Rare infections surge across Kerala as doctors improve detection but climate change fuels risks
Kerala, India’s southern state famed for its rivers and wells, is grappling with a sudden outbreak of the brain eating amoeba, sparking a Kerala health alert. This rare but deadly water-borne infection has triggered swift action from health authorities, who are working to contain the spread while balancing public awareness with the risk of widespread fear.
Rising Infections and Fatalities: Brain Eating Amoeba Threat
Since January 2025, Kerala has recorded 69 cases of primary amoebic meningoencephalitis (PAM) caused by Naegleria fowleri, including 19 deaths. Victims have ranged from a three-month-old baby to a 92-year-old man. Last year, the state saw 36 cases and nine deaths, marking a sharp increase. While infections remain rare, the fatality rate exceeds 95% worldwide, according to the CDC.
How the Amoeba Spreads
The single-celled organism thrives in warm freshwater—lakes, ponds, and rivers—and enters the body through the nose, usually while swimming or bathing. Once inside, it can destroy brain tissue rapidly, leading to seizures, hallucinations, and coma. The World Health Organization notes that most cases are detected too late for effective treatment.
Detection and Survival Rates
Kerala’s survival rate is slowly improving thanks to better testing and rapid treatment. “Cases are rising but deaths are falling,” said Dr. Aravind Reghukumar, head of infectious diseases at Thiruvananthapuram Medical College. In 2024, the mortality rate was about 23%, while in 2025 it is around 24.5% despite higher caseloads. State-of-the-art labs now allow faster identification and tailored drug cocktails of antimicrobials and steroids.
Public Health Response
Authorities have chlorinated millions of wells and thousands of public water tanks. Warning signs have been placed around ponds, and households are urged to clean tanks, avoid stagnant water, and use nose plugs while swimming. Yet, with 5.5 million wells and 55,000 ponds across Kerala, enforcement is a daunting task. Fish stocks also make widespread chlorination of ponds impractical.
Climate Change and Rising Risks
Scientists warn that warming waters and pollution are fueling amoeba growth. “Even a 1°C rise can trigger its spread in Kerala’s tropical climate,” says epidemiologist Prof. Anish TS. The amoeba feeds on bacteria in polluted water, meaning environmental degradation compounds the risk. Experts stress that the challenge is not unique to Kerala—similar outbreaks have been reported in the U.S., Pakistan, and Australia.
A Global Lesson
Since 1962, only about 500 cases of PAM have been reported worldwide. But Kerala’s experience highlights how climate change and urbanization may make rare diseases more frequent. Infectious disease expert Dennis Kyle cautions that the current treatment regimens are “sub-optimal,” with survival depending on early diagnosis. The state’s efforts underscore both the promise of improved public health systems and the looming threat of climate-driven diseases.
Kerala’s fight against Naegleria fowleri shows how local health crises can signal global risks. While the state’s laboratories and awareness campaigns are saving more lives, climate change may widen the amoeba’s reach. For India and beyond, the lesson is clear: resilient public health strategies must adapt as rare pathogens become increasingly common.
Sources: Al Jazeera (2025) , BBC (2025)
Keywords: Brain Eating Amoeba, Kerala, Naegleria Fowleri, Primary Amoebic Meningoencephalitis, Waterborne Infections, Climate Change
