On the eve of Onam, the most joyous festival in India's Kerala state, 45-year-old Sobhana lay shivering in the back of an ambulance, drifting into unconsciousness as her family rushed her to a medical college hospital. Just days earlier, the Dalit woman had complained of nothing more alarming than dizziness and high blood pressure. Doctors prescribed pills and sent her home. But her condition spiralled with terrifying speed: uneasiness gave way to fever, fever to violent shivers, and on September 5, Sobhana was dead.
The culprit was Naegleria fowleri - commonly known as the brain-eating amoeba - an infection usually contracted through the nose in freshwater and so rare that most doctors never encounter a case in their entire careers. We were powerless to stop it. We learnt about the disease only after Sobhana's death, says her cousin Ajitha Kathiradath, a prominent social worker.
In Kerala this year, more than 70 people have been diagnosed, and 19 have died from the brain-eating amoeba. Patients have ranged from a three-month-old to a 92-year-old man. Normally feeding on bacteria in warm freshwater, this single-cell organism causes a near-fatal brain infection known as primary amoebic meningoencephalitis (PAM). It enters through the nose during swimming and rapidly destroys brain tissue.
Kerala began detecting cases in 2016, reporting one or two a year until recently, with almost all being fatal. A study has found only 488 cases reported globally since 1962 - mostly in the US, Pakistan, and Australia, with a 95% fatality rate.
However, survival appears to be improving in Kerala: last year, there were 39 cases with a 23% fatality rate, and this year, nearly 70 cases have been reported with a mortality rate of about 24.5%. Improved detection, thanks to state-of-the-art labs, has played a vital role. Cases are rising but deaths are falling. Aggressive testing and early diagnosis have improved survival - a strategy unique to Kerala, explains Aravind Reghukumar, head of infectious diseases at the Medical College and Hospital in Thiruvananthapuram.
With nearly 5.5 million wells and 55,000 ponds, Kerala is particularly vulnerable due to its reliance on groundwater and natural water bodies. Public health authorities have initiated large-scale responses, including chlorinating 2.7 million wells in a single campaign in late August. Local governments are warning against swimming or bathing in certain areas, yet with such an extensive water network, it remains a challenge to manage health risks effectively.
Moreover, scientists warn that climate change amplifies the risk: warmer waters and rising temperatures create ideal conditions for the amoeba to thrive. Kerala's proactive measures, such as public awareness campaigns and early detection strategies, provide a blueprint for confronting this precarious public health issue — one that is complicated further by the unpredictable impacts of climate change.
The culprit was Naegleria fowleri - commonly known as the brain-eating amoeba - an infection usually contracted through the nose in freshwater and so rare that most doctors never encounter a case in their entire careers. We were powerless to stop it. We learnt about the disease only after Sobhana's death, says her cousin Ajitha Kathiradath, a prominent social worker.
In Kerala this year, more than 70 people have been diagnosed, and 19 have died from the brain-eating amoeba. Patients have ranged from a three-month-old to a 92-year-old man. Normally feeding on bacteria in warm freshwater, this single-cell organism causes a near-fatal brain infection known as primary amoebic meningoencephalitis (PAM). It enters through the nose during swimming and rapidly destroys brain tissue.
Kerala began detecting cases in 2016, reporting one or two a year until recently, with almost all being fatal. A study has found only 488 cases reported globally since 1962 - mostly in the US, Pakistan, and Australia, with a 95% fatality rate.
However, survival appears to be improving in Kerala: last year, there were 39 cases with a 23% fatality rate, and this year, nearly 70 cases have been reported with a mortality rate of about 24.5%. Improved detection, thanks to state-of-the-art labs, has played a vital role. Cases are rising but deaths are falling. Aggressive testing and early diagnosis have improved survival - a strategy unique to Kerala, explains Aravind Reghukumar, head of infectious diseases at the Medical College and Hospital in Thiruvananthapuram.
With nearly 5.5 million wells and 55,000 ponds, Kerala is particularly vulnerable due to its reliance on groundwater and natural water bodies. Public health authorities have initiated large-scale responses, including chlorinating 2.7 million wells in a single campaign in late August. Local governments are warning against swimming or bathing in certain areas, yet with such an extensive water network, it remains a challenge to manage health risks effectively.
Moreover, scientists warn that climate change amplifies the risk: warmer waters and rising temperatures create ideal conditions for the amoeba to thrive. Kerala's proactive measures, such as public awareness campaigns and early detection strategies, provide a blueprint for confronting this precarious public health issue — one that is complicated further by the unpredictable impacts of climate change.
