Kerala Health dept. denies delay in diagnosing and treating amoebic meningoencephalitis

The Health department has brushed aside speculations that there is inordinate delay in diagnosing amoebic meningoencephalitis in the State as samples are being sent to the State Public Health Lab.

In a statement here on Wednesday, the Health department said that the microbiology lab at the Kozhikode Medical College Hospital had the facility to check cerebrospinal fluid samples and make the presumptive diagnosis that it was a trophozoite causing the encephalitis and treatment is initiated as soon as this happens.

The samples are sent to the State Public Health Lab only for confirmatory diagnosis and for identifying the amoeba species responsible for the infection and in no way it delays treatment initiation, it said.

However, when testing for the presence of amoeba in water samples, often repeat tests and culture tests have to be done, which could take time.

Only 5 labs in country

Only five laboratories in the country have the facilities for molecular diagnosis (PCR) of amoebic encephalitis and most of these labs have only facilities to identify three amoeba species that cause infections in humans.

Since June, the State Public Health Laboratory has had molecular diagnostic facilities to identify five common species of free living amoeba which are toxic to humans and which can cause amoebic meningoencephalitis. Hence the State no longer depends on diagnostic facilities outside the State, such as PGI Chandigarh, for confirmatory diagnosis of amoebic meningoencephalitis.

Only 6 pathogenic

Though there are over 400 species of free living amoeba in the environment, only six have been documented to be pathogenic to humans. The State PH lab is the only lab which has the ability to identify five of these toxic organisms—Naegleria fowleri, Acanthamoeba spp., Vermamoeba vermiformis, Balamuthia mandrillaris and Paravahlkampfia francinae. The State has already initiated steps to develop confirmatory molecular diagnostic facilities for amoebic encephalitis in the Kozhikode lab also, the statement said.

After amoebic meningoencephalitis cases began to be reported on a fairly regular basis, the Health department had issued a directive that all acute encephalitis syndrome samples be tested for amoebic encephalitis too. Which was the reason more cases of amoebic encephalitis are being diagnosed and treated in the State, significantly bringing down the mortality rate of the disease.