Primary Amoebic Meningoencephalitis (PAM)

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News: The Health department in Kozhikode, Kerala, has issued an alert against primary amoebic meningoencephalitis (PAM) in the district in view of the reporting of three cases of the infection and a death here in recent days.

About Primary Amoebic Meningoencephalitis (PAM)

Source – Taylor and Francis Journals
  • It is a rare but lethal central nervous system infection
  • Caused by: It is caused by Naegleria fowleri, known as the “brain eating amoeba”.
    • It is a free-living amoeba found in warm, fresh water and soil, and infects people when it enters the body through the nose.
  • Risk factors: Risk factors for infection include swimming, diving, waterskiing, surfing, and exposure to hot springs.
  • Season/region of vulnerability: PAM is more common in warmer regions and generally occurs in the warmer months of spring and summer, possibly due to the increased likelihood of participation in waterborne activities.
  • Symptoms: Symptoms include headache, fever, nausea, and vomiting.
  • Testing and diagnosis: PAM is difficult to diagnose because of the rarity of the infection and the non-specific early symptoms.
  • Prevention: People should focus on limiting the amount of water going up the nose.
  • Treatment and recovery: Several drugs are effective, however, their effectiveness is unclear since almost all infections have been deadly, even when people were treated.
  • Cases in India: The first case of PAM in India was reported in 1971, and the first case in Kerala was reported in 2016.

Note:

Amoebic Encephalitis

  • There are 2 types of amebic encephalitis
    • Primary Amoebic Meningoencephalitis (PAM)
    • Granulomatous Amoebic Encephalitis (GAE).
  • The initial symptoms of PAM are indistinguishable from bacterial meningitis, while the symptoms of GAE can mimic a brain abscess, encephalitis, or meningitis.
  • These infections are almost uniformly fatal.
  • The mortality rate is above 90%, despite antimicrobial therapy.
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