NewsDesk @bactiman63

Officials with the Sindh Health Department are reporting the first death due to primary amoebic meningoencephalitis (PAM) caused by Naegleria fowleri in 2022, according to a report in The News.

Naegleria (cropped)/CDC

The patient was a 59-year-old man from Kemari.

The health authorities said that since 2011, around 90 people died due to PAM caused by Naegerlia fowleri in Karachi. They added that overhead and underground water tanks in the city had become reservoirs for the microscopic organism causing the deadly disease.

Naegleria fowleri can be killed by chlorinating water but the Karachi Water and Sewerage Board has failed to properly chlorinate water before supplying it to houses. “Samples analyzed from all city areas confirmed fecal contamination of water being supplied by the KWSB. No trace of chlorine was found in the water samples tested by us,” an official of the health department said.

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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.