Amoebic meningoencephalitis confirmed in two children in Kerala

Amoebic meningoencephalitis cases are spiking again in the State, with cases scattered across districts and all groups. A total of 113 cases have been reported in the State so far this year (as on Monday), of whom 25 persons have died.

Amoebic meningoencephalitis was confirmed in two children and an elderly person, all of whom were admitted at Government Medical College Hospital, Kozhikode, on Sunday. A 48-year-old woman from Kollam who was confirmed to be having the disease died on Saturday.

Health officials confirmed that 40 persons are undergoing treatment for amoebic meningoencephalitis in public and private hospitals across the State.

Treatment protocol

Patients are being treated with a cocktail of drugs, as specified in the treatment protocol developed by the State, as soon as the presence of amoeba shows up on wet microscopy. As early initiation of treatment is crucial, authorities are not waiting for confirmation through molecular diagnosis.

Officials said that while epidemiological investigations were on, the source of infection remains unclear in many cases, especially the ones due to Acanthamoeba, which has an incubation period ranging from days to almost a year. While Naegleria fowleri has a shorter incubation period and almost always has a clear link to recent exposure to waterbodies, in the case of Acanthamoeba, an epidemiological link cannot always be established.

Co-infection

Doctors involved in the clinical treatment of amoebic meningoencephalitis cases say that except for a small subset who develop severe symptoms, most of the patients seem to be having a mild disease. Several cases of co-infection of amoebic infection with bacterial meningitis or tuberculosis are being reported and most of those who did not survive had immunocompromising conditions like cancer or renal issues

While increased detection is primarily responsible for the surge in cases, the Health department is continuously unearthing new learnings. Early detection has been saving lives, authorities say.

Thiruvananthapuram has had the highest number of cases so far at 30, with three deaths, followed by Kozhikode 22 cases (6 deaths), Malappuram 21 cases (7 deaths), and Kollam 17 cases (5 deaths).