The infection, known medically as primary amoebic meningoencephalitis (PAM), is caused by Naegleria fowleri, a free-living amoeba found in warm freshwater bodies. It earns its nickname due to its ability to enter the brain through the nose and destroy brain tissue, leading to a fatal infection in over 95% of cases.
Alarmingly, nine of the 19 deaths this year have occurred in September alone, prompting heightened surveillance across the state. While last year’s cases were largely concentrated in specific areas, infections this year have been reported across multiple regions of Kerala, according to Dr. Altaf Ali, a member of the state’s government task force on PAM. “Though the total numbers remain small, the wider geographic spread is a serious concern,” he told AFP.
Despite the increase, Kerala Health Minister Veena George clarified that no cluster outbreaks have been identified this year, unlike in 2024 when several cases were localized.
The amoeba typically infects people when contaminated water enters the nasal passages—often while swimming or bathing in warm lakes, rivers, or poorly maintained pools. The infection does not spread from person to person.
Symptoms begin with headache, fever, and vomiting, and rapidly escalate to seizures, confusion, hallucinations, and coma, according to the World Health Organization (WHO). The U.S. Centers for Disease Control and Prevention (CDC) notes that while infections are extremely rare, they are almost always fatal.
Globally, fewer than 500 cases of PAM have been documented since 1962, with the majority reported in the United States, India, Pakistan, and Australia.