Kerala on alert as brain-eating amoeba claims 23 lives: How the state is battling a rare disease

Kollam and Thiruvananthapuram districts are among the most affected areas, with Kozhikode and Malappuram also reporting a surge in cases. (Image credit: @IndianTechGuide)

Kerala is on high alert after a surge in cases of cases of amoebic encephalitis (brain fever) — popularly called the “brain-eating amoeba.” So far, the state has reported a total of 104 cases of amoebic encephalitis (brain fever), News18 reported.

State health minister Veena George said 23 patients have so far died due to the infection. Kollam and Thiruvananthapuram districts are among the most affected areas, with Kozhikode and Malappuram also reporting a surge in cases.

“Following the Nipah outbreak in Kozhikode in 2023, it was decided and directed that all cases of encephalitis (brain fever) must be mandatorily reported and that the causes behind such cases should be identified. As a result, from 2024 onwards, encephalitis cases began to be officially reported, and some of them were found to be amoebic encephalitis," the minister said in a post on Facebook on Sunday.

“Including the cases reported today, a total of 104 amoebic encephalitis cases have been reported so far, of which 23 patients have died," she added.

As per the report, George also mentioned that the fatality rate for Naegleria fowleri infection is 98 per cent globally, and for Acanthamoeba-related cases, it is above 70 per cent.

Early detection, One Health approach help cut death rate

Early detection and "One Health" approaches have proven effective in significantly lowering the fatality rate of amoebic encephalitis

“Despite such high global mortality rates, Kerala has managed to significantly reduce the death rate by detecting and treating the disease at an early stage," she said.

In 2025, a comprehensive action plan based on the One Health approach was developed and implemented to prevent the spread of amoebic encephalitis by safeguarding human, animal, and environmental health in an integrated way.

“Based on the decisions taken at a joint meeting chaired by the Chief Minister Pinarayi Vijayan, various departments are working together to ensure scientific chlorination and other preventive measures are carried out continuously across the state," she said.

Causes, early signs, and how to stay safe

Amoebic encephalitis, often referred to as brain fever, is a rare but deadly infection caused by free-living amoebae such as Naegleria fowleri, Acanthamoeba, or Balamuthia mandrillaris. These organisms are commonly found in warm freshwater bodies like lakes, ponds, and hot springs. The infection usually begins when contaminated water enters the body through the nose, allowing the amoeba to travel to the brain.

Once it reaches the brain, it causes severe inflammation known as encephalitis, leading to symptoms such as headache, fever, nausea, vomiting, confusion, seizures, and sometimes hallucinations. The disease progresses rapidly, and most cases are fatal despite medical intervention. Early detection is critical, but diagnosis is often delayed because symptoms resemble those of meningitis. Preventive measures include avoiding swimming in warm, stagnant water and using sterile or boiled water for nasal cleansing. Prompt medical attention is vital for any suspected exposure.

Symptoms of brain fever

• High-grade fever with sudden onset
• Severe and persistent headache
• Nausea and vomiting
• Neck stiffness and pain during movement
• Confusion, disorientation, or altered mental state
• Extreme fatigue or drowsiness
• Sensitivity to light (photophobia)
• Blurred or double vision
• Seizures or convulsions
• Loss of coordination and balance
• In advanced stages, coma or death may occur if not treated promptly