Why in the News?

There have been four cases, including three deaths, of the rare, but fatal brain-eating primary amoebic Meningoencephalitis (PAM) in Kerala in the last two months.

What is Primary Amoebic Meningoencephalitis (PAM)?

• PAM is a rare brain infection caused by Naegleria fowleri, a free-living amoeba found in warm freshwater and soil worldwide.
  • An amoeba is a type of cell or unicellular organism with the ability to alter its shape, primarily by extending and retracting pseudopods.
  • Higher temperatures of up to 115°F (46°C) are conducive to its growth and it can survive for short periods in warm environments.
• The amoeba enters the body through the nose, typically during activities like swimming, and travels to the brain, causing severe damage.
• PAM is also non-communicable.
• Symptoms: Headache, fever, nausea, vomiting, stiff neck, confusion, seizures, hallucinations, and 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.

Diagnosis and Treatment:

• Currently, there are no established effective treatments for PAM.
• Diagnosis involves PCR tests of cerebrospinal fluid, though detection can be challenging due to the rarity of PAM.
• Treatment follows CDC guidelines, including miltefosine, Azithromycin, and Amphotericin B, with miltefosine recently procured by the State Health Department from Germany.
  • Medical interventions typically involve a combination of drugs, including amphotericin B, azithromycin, fluconazole, rifampin, miltefosine, and dexamethasone.

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