Brain-Eating Amoeba Surge in Kerala

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Kerala is facing a sudden increase in Amoebic Meningoencephalitis, which is a rare and dangerous brain infection.
Contaminated water carries the free-living amoebae responsible for this infection, and Kerala has seen several deaths in early 2026.
India reported only about two dozen cases of Primary Amoebic Meningoencephalitis (PAM) from the first recorded case in 1971 until 2023, making the current surge very unusual.

Amoebic Meningoencephalitis includes Primary Amoebic Meningoencephalitis (PAM) caused by the brain-eating amoeba *Naegleria fowleri*, and Granulomatous Amoebic Encephalitis (GAE) caused by *Acanthamoeba*.
Both types of infections happen when contaminated water enters the human body through the nose.

In the past, most infections were Primary Amoebic Meningoencephalitis (PAM), but Granulomatous Amoebic Encephalitis (GAE) has now become the dominant type.
This newer dominant type is linked to *Acanthamoeba*, which lives in water bodies, soil, and dust.
Warm tropical climates, poor water quality, high coliform bacteria, and vegetated water bodies help the amoeba grow.
High population density in Kerala leads to polluted water sources, and many homes have toilet pits placed too close to open wells.

Water bodies with high coliform bacterial counts easily support *Acanthamoeba* because the amoeba feeds on bacteria like *E. coli*.
Most victims are elderly or immunocompromised persons, which makes them much more vulnerable to severe health complications.

Infection happens when dirty water enters through the nose during activities like swimming, but the disease does not spread person-to-person or through drinking water.
Early signs include fever, headache, and nausea, which quickly progress to seizures, hallucinations, coma, and death within days without treatment.

In 2024, the Kerala health department created a special treatment protocol and Standard Operating Procedure (SOP) to manage the disease.
Kerala became the first state in India to do this, which helps doctors detect cases early and improves patient survival.