Confronting the Fatal Threat of Brain-Eating Amoeba in Kerala

Mon Oct 20 2025 19:11:33 GMT+0300 (Eastern European Summer Time)

In Kerala, India, a resurgence of Naegleria fowleri infections, known as the brain-eating amoeba, is raising urgent public health concerns amidst rising temperatures and contamination of vital water sources.

The state of Kerala faces a troubling health crisis as more than 70 people have contracted infections from Naegleria fowleri, a brain-eating amoeba that thrives in warm freshwater. Despite improving survival rates due to early detection and treatment, the rising cases are pointing to environmental challenges exacerbated by climate change. Authorities are undertaking measures to raise awareness about the risks associated with untreated water sources.

On the eve of Onam, the most joyous festival in India's Kerala state, 45-year-old Sobhana lay shivering in the back of an ambulance, drifting into unconsciousness as her family rushed her to a medical college hospital.

Just days earlier, the Dalit (formerly known as untouchables) woman, who earned her living bottling fruit juices in a village in Malappuram district, had complained of nothing more alarming than dizziness and high blood pressure. Doctors prescribed pills and sent her home. But her condition spiralled with terrifying speed: uneasiness gave way to fever, and on 5 September - the main day of the festival - Sobhana was dead.

The culprit was Naegleria fowleri - commonly known as the brain-eating amoeba. This infection is usually contracted through the nose in freshwater and is so rare that most doctors never encounter a case in their entire careers.

In Kerala this year, more than 70 people have been diagnosed and 19 have died from the brain-eating amoeba. Patients have ranged from a three-month-old to a 92-year-old man. This single-cell organism causes a near-fatal brain infection called primary amoebic meningoencephalitis (PAM), which enters the body through the nose while swimming, rapidly destroying brain tissue.

While Kerala began detecting Naegleria fowleri cases in 2016, the incidence has alarmingly grown—39 cases with a 23% fatality rate last year, and nearly 70 incidents with a 24.5% mortality this year, indicating better case detection. Health experts attribute this rise in numbers to enhanced testing capabilities and timely medical interventions.

The heavy reliance on groundwater and natural water bodies makes Kerala particularly vulnerable, including the troubling trend of contaminated water leading to infections. Public health authorities are implementing widespread initiatives to chlorinate wells and raise community awareness about safe water practices, though challenges remain in executing these measures effectively.

Climate change poses another significant risk, with warmer waters enabling the amoeba's proliferation. As the state grapples with these issues, the lessons learnt in Kerala resonate globally, spotlighting the persistent threat of rare diseases in a changing climate.