Naegleria fowleri: Deadly organism resurfaces after a hiatus of two months

Doctors say that an epidemic is not imminent and there is no need to panic.

KARACHI: After a brief respite for two months, the attention of health officials and doctors has once again turned to the deadly amoeba, naegleria fowleri. The waterborne organism, which causes Primary Amoebic Meiningoencephalitis, has killed three more people over the last week.

Doctors were initially left scratching their heads, unable to glean a pattern in data on the disease and pin it down to a particular factor. But now, there is a growing consensus among them that the life-threatening amoeba is probably breeding in the water supply lines, infecting people when they rinse their noses.

Dr Aslam Pervez, Karachi Metropolitan Corporation’s (KMC) district health officer, has been collecting data on people who were killed by the disease. He said that the only common factor in all cases was that the patients used to pray regularly. He conjectured that the organism may have entered the patients’ bodies when they were performing ablution.

Dr Naseem Salahuddin, the head of Indus Hospital’s infectious diseases department, said, “We need a large number of cases to work out the significance of age, gender and area on the likelihood that someone will be infected. We can’t do this if we only have between 8 and 10 cases.”

She said that the amoeba can only enter the human brain when contaminated water hits the roof of the nose. She said that the organism only lives in water, clearing misconceptions that the disease can be contracted by inhaling dust.

Dr Salahuddin added that based on the number of cases, an epidemic cannot be declared. The amoeba breeds whenever there is a slight increase in the temperature of stagnant water which has not been chlorinated. “It is not a new organism. It has always been in our atmosphere. The only difference is that we are aware of it now and know how to check for its presence in the human body,” she said. “Previously, doctors did not have awareness and used to treat cases of the disease as bacterial meningitis. Now they test the patients for naegleria.”

Another KMC official lamented that the health department does not have any control over the Karachi Water and Sewerage board’s practices.

He said that the KMC wrote its third letter to the water board on Friday, asking it to ensure proper chlorination of water.

The municipal authority has also written to private, public and district hospitals, telling them how to identify patients. They have also been asked to report all cases to the government. According to the official figures, ten people have died because of the organism since July.

Three new cases

A four-year-old boy from Gulberg Town was taken to the Habib Medical Hospital on September 27 died of the disease on September 30. A 24-year-old man, who was being treated for the disease at the Liaquat National Hospital died on October 2. The last person to die of the disease was a 21-year-old resident of FB Area who was taken to Aga Khan Hospital. He was admitted on September 29 and passed away on October 3.

Published in The Express Tribune, October 8^th, 2012.