After reporting the first Naegleria fowleri, or “brain-eating amoeba” death of 2015 last month in Karachi, Pakistan media reports that two additional deaths due to parasite have been reported in the region.

Naegleria fowleri Life Cycle/CDC
Naegleria fowleri Life Cycle/CDC

According to an Express Tribune report Friday, two adults died from the deadly amoeba during the past two weeks– A 37-year-old male patient died at a private hospital located in Clifton on Thursday and a 40-year-old woman, a resident of Clifton,  died of the disease about two weeks ago as well.

The hospitals have confirmed the deaths; however, the provincial health department seemed unaware of the fatalities at first.

It is not clear how the two victims contracted the amoeba.

This relatively rare, pathogenic amoeba is found in warm or hot freshwater like lakes, rivers and hot springs. It is also possible to get it from dirty unchlorinated or under-chlorinated swimming pools. This parasite is found worldwide.

Naegleria fowleri  is a single celled, free-living amoeba. It is also called the “brain-eating amoeba”.

People typically contract this parasite when contaminated water rushes up the nose when jumping into the water. Once the amoeba enters the nose, it travels to the brain where it causes Primary Amoebic Meningoencephalitis (PAM). From here it destroys brain tissue with a fatality rate of well over 99 percent.

According to the Centers for Disease Control and Prevention (CDC), initial symptoms of PAM start about 5 days (range 1 to 7 days) after infection. The initial symptoms may include headache, fever, nausea, or vomiting. Later symptoms can include stiff neck, confusion, lack of attention to people and surroundings, loss of balance, seizures, and hallucinations. After the start of symptoms, the disease progresses rapidly and usually causes death within about 5 days (range 1 to 12 days).

Treatment for this parasite has been unsatisfactory.

You should always assume there is some risk when swimming in freshwater. The location and number of amoeba present in a body of water varies from time to time. The Centers of Disease Control and Prevention recommends these four steps to reduce your risk of infection:

• Avoid water-related activities in bodies of warm freshwater, hot springs, and thermally-polluted water such as water around power plants.
• Avoid water-related activities in warm freshwater during periods of high water temperature and low water levels.
• Hold the nose shut or use nose clips when taking part in water-related activities in bodies of warm freshwater such as lakes, rivers, or hot springs.
• Avoid digging in or stirring up the sediment while taking part in water-related activities in shallow, warm freshwater areas.