Shiwani
Shiwani works as a Senior Sub Editor at India.com, covering entertainment and lifestyle. With a strong background in media, she is a true cinema buff who loves keeping up with the latest in pop cultur ... Read More
Kerala’s health department is on high alert after reporting an alarming rise in Primary Amoebic Meningoencephalitis (PAM), a rare but deadly brain infection caused by Naegleria fowleri, also known as the “brain-eating amoeba.” So far in 2025, the state has logged 61 confirmed cases and 19 deaths, with most fatalities recorded in recent weeks.
Health Minister Veena George admitted the state is battling a serious challenge. “Unlike last year, we are not seeing clusters linked to a single water source. These are single, isolated cases, and this has complicated our epidemiological investigations,” she said. Patients range from infants to the elderly, with cases spread across districts like Kozhikode and Malappuram.
According to a government health note, PAM targets the central nervous system and rapidly destroys brain tissue. “This infection destroys brain tissue, causing severe brain swelling and death in most cases. PAM is rare and usually occurs in otherwise healthy children, teens and young adults,” the report states.
The infection typically occurs when people swim, dive, or bathe in warm, stagnant freshwater. The amoeba enters through the nose and travels to the brain via the olfactory nerves. Importantly, it is not contracted by drinking contaminated water, nor does it spread from person to person.
Experts have also linked climate change to the rising threat. “Climate change raising the water temperature and the heat driving more people to recreational water use is likely to increase the encounters with this pathogen,” the note warns.
One of the biggest challenges with PAM is its late diagnosis. Its symptoms—headache, fever, nausea, and vomiting—mirror bacterial meningitis, making it difficult to detect early. “By the time other more common causes of meningitis are ruled out and the diagnosis of PAM is considered, it is often too late to save the patient from the cerebral edema that quickly develops and causes death,” the report says.
Symptoms can appear between one and nine days after exposure. Once they set in, the disease progresses rapidly, leading to fatal brain swelling. Most patients who reach hospitals already show signs of severe central nervous system involvement.
Globally, only a handful of people have survived PAM in the past 60 years, and those who did were diagnosed early. “This shows that early diagnosis of PAM and timely initiation of an antimicrobial cocktail might be lifesaving,” the report highlights.
Health Minister Veena George has also underlined the importance of vigilance: “Early detection is key.” However, she admitted that the rarity of the infection and difficulty in rapid diagnosis limit the evaluation of effective drug regimens.
Kerala recorded its first PAM case in 2016. Till 2023, the state had just eight cases. But in 2024, the numbers jumped dramatically to 36 cases and nine deaths. In 2025, the figure has nearly doubled, raising red flags across the public health system.
Authorities are now urging people to avoid swimming in untreated freshwater ponds and lakes. Nose clips have been advised for swimmers, and proper chlorination of wells and water tanks has been recommended. The state, with support from the National Centre for Disease Control, is also carrying out environmental sampling to trace possible contaminated water sources.
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