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September 14, 2019

Brain-eating bug claims 13th life in Karachi

Karachi

September 14, 2019

The brain-eating bug or Naegleria fowleri claimed another life in Karachi after a young man died due to parasitic meningitis infection and its complications at Jinnah Postgraduate Medical Centre (JPMC) on Friday, bringing the death toll to 13 this year, officials said.

“Jamshed Hamid, 20, a resident of Yousuf Goth, Malir, was brought to the JPMC with an altered level of consciousness and symptoms of meningitis on September 11. He was shifted to the Medical ICU on the same day after his condition deteriorated where he expired late on Thursday night. Analysis of his cerebrospinal fluid revealed that he was infected with Naegleria fowleri,” said Dr Seemin Jamali, the executive director of the JPMC.

Experts say the disease caused by Naegleria fowleri is a rare and usually fatal brain infection and exposure to this microorganism occurs during swimming or other water sports as this protozoa is found in freshwater lakes, rivers and hot springs. The amoeba ravels up the nose to the brain, where it causes severe damage.

It is the 13th death due to Naegleria fowleri infection in Karachi this year. Last month, a 16-year-old boy from the Mahmoodabad area of the city had died due to Primary Amoebic Meningoencephalitis (PAM), a rare disease caused by the brain-eating bug.

Dr Munir Afzal, a neurologist at the Neurology Department of the JPMC, said the patient, Jamshed Hamid, was brought to their ward in an extremely serious condition from the Yousuf Goth area of the city in semiconscious condition with a high-grade fever and headache, adding that they immediately started the treatment as per standard protocols and shifted the patient to the Medical ICU after his condition deteriorated.

He maintained that fluid from the spinal cord of the patient was sent for an analysis after they suspected Naegleria fowleri infection. He added that the lab report confirmed that the patient was infected with deadly amoeba, who died during treatment at the hospital.

Director General Health Sindh Dr Masood Solangi said their teams of experts had started investigating the case and visited the residence of the deceased to interview his family, who informed him that Hamid had gone to a local pool for swimming. He said the swimming pool without having any chlorination could have been a place where he contracted the deadly brain infection.

“For the last many months and years, our teams of experts have been recommending that there is an urgent need to assess the process of chlorination and the level of chlorine in water at all the major reservoirs supplying water as per WHO recommendations,” Dr Solangi said, adding that cleanliness must be maintained at all reservoirs, overhead tanks and other reservoirs of households, pumping stations and hydrants at regular intervals.

He maintained that water lines must be checked for leakages and rectified at the earliest to avoid contamination with sewerage water while there was an urgent need for sensitising people to treat their tanks with bleaching powder on a regular basis.

The capacity-building of local healthcare workers in terms of surveillance, early identification and case management were also required, he admitted.

“We are planning to involve print and electronic media for public awareness on a regular basis. On the other hand, authorities should direct water tankers’ contractors to maintain chlorine level in their tankers’ water, whatever the status of chlorine in source water, whether they are taking water from water board hydrants, subsoil water wells or borings,” he said, adding that the water source of mosques should also be treated with bleaching powder on a regular basis.

N fowleri colonies

A team of local researchers have claimed that colonies of Naegleria fowleri have settled in the mud and sludge accumulated in the overhead and underground tanks of the homes, apartment buildings and mosques and whenever they found favourable temperatures, they start moving in the water and cause infection of the brain when people ingests water through nostrils.

“Due to lack of chlorination of water by the authorities, Naegleria fowleri colonies have now settled in the mud and sludge of overhead and underground water tanks in the city. Simple chlorination is not enough to disinfect the water in these tanks until and unless they are cleaned regularly and then chlorinated,” says a research paper on the presence of Naegleria fowleri in Karachi.

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