KARACHI: A young man, infected with Naegleria fowleri, better known as brain-eating amoeba, died at a hospital in Clifton, officials said on Friday.

They said that another patient was currently under treatment. Both patients were admitted to private hospitals over two weeks back.

According to health authorities, the 21-year-old victim was admitted to a hospital with complaints of high fever and headache on June 18. He died on July 6.

They said that he was kept on the ventilator for several days with his family’s consent in the hope that he might survive. He was finally taken off the mechanical life support system on Thursday.

“This is the fifth death by Naegleria in Karachi. The patient was a DHA resident and reportedly bathed in a swimming pool in his locality,” said Dr Abdul Hameed Jumani, the director of the health services Karachi.

Another Naegleria patient was under treatment at a private hospital, he added.

Sources said that the other patient, who hails from Jamshoro, was 22 years old and currently under treatment at PNS Shifa Hospital. He is an employee of the Pakistan Air Force.

In May, the health department confirmed three deaths from Naegleria in a short span of one week in the metropolis. None of the three victims had a history of swimming and it appeared that the infection occurred due to the use of contaminated, or non-chlorinated, tap water.

A free living amoeba, Naegleria is commonly found in warm fresh water (such as lakes, rivers, and hot springs) and soil. Only one species of Naegleria infects people: Naegleria fowleri.

It infects people when water containing the amoeba enters the body through the nose. This typically happens when people go swimming, diving, or when they put their heads under fresh water, like in lakes and rivers. The amoeba then travels up the nose to the brain, where it destroys the brain tissue and causes a devastating infection called primary amoebic meningoencephalitis (PAM). PAM is almost always fatal.

According to the Centres of Disease Control and Prevention, US, the first symptoms of PAM usually start about five days after infection, but they can start within one to 12 days. Symptoms may include headache, fever, nausea, or vomiting. Later symptoms can include stiff neck, confusion, lack of attention to people and surroundings, seizures, hallucinations, and coma.

After symptoms start, the disease progresses rapidly and usually causes death within about five days (but death can happen within one to 18 days). The death rate is over 97 per cent. Only four people have survived out of 157 known infected individuals in the United States from 1962 to 2022.

In a statement, the Pakistan Medical Association urged the general public to adopt measures to prevent the fatal infection.

“Personal actions to reduce the risk of N.fowleri infection should focus on preventing water from going up the nose. Besides, always drink boiled water and do not wash your face or bathe with polluted water. Do not swim in non-chlorinated pools.

“People are also requested to put chlorine in underground water tanks [one tablet in 1,000 gallons of water]. Water tanks at homes, hospitals, schools, shopping malls, and offices should be cleaned once a year,” it said.

The association requested that all the doctors, particularly the general practitioners and family physicians, take it seriously if a patient comes to them with symptoms of nausea, vomiting, headache, and a high fever.

Published in Dawn, July 8th, 2023