A dangerous illness

There is rising concern about the increased incidence of cases of illness usually leading to death caused by the Naegleria Fowleri (NF) amoeba. This is a protozoic that lives in fresh water and if it gets into the human body, usually via contaminated drinking water, it attacks the nervous system and quickly causes paralysis and death. The survival rate globally is about one per cent, which makes it considerably more deadly in terms of mortality rates than the Ebola virus currently rampaging across the countries of West Africa. The amoeba lives in poorly chlorinated potable water and therein lies the source of current concerns. It is often wrongly diagnosed as meningitis in its early stages and by the time it can be diagnosed it is usually too late for the patient, and many diagnoses are made post-mortem. It has a relatively low incidence in Pakistan with the majority of reported cases being from Karachi.

Ten people have died in Karachi since May 2014. There are a handful of cases nationally most years but now a spike has appeared, and it is difficult not to associate this with deficiencies in the chlorination of potable water in the city. There were 3,141 water samples taken in different parts of the city of which 561 were shown to be chlorine-deficient, or around 16 per cent of the total, a worryingly high figure. Chlorine is the globally used deterrent for NF. Some 30 per cent of the water in the city is inadequately chlorinated. It is true as pointed out by a chief chemist of the Karachi Water and Sewerage Board, that too much chlorine in the water is itself harmful, but this fails to address the point. The potable water system in the city is ancient, badly maintained and underfunded. Contamination with sewage is not unknown. Until the matter is resolved the residents of Karachi need to ensure that their drinking water is from a clean source and preferably boiled for a minimum of one minute. Prevention is better than cure — especially when there is no cure.

Published in The Express Tribune, September 22^nd, 2014.

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