With mercury soaring, N fowlericlaims year’s first victim in Sindh

Health department reiterates chlorination of water only

option to prevent infections in urban areas

As the mercury soars across Sindh, the dreaded Naegleria fowleri, informally known as the brain-eating amoeba, has returned to the province to claim its first victim of the year, health officials said on Friday.

An unconscious Aslam Hasan, 23, a resident of Goth Haji Muhammad Ismail Magsi in District Tando Allah Yar, was brought to the Liaquat National Hospital (LNH) in Karachi in the wee hours of Wednesday. He was admitted in the surgical ward's intensive care unit (ICU), but he died within a few hours.

“Analysis of the cerebrospinal fluid extracted from the body of the deceased indicated that he was infected with Naegleria fowleri, an amoeba that infects the central nervous system of the victim,” an infectious disease (ID) specialist at the hospital told The News.

N fowleri is a freshwater amoeba or a microorganism found in lakes and canals. It grows rapidly in high temperatures with abundance of organic matter in the water.

When a person swims or takes a bath in the water containing colonies of N fowleri, which cannot be seen with the naked eye, the organism enters the body through the nasal cavity and damages the brain and the nervous system cells, resulting in death.

“The patient was brought to us in an extremely precarious condition,” said the ID specialist. “He was unconscious with high-grade fever at the time of admission. He was immediately shifted to the ICU, and tests were conducted, but by the time the results were received, he had died at around 9:30am.”

Dozens of people have died in Karachi, other cities of Sindh and even in Hub Tehsil of District Lasbela in Balochistan during the past decade because of the brain-eating amoeba.

Health experts believe that it is the better diagnostic facilities and understanding of the organism that now doctors are able to identify the cause of death after a person swims in freshwater or ingests water through the nasal cavity during ablution.

LNH officials said the deceased was a professional swimmer and used to swim in canals and lakes in his locality and other districts of the province, adding that he had saved many people from drowning in canals.

Quoting the family members of the deceased, they said Hasan's condition had deteriorated a few days ago after he contracted fever, fell unconscious and did not respond to medicines prescribed by the local doctors, on whose advice he was shifted to the LNH.

The LNH administration has apprised the World Health Organisation and the Sindh Health Department of Hasan's death, and ID control experts have warned that with the increase of temperature in Sindh, more N fowleri cases could be reported in the following days.

The health department's Dr Zafar Mehdi said chlorination of water was the only option to prevent N fowleri infections in the urban areas of the province.

“People should take precautionary measures while swimming in lakes and canals, which cannot be chlorinated, but water supplied to cities must be chlorinated by the utility service providers so that the amoeba could be eliminated from potable water.”

Dr Mehdi suggested that people use chlorine available in the market or common bleach to use in the underground and overhead water tanks in their houses, flats and buildings so that chances of N fowleri's growth could be eliminated.

He said the Karachi Water & Sewerage Board should also ensure that chlorine was added to the water at pumping stations and that it remained in the water by the time it reached the consumers, adding that several people had died in Karachi in the recent years due to N fowleri infections because water was supplied to citizens without being chlorinated.’

Naegleria fowleri

* Thermophilic or heat-loving amoeba

* Thrives in warm freshwater bodies

* Poses a threat if it enters the body through the nose

* Initial symptoms: headache, fever, nausea or vomiting

* Later symptoms: stiff neck, confusion or hallucinations, loss of balance, seizures, blurred vision and loss of the sense of taste

* Usually causes death within five days