The brain-eating amoeba has returned to Sindh province, Pakistan with a vengeance since the first case, an 18 year old woman, died from the parasitic disease in late April.

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

According to Dunya News today, with the additional reports of two more fatalities, the case/death tally in the hard hit province now stands at seven.

Earlier this month, the the Sindh Health Department constituted a six member committee to focus on preventive measures against the disease. Examination of water samples in Karachi to date show that chlorination levels are dismal.

Fifty-five percent of the 38 samples collected to date show no detectable levels of chlorine.

In 2014, 14 Naegleria fowleri related deaths were reported in the province.

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 whencontaminated 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 ofbalance, 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 freshwatersuch as lakes, rivers, or hot springs.
• Avoid digging in or stirring up the sediment while taking part in water-related activities in shallow, warm fresh water areas.