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Health authorities in Karachi, Pakistan have reported the fourth case and death of primary amebic meningoencephalitis (PAM) caused by the free living amoeba, Naegleria fowleri this year, and the fifth case reported in Sindh province, according to a Geo News report.

brain eating amoeba
Naegleria fowleri

The case, a 21-year-old male, died Thursday from the parasite believed to be contracted while swimming in a pool. Poor chlorination is suggested.

Pakistan: 1st Naegleria fowleri case reported in Lahore this year


Health officials in Kerala state report the death of a 15-year-old boy, a native of Panavally in Cherthala taluk, according to a The Hindu report.

It is not clear how the boy contracted the deadly amoeba; however, it is reported that he also had leptospirosis.

Prior to this case, Kerala has seen a total of five PAM cases since 2016.

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.

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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.

Third Naegleria fowleri death reported in a week in Karachi, Pakistan