What is Naegleria fowleri, brain-eating amoeba, that killed 5-year-old girl
A five-year-old girl from Malappuram district, Kerala, lost her life to a rare brain infection caused by Naegleria fowleri last week. This amoeba is typically found in warm freshwater and moist soil. Despite receiving treatment for over a week at the Kozhikode Medical College's Institute of Maternal and Child Health, the child was unresponsive to medication and eventually succumbed to the infection. Her death has raised the question of what this dangerous infection is. Here, we try to understand it.
Infection traced back to local pond bath
The infection, known as amoebic meningoencephalitis, is caused when free-living, non-parasitic amoebae bacteria enter the body through the nose from contaminated water. According to reports, the girl had bathed in a nearby pond on May 1 and, soon after, started showing symptoms of fever, headache, and vomiting by May 10. Other children who also bathed in the same pond were observed but later discharged after being found free of infection.
What is Naegleria fowleri
Naegleria fowleri, the amoeba responsible for the infection, thrives in heat and is most commonly found in water during the summer. It can also survive in considerably lower temperatures, residing at the bottom of freshwater bodies. The amoeba can grow in hot water heaters, pipes, and water systems, including those treated for public drinking, but has not been found in salt water.
Infection progression and current treatment methods
Naegleria fowleri can cause primary amebic meningoencephalitis (PAM), a rare brain infection that is nearly always fatal as it rapidly destroys brain tissue. Most PAM infections occur when a person gets water in their nose from lakes, rivers, or other untreated freshwater bodies. Public water supplies contaminated with Naegleria fowleri have also been linked to deaths in Australia and Pakistan.
Symptoms of PAM
According to the US Centers for Disease Control and Prevention (CDC), "Most people with PAM die within 1 to 18 days after symptoms begin. It usually leads to coma and death after 5 days." Early symptoms appear within one to nine days of exposure and include a severe headache, fever, nausea, and vomiting. No effective treatments for PAM have been identified yet. Currently, doctors treat it with a combination of drugs, including amphotericin B, azithromycin, fluconazole, rifampin, miltefosine, and dexamethasone.
