Officials with the Jinnah Postgraduate Medical Centre (JPMC) in Karachi, Pakistan is reporting the death of a 21-year old student from the Orangi Town area due to the “brain-eating amoeba”, Naegleria fowleri.

Image/Jordan Smelski Foundation Facebook page

The patient presented with a high-grade fever and other complaints. Upon suspicion of meningitis, he was transferred to the hospital ICU and died from primary amoebic meningoencephalitis (PAM) Friday.

Laboratory analysis confirmed the presence of the parasite, Naegleria fowleri in the cerebrospinal fluid.

How the patient contracted the amoeba is not noted in the report.

In 2018, seven fatalities were reported in Karachi.

The Naegleria fowleri interviews

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.

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.