Brain-eating amoeba claims year’s fifth life in city

The dreaded Naegleria fowleri has claimed this year’s fifth life in Karachi, as health authorities announced on Wednesday that a 14-year-old student died due to meningitis caused by the freshwater amoeba that infects the brain and results in death in most of the cases.

Naegleria fowleri is a freshwater microscopic organism that is found in rivers, streams and freshwater lakes, and through the water supply network it can form colonies in overhead and underground water tanks in cities, said experts, adding that it causes a rare and devastating infection of the brain called Primary Amoebic Meningoencephalitis (PAM).

“Fourteen-year-old Nouman Meer, a resident of Madina Arcade in North Nazimabad No 1, was brought to the Liaquat National Hospital on July 7 with complaints of severe headache, vomiting, restlessness and fits. During investigation it was confirmed that the teenager was infected with Naegleria fowleri,” said Dr Zafar Mehdi, focal person for the Sindh Health Department’s Naegleria fowleri monitoring committee.

The teenager died on Tuesday afternoon due to multiple organ failures despite the fact that he was provided with artificial support, said Dr Mehdi, adding that he was the fifth victim of the brain-eating bug in the city this year.

Naegleria fowleri has become a serious cause of concern for health experts in the metropolis, as almost all the patients infected with the microorganism have died despite receiving the best available treatment and after all the available antibiotics failed to cure them.

“Naegleria fowleri causes an incurable disease, and the only prevention is chlorination of water and regular cleaning of underground and overhead water tanks,” said Dr Mehdi, adding that fortunately, the deadly microorganism infects very few people despite being present in the water in abundance.

Experts believe that Naegleria fowleri has now taken shelter and formed colonies in the sludge settled in the underground and overhead tanks at houses and in buildings across the city, as these tanks are seldom cleaned and chlorinated.

They said that in the presence of suitable temperature and environmental conditions, Naegleria fowleri becomes active and targets people with weak immunity, causing their deaths.

Dr Mehdi said the health department had formed a two-member team of experts to investigate the recent case, and they found that the teenager had neither bathed in a swimming pool in the past 30 days nor travelled outside the city, adding that he had not taken a bath at any place outside his house as well.

“According to his family, he regularly went for his Juma prayers to a nearby mosque. At home they use pipeline water for bathing. He first reported his symptoms after offering the prayer at the Ghousia Majid in his locality.”

Quoting experts of the Regional Disease Surveillance & Response Unit, Field Epidemiology & Laboratory Training Programme, Dr Mehdi stressed an urgent need to assess the process of chlorination and the level of chlorine in water at all the major water reservoirs supplying the commodity and also at consumers’ end. Cleanliness must be maintained at all reservoirs, pumping stations and hydrants, he added.

“Pipelines must be checked for leakages and rectified at the earliest to avoid contamination by sewage. The chlorination level should be achieved as per the World Health Organisation’s recommendations so that the water may be made fit for human use by destroying the deadly amoeba and other microorganisms.”

Health officials have said households should be sensitised to treat their tanks with bleaching powder on a regular basis by themselves, while capacity building of health care workers in terms of early identification and case management should also be carried out.

“The health department should issue notifications to all public and private hospitals directing them to notify suspected and confirmed cases to the department immediately,” said Dr Mehdi, adding that print and electronic media may be involved for public awareness on a regular basis.

“Water tankers’ contractors should be directed to maintain the chlorine level in their water, whatever the status of chlorine in their source water, either they are taking water from the water board’s hydrants or the subsoil water wells.”