The state of Kerala is currently grappling with a concerning increase in amoebic meningoencephalitis cases, a rare and often fatal brain infection. In just the past two days, additional cases, including one tragic death, have been reported, bringing the year’s total to an alarming 129 cases and 26 fatalities.
As of Saturday morning, October 18, 2025, medical facilities across Kerala are actively treating 53 individuals for amoebic meningoencephalitis, highlighting the ongoing severity of the situation.
Thiruvananthapuram district has emerged as a hotspot, accounting for 36 cases and three deaths. A single day last Thursday saw five new cases from areas including Aanad, Mangalapuram, Pangappara, Rajaji Nagar, and Thonnakkal, contributing significantly to public apprehension.
The upward trend continued on Friday with two more cases confirmed: one again in Thiruvananthapuram and another in Kozhikode.
Explaining the diverse routes of infection, a senior health official detailed two recent cases. The patient in Kozhikode had a history of swimming in a resort pool. In contrast, a headload worker from Thiruvananthapuram, who presented with seizures but no fever, was diagnosed after amoeba was discovered in his cerebrospinal fluid during neurological tests. Although he hadn’t entered large water bodies, he recalled occasionally stepping into a stream to wash his hands and feet, and reportedly had a foot wound. Officials believe that Acanthamoeba, one of the causative amoebae, can enter the bloodstream through skin abrasions.
This observation reinforces the understanding that in numerous recent infections, Acanthamoeba likely gained entry via skin wounds, particularly when individuals had contact with various natural water sources like streams.
While epidemiological investigations are ongoing for all cases, pinpointing the exact source of infection can be challenging, especially with Acanthamoeba. This specific amoeba has an incubation period that can stretch from a few days to nearly a year, making direct links to exposure difficult to establish.
Unlike Naegleria fowleri, which typically has a shorter incubation period and a more direct connection to recent water exposure, establishing a clear epidemiological link is often not straightforward for Acanthamoeba infections.
Interestingly, many patients initially present with only mild symptoms, such as headache or vision problems, and sometimes even without fever. “Except for a small subset who develop serious neurological symptoms, most cases are discovered incidentally when individuals seek treatment for other neurological issues like seizures,” the official added, emphasizing the subtle onset of the disease in many instances.
A clinician at Government Medical College, Thiruvananthapuram, highlighted the critical role of prompt diagnosis: “Early detection and rapid treatment have proven life-saving for many, though the prognosis remains challenging for immunocompromised individuals.” They also noted that an aggressive testing strategy is leading to more identified cases, a trend also seen in West Bengal, which is commendable for public health but can sometimes be misconstrued.
Public Anxiety Leads to Exodus from Swimming Pools
Despite official reassurances about the safety of chlorinated swimming pools, the recent surge in amoebic meningoencephalitis cases has understandably caused significant public panic. Many regular swimmers in Thiruvananthapuram, who rely on pools for their daily exercise, are now opting for alternatives like walking, choosing caution over their usual routine.
In response to the growing concerns, the Health Department has reissued strict guidelines for swimming pool operators. These directives mandate specific chlorine levels to be maintained consistently and require daily logs of chlorine measurements to be kept for public scrutiny.
A coordinator at Jimmy George Sports Hub in Thiruvananthapuram commented on the impact: “Our pool strictly adheres to government chlorination standards, with levels recorded and displayed for all users. The water is visibly clean. Yet, we’ve seen a sharp drop in attendance. People are simply too scared and aren’t willing to take any risks.” This highlights the deep-seated anxiety gripping the community.