The news coming from Kerala is both alarming and deeply tragic. A mysterious killer, commonly called the “brain-eating amoeba,” has claimed 19 lives this year, pushing health authorities into crisis mode. This deadly infection, scientifically known as Primary Amoebic Meningoencephalitis (PAM), is rare but devastating, with an extremely high fatality rate. Unlike common infections, it doesn’t spread through contact between people. Instead, it hides silently in warm, stagnant freshwater waiting for swimmers, divers, or bathers to unknowingly inhale it through the nose. Once it enters the body, the amoeba travels swiftly to the brain, causing tissue destruction and swelling that almost always proves fatal.
Rising Cases Across Kerala
Kerala is now facing its most severe outbreak of PAM to date. According to the state health department, 61 confirmed cases have been recorded this year, out of which 19 have already resulted in deaths. Patients have ranged from a three-month-old infant to a 91-year-old, proving that no age group is immune. Health Minister Veena George has confirmed that unlike previous years, these cases are no longer confined to clusters within specific districts. Instead, infections are surfacing sporadically across the state, making epidemiological investigations far more complicated. The Kerala government, working in collaboration with the National Centre for Disease Control, has begun environmental sampling to track possible sources of contamination.
The rapid spread also highlights how different this year’s outbreak is compared to the past. Between 2016 and 2023, the state reported just eight confirmed cases. But last year alone saw a sudden spike with 36 cases and nine deaths. Now in 2025, the numbers have nearly doubled again, sparking urgent concerns about how environmental and climate changes are playing a role in this deadly surge.
Understanding Naegleria Fowleri and PAM
The so-called “brain-eating amoeba” is scientifically known as Naegleria fowleri. It is a free-living microscopic organism that thrives in warm freshwater environments like ponds, lakes, rivers, and even poorly maintained swimming pools. Importantly, it is not harmful if swallowed, which is why drinking contaminated water does not cause illness. The danger lies in water entering through the nose. Once the amoeba makes its way into nasal passages, it quickly passes through the cribriform plate and enters the brain. There it begins its lethal assault, destroying brain tissue and causing swelling that results in death within days.
The infection was first identified in 1965 in Australia, where four children died at Adelaide Children’s Hospital. Since then, it has been reported worldwide, mostly in areas with warmer climates. Though it was first discovered in Australia, researchers believe its evolutionary origins may lie in the United States. Today, climate change is worsening the threat. Rising global temperatures are warming water bodies, while increasing heatwaves are driving more people to seek relief in ponds and lakes—conditions that give the amoeba an opportunity to spread more widely.
Symptoms, Diagnosis, and Treatment Challenges
One of the greatest challenges in fighting PAM is its similarity to bacterial meningitis. Initial symptoms headache, fever, nausea, and vomiting—are often misdiagnosed. As the infection progresses, patients may develop seizures, hallucinations, confusion, and stiff neck. Symptoms typically appear between one and nine days after exposure, and the disease often proves fatal within two weeks.
By the time PAM is suspected, the infection has usually advanced too far for effective treatment. This explains why the mortality rate is above 95 percent. Treatment options remain limited, with only a handful of global survivors in the last six decades. Those who did survive were diagnosed extremely early and treated aggressively with a cocktail of antimicrobial drugs that could cross the blood-brain barrier.
In Kerala, doctors are stressing the importance of immediate medical attention for individuals who develop neurological symptoms after swimming or bathing in untreated freshwater. Health Minister Veena George has reiterated that “early detection is key,” though she acknowledged how difficult timely diagnosis can be.
Prevention: The Only Real Shield
Given the challenges of diagnosing and treating PAM, prevention remains the best defence. Kerala health authorities have issued clear advisories urging people to avoid swimming or bathing in stagnant and untreated freshwater sources. Those who do enter such water bodies are being advised to wear nose clips, especially children and young adults, who are at higher risk.
At the household level, regular chlorination and cleaning of water tanks, wells, and swimming pools are crucial. Proper maintenance of recreational water facilities can drastically reduce risks. Public awareness campaigns are also being rolled out to ensure both rural and urban populations understand the danger posed by untreated water.
The government’s decision to carry out widespread environmental sampling across districts is a step in the right direction. However, experts stress that without community participation—through vigilance, sanitation, and caution such measures will not be enough.
A Wake-Up Call for the Future
The rise of brain-eating amoeba infections in Kerala is more than just a medical crisis; it is a stark warning for the future. The doubling of cases within a year signals how climate change and shifting environmental conditions are creating new risks. What was once considered an extremely rare disease has now become a recurring threat.
The loss of 19 lives is heartbreaking, but it must serve as a lesson. In an age where pathogens adapt quickly, humans must adapt even faster with robust public health surveillance, stronger awareness campaigns, and strict water safety practices. The tragedy in Kerala is a reminder that unseen dangers can emerge from the most ordinary places a pond, a lake, or even a backyard water tank. With vigilance and preventive action, India can ensure that this silent killer does not claim more lives in the years ahead.