By NewsDesk  @infectiousdiseasenews

Pakistan has been a hotspot for infections with the “brain-eating amoeba”, Naegleria fowleri in recent years and now officials are reporting two more cases/deaths in the city of Karachi.

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Health officials report two cases in two months–One patient died in mid-May and the other in the first week of June.

It is reported they both, individuals under the age of 40, contracted the lethal parasite by ablution.

Naegleria fowleri is a microscopic amoeba which is a single-celled living organism. It can cause a rare and devastating infection of the brain called primary amebic meningoencephalitis (PAM). The amoeba is commonly found in warm freshwater such as lakes, rivers, ponds and canals.

Infections can happen when contaminated water enters the body through the nose. Once the amoeba enters the nose, it travels to the brain where it causes PAM (which destroys brain tissue) and is usually fatal. Infections usually occur when it is hot for prolonged periods of time, which results in higher water temperatures and lower water levels.

Naegleria fowleri infections are rare. Most  infections occur from exposure to contaminated recreational water. Cases due to the use of neti pots and the practice of ablution have been documented.

The practice of ablution is included in Yogic, Ayurvedic, and Islamic traditions. Within the Islamic faith, ritual nasal rinsing is included in a cleansing process called “wudu” or “ablution.” It is usually performed several times a day in preparation for prayer, according to the Centers for Disease Control and Prevention.

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You cannot be infected with Naegleria fowleri by drinking contaminated water and the amoeba is not found in salt water.

Initial symptoms of PAM usually start within 1 to 7 days after infection. The initial symptoms may include headache, fever, nausea, or vomiting. Other symptoms can include stiff neck, confusion, loss of balance, seizures, and hallucinations. After the start of symptoms, the disease progresses rapidly.