally fatal infection, caused by what is commonly known as the “brain-eating amoeba,” has claimed an alarming number of lives, sending shockwaves across the region and putting health authorities on a war footing. The deadly pathogen, scientifically identified as Naegleria fowleri, has caused multiple deaths and numerous cases of Primary Amoebic Meningoencephalitis (PAM), a severe brain infection with a grim prognosis.
Understanding the Scourge: What is Naegleria Fowleri?
Naegleria fowleri is a microscopic, single-celled living amoeba that thrives in warm, freshwater environments. It is a thermophilic organism, meaning it flourishes in high temperatures, typically between 25°C and 45°C. This makes stagnant or slow-moving freshwater bodies like ponds, lakes, rivers, canals, and even poorly maintained swimming pools and hot springs its ideal habitat. The amoeba can exist in three forms: a dormant cyst, a motile flagellate, and a reproducing trophozoite, the form that is infectious to humans.
The terrifying moniker “brain-eating amoeba” is a direct description of its devastating effect on the human body. The infection, known as Primary Amoebic Meningoencephalitis (PAM), is not contracted by drinking contaminated water. Instead, the amoeba enters the human body through the nose, usually when an individual is swimming, diving, or participating in water sports in infected water sources. Once inside the nasal passages, Naegleria fowleri travels up the olfactory nerve to the brain. There, it multiplies rapidly, causing a severe and destructive inflammation of the brain and its protective membranes. The amoeba literally consumes brain tissue, leading to a rapid and fatal progression of the disease.
While Naegleria fowleri is found worldwide, cases of PAM are rare. However, when they do occur, they are almost always fatal. The high fatality rate, often exceeding 97%, and the rapid progression of the disease make it one of the most feared infections known to medicine. The current outbreak in Kerala, with a concerning number of confirmed cases and deaths, underscores the seriousness of this public health emergency.
The Alarming Spread in Kerala
According to recent reports, Kerala has seen a significant spike in cases of Primary Amoebic Meningoencephalitis in 2025. The state’s health authorities have confirmed a total of 69 cases, leading to 19 deaths this year alone. This is an alarming increase compared to previous years and has prompted the state government to declare a high alert.
What makes this outbreak particularly concerning is the scattered nature of the cases. Unlike previous years, where clusters were linked to specific, contaminated water sources, the current infections appear to be sporadic, occurring across multiple districts. This suggests a more widespread presence of the amoeba in various water bodies throughout the state. The rising temperatures and changes in weather patterns, which create ideal conditions for the amoeba to multiply, are believed to be contributing factors to this surge.
Kerala’s Health Minister, Veena George, has clarified that while there are confirmed cases and deaths, there is no evidence of a cluster outbreak this year, unlike in 2024 when a common water source was identified. However, the minister has emphasized that every case of meningoencephalitis is being investigated for a possible amoebic link, and physicians have been instructed to begin immediate treatment if Naegleria fowleri is suspected. The National Centre for Disease Control (NCDC) is collaborating with the state health department on epidemiological investigations, including environmental sampling and water testing.
The Haunting Symptoms: A Race Against Time
The initial symptoms of PAM can be insidious and often mimic those of more common infections like bacterial meningitis or viral flu. This makes early diagnosis and treatment a formidable challenge. Symptoms typically appear within 1 to 9 days after exposure to the infected water.
The early signs to watch out for include:
- Sudden, severe frontal headache
- High fever
- Nausea and vomiting
- Stiff neck
As the disease progresses and the amoeba destroys brain tissue, the symptoms rapidly escalate. These advanced symptoms can include:
- Confusion or disorientation
- Hallucinations
- Seizures
- Altered mental status
- Inattention or lack of focus
- Loss of consciousness, leading to coma
The progression from initial symptoms to death is often shockingly fast, with a median survival time of just five days. This rapid and aggressive nature of PAM is what makes it so lethal. Once the infection takes hold and the brain is affected, the chances of survival are incredibly low, even with aggressive medical intervention.
The Lifesaving Power of Prevention: A Public Health Imperative
Given the near-zero survival rate of PAM, prevention is not just the best option—it is the only effective defense. The public must be educated on the risks and empowered with the knowledge to protect themselves and their families. The following preventive measures are critical:
- Avoid Stagnant Freshwater: Steer clear of swimming, diving, or engaging in water sports in warm, stagnant freshwater bodies, especially during hot weather. This includes ponds, lakes, and canals.
- Use Nose Clips: If swimming in freshwater is unavoidable, it is crucial to use a nose clip or hold your nose shut to prevent water from entering your nasal passages.
- Ensure Proper Chlorination: For public and private swimming pools, ensure that the water is adequately chlorinated and the facilities are well-maintained. Naegleria fowleri does not survive in properly treated pools or in saltwater.
- Safe Nasal Rinsing: For those who use devices like a neti pot or other nasal rinsing systems, it is absolutely essential to use only sterile, distilled, or previously boiled and cooled tap water. Tap water, even if it appears clean, can contain the amoeba. Boiling the water for at least one minute (three minutes at higher altitudes) is a simple and effective way to sterilize it.
- Community Awareness: Community leaders, health workers, and media outlets play a vital role in disseminating information about the risks. Public awareness campaigns should be intensified to educate people on the signs and symptoms, and the importance of seeking immediate medical attention if they experience symptoms after any freshwater exposure.
- Water Testing and Surveillance: The government must continue to monitor and test community water sources, especially wells and local ponds, to identify and contain potential threats. Chlorination of public water sources should be a priority.
1.What Is a Brain-Eating Amoeba?
Brain-eating amoeba is a species discovered in 1965. Its formal name is Naegleria fowleri. It usually lurks in warm freshwater bodies or untreated, contaminated waters. When it finds its way inside the human body, it causes a rare, yet deadly infection and inflammation in the brain and eventually destroys the brain tissue by “eating” it. Doctors call this disease primary amebic meningoencephalitis (PAM). You can only get it when contaminated water with the brain-eating amoeba travels up your nose.
2. How Long Until Symptoms of a Brain-Eating Amoeba Appear?
It takes two to 15 days for symptoms to appear after N. fowleri amoebas enter the nose. Death usually occurs 3 to 7 days after symptoms appear. The average time to death is 5.3 days from symptom onset. Only a handful of patients worldwide have been reported to have survived an infection.
3. Is There a Rapid Test for Infection With Brain-Eating Amoeba?
There is no rapid test for infection with brain-eating amoeba. But researchers are working to develop one. Until such tests come along, it can take weeks to identify the amoeba.
4. How Deadly Is the Brain-Eating Amoeba?
PAM caused by the brain-eating amoeba is considered a fatal infection. More than 97% of the people infected with N. fowleri die. In the U.S., between 1962 and 2019, only four out of 128 infected people survived.