Representative Picture
Amoebic Meningoencephalitis (AME) is not a new disease in India. It has been documented since the 1970s, with the first case reported in 1971 in two children. Over the decades, cases appeared sporadically across the country, often with fatal outcomes.
Kerala, however, has recently come into the spotlight because of a sharp surge in AME cases. The first case in the State was noted in 2016. Till 2023, cases were rare but fatal. In 2024, Kerala reported 39 cases with eight deaths, and in 2025 (till September), 71 cases with 19 deaths have already been recorded.
Why the sudden surge?
The rise in numbers is not necessarily due to a sudden outbreak. Instead, it is largely due to aggressive testing and early diagnosis by Kerala’s health system after the Nipah outbreak of 2023. Now, all Acute Encephalitis Syndrome (AES) cases that test negative for viral causes are screened for amoebic infections. This has helped in timely treatment and reduced mortality to 24.5%, compared to almost 100% earlier.
Misleading headlines about the “brain-eating amoeba”
Out of the 110 AME cases reported in 2024–25 in Kerala, only 11 were due to Naegleria fowleri (the so-called “brain-eating amoeba”), which causes Primary Amoebic Meningoencephalitis (PAM) with a fatality rate of 99%.
The majority of cases were caused by Acanthamoeba, another free-living amoeba, which is widespread in waterbodies, wells, tap water, hospital dust, and air-conditioning systems. Unlike Naegleria, Acanthamoeba infections mainly affect immunocompromised individuals such as dialysis patients, cancer patients, or diabetics.
Challenges in diagnosis and public perception
- Naegleria infection → Fast onset (5–14 days), clear link to swimming or nasal irrigation with contaminated water.
- Acanthamoeba infection → Incubation period of weeks to months, difficult to trace exact source.
This makes Acanthamoeba infections harder to diagnose, while also fueling public fear that Kerala is facing a “new epidemic.”
Public Health Measures
Kerala has launched a statewide chlorination drive across its 55,000 ponds and 55 lakh wells to reduce amoebic density in water. While this is a massive challenge, it reflects a One Health approach that integrates human, animal, and environmental health.
Key Takeaways
- AME is not new in India; it has been underdiagnosed due to lack of awareness.
- Kerala’s proactive testing has revealed more cases, but also saved many lives.
- Most AME cases in Kerala are due to Acanthamoeba, not the “brain-eating amoeba.”
- The infection poses the greatest risk to immunocompromised individuals, not the general population.
- Early detection and intensive management have reduced mortality significantly.
✅ Disclaimer: This article is for educational purposes, especially useful for UPSC/State PCS Current Affairs, and should not be taken as medical advice.
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