Pakistani news media are reporting an additional case of Naegleria fowleri infection in Karachi. A 34-year old man was infected with the lethal parasite and is struggling for life at a private hospital in the city.
Health officials say this is the 3rd case in Karachi this year and the other two cases were fatal.
“It enters the body through the nose, and it moves on to the brain. Infection typically occurs when people go swimming in lakes and rivers or people put water in the nose while making ablution,” said Dr Zafar Mehdi, focal person for the Sindh health department’s Naegleria fowleri monitoring committee.
According to Dr Zafar Mehdi, seven persons had lost their lives due to the lethal infection caused by the brain-eating bug in the city in 2018 as the Karachi Water and Sewerage Board have been providing non-chlorinated water to the citizens for the last several years. “Chlorination of water kills all the microorganisms, but unfortunately, our water utility is not adding chlorine to the water,” Dr Mehdi said.
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.