Primary Amoebic Meningoencephalitis (PAM)

Why in News?

Recently, three cases of primary amoebic meningoencephalitis (PAM) have been reported in Kerala, leading to the death of a 9-year-old and infecting a 3-month-old baby.

• PAM is a rare brain infection caused by Naegleria fowleri.
• Naegleria fowleri – It is a free-living amoeba or a single-celled living organism.
• It is also called ‘brain-eating amoeba’.
• It lives in warm, fresh water and soil around the world, and infects people when it enters the body through the nose.
• Higher temperatures of up to 115°F (46°C) are conducive to its growth, and it can survive for short periods in warm environments.
• It can also be found in swimming pools, splash pads, surf parks, or other recreational venues that are poorly maintained or minimally chlorinated.
• Spread - Enters the body through the nose, usually when people are swimming.
• It then travels up to the brain, where it destroys the brain tissue and causes swelling.
• PAM is also non-communicable.
• Symptoms – In Initial stage - Headache, fever, nausea and vomiting.
• In Later stage - The patient may have a stiff neck and experience confusion, seizures, hallucinations and slip into a state of coma.

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.

• Treatment – No treatment available for this disease at present.
• At present, doctors treat it with a combination of drugs, including amphotericin B, azithromycin, fluconazole, rifampin, miltefosine, and dexamethasone.      
• Past incidents of infection - The 1^st case of PAM in India was reported in 1971 and the first case in Kerala was reported in 2016.
• Last year, Kerala had 36 cases and 9 deaths.
• Reason of high incidence in Kerala - One of the reasons for the spike in cases in Kerala has been increased testing for acute encephalitis syndrome (AES).
• Acute Encephalitis Syndrome (AES) is a condition that can be caused by various diseases, including PAM as well as other factors such as climate change and environmental pollution.
• In the new cases, another possibility could be that the PAM was caused by a different category of amoeba, which is found in dust and soil, according to health department officials.

Reference

The Indian Express | primary amoebic meningoencephalitis (PAM)