KARACHI, July 25: The rising number of deaths due to waterborne Naegleria meningitis in the city has brought the performance of the Karachi Water and Sewerage Board — the main government agency responsible for the provision of water to the entire population and industries in Karachi — into focus.

A source in the health department said the WHO’s Disease Early Warning System (DEWS) confirmed on Wednesday yet another death of a person in the city, who was being treated at an armed forces hospital.

Since five of the six people died of primary amoebic meningoencephalitis (PAM) had no history of swimming in a public pool or a recreational farm settings in days before their deaths, a DEWS team in collaboration with another international agency has been considering measures to contain the outbreak of the disease and to assist the health department and the KWSB in controlling the emergency-like situation due to the disease caused by an amoeba — Naegleria fowleri.

In a report submitted to the provincial health minister on Wednesday, the health officers assigned to look into the waterborne amoeba-caused deaths in various private hospitals since July 6, among other observations, called for proper chlorination of water supplied to the city.

Naegleria fowleri is an organism typically found in warm bodies of freshwater, lakes, ponds and in water reservoirs and swimming pools of recreational places, residential/commercial hotels, farm houses, parks, etc, if they are not chlorinated after refilling of the reservoir within 15 minutes, the report said.

The report said that an inspection committee under the head of EDO-Health Karachi had been constituted to examine all such places on a permanent basis and ensure all swimming pools have chlorinated water.

An expert commented that water used for drinking and cooking should be free of pathogenic (disease causing) micro-organisms.

Purification of drinking water containing pathogenic micro-organisms requires specific treatment called disinfection.

It was said that although there were several methods to eliminate disease-causing micro-organisms from water, chlorination was the most commonly used method. “When combined with filtration, chlorination is an excellent way to disinfect drinking water supplies,” the expert said.

According to DEWS, the patient who died at the armed forces hospital was a 49-year-old man admitted to the hospital on July 8, while the cerebrospinal fluid (CSF) culture was found positive for Naegleria fowleri on July 10.

The patient was admitted to the intensive care unit of the hospital with a history of high-grade fever, altered consciousness, headache, vomiting, neck stiffness and he died on July 16, a DEWS report said.

In the meantime, the DEWS team also had a meeting with United Nations International Children's Emergency Fund representatives on containment measures regarding Naegleria meningitis.

The participants in the meeting were told that the micro-organisms could only survive in fresh stagnant water (un-chlorinated) and they could be checked by appropriate chlorination of fresh water sources.

During the meeting it was concluded that the main stakeholder in the matter apart from the health department was the Karachi Water and Sewerage Board so both the WHO and the UNICEF teams would try to contact the officials concerned and sensitise them to the matter so that they take necessary steps.

It was further noted in the meeting that the public needed to be sensitised to the issue so that they protect themselves from getting this deadly infection, without getting into a panic about the situation.

According to DEWS, so far three patients have died at the Liaquat National Hospital and one each at the Aga Khan University Hospital, the Munawar Memorial Hospital and the PNS Shifa Hospital.

Four of the patients who died on July 6, 11, 13 and 14 were between 22 and 27 years of age, while two deceased were between 44 and 49 years of age and only one of them had a history of swimming, the relevant data suggested.A chief engineer of the KWSB, Syed Zaheer Abbas Zaidi, told Dawn on Wednesday that authorities at the board were already alarmed over the situation and personally visiting various installations to know about the filtration and chlorination activities in an effort to build up public confidence in the water consumed round the year.

He said that the board had been conducting the chlorination of over 500 million gallon of water every day at its six filter and water treatment plants, adding that there was no laxity in efforts to check the quality of water and measures were being taken in line with international water purification standards.

MPAs visit to KWSB filter plant

A KWSB communication said that MPAs Syed Khalid Ali, Nishat Ahmad Zia and Rehan Zafar visited the COD Filter Plant of the KWSB on Wednesday and witnessed the working of the Central Water Laboratory there.

They were told that chlorine cylinders were available in adequate stock, while process of disinfecting the water was also being carried out on a regular basis.

The members of the provincial assembly asked the officials and engineers concerned to have samples of water collected from various areas and tested them on a regular basis, a KWSB press release said.