Kerala Health Minister Veena George recently addressed the State Assembly, highlighting a concerning potential correlation: increased pollution in the state’s water bodies and rising ambient temperatures might be contributing to a higher concentration of amoebae, subsequently leading to a surge in amoebic meningoencephalitis cases.
In her detailed written response to queries regarding amoebic meningoencephalitis, Ms. George confirmed that amoeba presence has been detected in numerous water samples. These samples were collected from various sources—including household wells, storage tanks, piped water supplies, public wells, ponds, and even swimming pools—all of which had been utilized by individuals diagnosed with the infection.
Through PCR testing, several amoebic species were identified: Balamuthia mandrillaris, Vermamoeba vermiformis, Paravahikampfika Francinae, and Acanthamoeba. Notably, five PCR-confirmed cases were attributed to Naegleria fowleri, often referred to as the ‘brain-eating amoeba,’ while over 20 cases involved Acanthamoeba as the causative agent.
She further stated that comprehensive epidemiological investigations are actively underway for every reported case of amoebic encephalitis.
These free-living amoebae are naturally found in all water bodies, particularly thriving in contaminated or stagnant pools. When water temperatures increase, these amoebae multiply more rapidly. Individuals who enter these water bodies face a risk of infection if the contaminated water enters their nasal passages.
Ms. George explained that Granulomatous Amoebic Encephalitis, caused by ubiquitous free-living amoebae like Acanthamoeba, can also infect the body through skin wounds or the respiratory tract, eventually reaching the brain and causing severe infection.
Proactive Measures and Action Plan
To combat this growing health concern, the Health Department has developed a robust action plan, based on the ‘One Health’ principle. This plan aims to raise public awareness about amoebic meningoencephalitis and mandates the involvement of all local bodies and other government departments in a concerted effort to clean and maintain the state’s water resources.
A widespread campaign involving mass chlorination of wells has been launched across the state. Additionally, stringent guidelines have been issued for the regular chlorination of swimming pools in hotels, resorts, clubs, and apartment complexes, specifying the required chlorine levels to ensure water safety.
Furthermore, the Health Department has initiated several critical research studies in collaboration with Government Medical Colleges throughout Kerala to deepen understanding of amoebic meningoencephalitis.
Ongoing Research and Collaborative Studies
One such collaborative study, titled ‘Microbiological profile of meningoencephalitis due to pathogenic free-living Amoebae: A case series,’ is being conducted jointly by medical colleges in Thiruvananthapuram and Kozhikode. The Kozhikode medical college has also undertaken a separate study to analyze the clinical and laboratory profiles of infected individuals. Another significant research project by Kozhikode medical college researchers focuses on ‘Integrating epidemiological profile and environmental surveillance with genomic sequencing to study the amoebic meningoencephalitis cases reporting to a tertiary care centre.’
Ms. George also mentioned that the Institute of Advanced Virology and ICMR are actively engaged in genomic sequencing studies for all molecularly confirmed cases of amoebic meningoencephalitis, further contributing to the scientific understanding of the disease.