Kerala brain-eating amoeba scare: 21 dead, 80 infected - why stagnant freshwater pose fatal risk

Brain eating amoeba

Kerala has confirmed 80 cases of Primary Amoebic Meningoencephalitis (PAM), with 21 deaths, according to state health minister Veena George. The rare and often fatal brain infection is caused by Naegleria fowleri, commonly called the “brain-eating amoeba.”

Speaking in New Delhi, the minister said Kerala began detecting more cases after it made reporting of all encephalitis cases mandatory from 2023.

“The reason we are seeing primary amoebic meningoencephalitis cases in Kerala is because, from 2023 onwards, we made it mandatory to report every encephalitis case and to find its cause,” George told reporters.

What is Naegleria fowleri?

The parasite thrives in warm, stagnant freshwater such as ponds, lakes, rivers and untreated swimming pools. Unlike many pathogens, it does not cause illness if swallowed. Instead, infection occurs when contaminated water enters the nose during activities such as diving, swimming, or nasal rinsing with non-sterile water, reported TOI.

From there, the amoeba travels through the olfactory nerves, crosses into the brain and begins destroying tissue. This triggers inflammation and rapid neurological decline, often proving fatal within days.

Rapid and deadly infection



Symptoms typically appear within one to nine days after exposure. The early stages resemble common infections, with headache, fever, nausea and vomiting often leading to misdiagnosis as bacterial meningitis.

As the infection progresses, it causes swelling of the brain, bleeding, seizures, confusion and eventually coma. Global survival rates are below 5 per cent, according to TOI. Even among rare survivors, long-term neurological damage such as memory loss and weakness may persist.

Kerala steps up testing and treatment

Minister Veena George underlined that early detection remains the only real defence. Kerala has expanded microbiology labs capable of carrying out PCR tests, which can directly confirm the presence of Naegleria fowleri.

“Early detection is crucial in saving lives. We now conduct PCR tests that can directly identify the presence of Naegleria amoebas. That is how we have been able to confirm infections,” she explained.

The state has also issued technical guidelines for identifying and treating PAM, first rolled out in 2024. Guidelines instruct doctors to immediately perform cerebrospinal fluid (CSF) tests for suspected cases and begin aggressive treatment using a combination of antimicrobials and supportive care to reduce brain swelling.

Asianet News reported that Kerala’s surveillance and rapid-response systems have been reinforced to deal with the spread of the disease.

A health challenge under watch



While the rising numbers in Kerala partly reflect stricter surveillance and reporting, health experts caution that the risk remains real. State authorities have signalled they will continue strengthening lab networks and community awareness to prevent further deaths.

With global survival rates alarmingly low, Kerala’s fight against the “brain-eating amoeba” will likely depend on a mix of awareness, early testing and immediate treatment protocols - measures the state is now urgently scaling up.