Kerala reports more amoebic meningoencephalitis cases, including a death

Kerala has reported more amoebic meningoencephalitis cases in the last two days, including a death, taking the total number of cases reported so far in the State this year to 129, including 26 deaths.

As on Saturday (October 18, 2025) morning, 53 persons are admitted and undergoing treatment for amoebic meningoencephalitis in various public and private hospitals across the State.

Thiruvananthapuram has reported the most number of cases at 36, including three deaths. On Thursday, the district reported five cases across the district, at Aanad, Mangalapuram, Pangappara, Rajaji Nagar in the Corporation limits and Thonnakkal, triggering much anxiety among the public.

On Friday, two more cases were reported in the State, one in Thiruvananthapuram and another in Kozhikode.

“The case in Kozhikode does have a history of swimming in some resort pool, while the case in Thiruvananthapuram is that of a headload worker, who reported to the medical college hospital with seizures, but no fever. His cerebrospinal fluid sample was drawn and tested as part of the other neurological investigations, when amoeba was detected in wet microscopy. While he has not entered any waterbody, he reports that he sometimes steps into a stream for washing hands and feet. Our field workers report that he has a wound on his foot. We know now that Acanthamoeba can enter through skin wounds and reach the blood stream,” said a senior health official.

He points out that in several cases reported in recent times, epidemiological investigations indicated that Acanthamoeba could have entered through skin wounds when people came into contact with random waterbodies or streams.

He says that while epidemiological investigations were on, the source of infection remains unclear in many cases, especially the ones due to Acanthamoeba, which has an incubation period ranging from days to almost an year.

While Naegleria fowleri has a shorter incubation period and almost always has a clear link to recent exposure to waterbodies, in the case of Acanthamoeba, it is not necessary that an epidemiological link can always be established.

“Except for a small subset who develop serious neurological symptoms, most of the patients seem to be having mild symptoms, not even fever. Many of the amoebic meningoencephalitis cases were picked up randomly, when patients came to the infectious diseases or Neurology department complaining of headache or vision problems or seizures,” the official says.

“Early detection and initiation of treatment has been life-saving, except in those with immunocompromising conditions when the course of infection might take a turn for the worse. Aggressive testing strategy has been yielding us more cases. West Bengal has been doing the same and there too there is a surge in cases. But we seem to be getting the flak for detecting and treating more cases,” says a clinician at Government Medical College, Thiruvananthapuram.

Many quit swimming pools

Despite assurances from the authorities that chlorinated swimming pools are safe, the spate of amoebic meningoencephalitis cases seem to have triggered panic among those who regularly visit the pools in Thiruvananthapuram city for swimming. Many pool regulars, for whom swimming is part of their daily exercise routine, say they have now switched to walking.

The Health department had issued a directive regarding the chlorination of swimming pools, the level of chlorine to be maintained in water at all times and that a registry had to be maintained of the chlorine levels recorded on each day.

“Our pool is chlorinated as per the government’s directive and the chlorine levels are recorded and displayed for the pool users to see. One can see that the water is clean and clear. Yet, we have witnessed a sudden reduction in the number of pool users in recent times because people are now scared and say they do not want to take chances,” says a coordinator at Jimmy George Sports Hub in Thiruvananthapuram.