KARACHI: The Sindh health authorities on Monday reported a second death within a short span of one week from Naegleria fowleri, commonly called brain-eating amoeba, in the city, raising the death toll from the deadly infection to 10 this year.

Sources said the second death within a week linked to the area of North Karachi.

The latest victim was a 22-year-old student. On Oct 24, a 45-year-old shopkeeper fell victim to the deadly infection from the same locality.

According to the health department officials, the student fell ill with high fever, headache and vomiting on Oct 25.

“His condition deteriorated, forcing the family to get him admitted to the intensive care unit of a private hospital two days later. He tested positive for Naegleria fowleri and died of complications on Oct 29,” a health department official shared.

A 22-year-old student becomes latest victim of Naegleria fowleri

According to him, the latest victim, as well as the other one, had no history of swimming to suggest that he might have contracted the infection during nasal passages.

A statement released by the department later in the day states that directives have been given to the town surveillance coordinator to collect water samples from the area (in order to detect the presence of the deadly amoeba in water) on the insistence of the victim’s family.

When contacted, Health Services Karachi Director Dr Abdul Hamid Jumani emphasised the need for preventive measures at the individual and community levels.

“The health department or the water board alone can’t prevent the spread of the deadly germs unless the community takes ownership of the challenge posing a serious threat to human life,” he said.

According to him, the health department collects water samples from the affected locality as soon as a Naegleria death is identified.

“I don’t have the whole lab data in front of me. But I can say that several samples taken from the affected areas (where deaths were reported) this year have tested positive for Naegleria.”

Dr Jumani pointed out that there could be multiple reasons for that contamination, including lack of chlorination, at different levels in the supply system.

“We know for sure that water tanks at homes and in high-rises are rarely cleaned, providing a favourable environment for the germs to thrive. Besides there could be seepage in lines that could contaminate the water supplies,” he said, underscoring the need for a mandatory protocol binding managements of high-rise buildings to ensure periodic cleaning of their water tanks.

KWSC claims proper chlorination

Officials of the Karachi Water and Sewerage Corporation officials, however, rejected the possibility of any lapse in their system and insisted that the department ensured proper chlorination at different levels of the supply system.

“Water samples are picked up on daily basis from different areas for analysis and chlorination is carried out at the nine filter plants as well as at the points where hydrants are located and water is supplied through tankers,” Intikhab Ahmed Rajput, chief engineer electrical and mechanical at the utility, explained.

He added that the department was equipped with seven functional labs.

According to him, committees at the district level have been monitoring the status of chlorination this year. Its members include officials of the KWSB and district administrations.

Mr Rajput blamed the Naegleria deaths on the lack of cleaning and hygiene practices at the household and community level. “People must clean up their water tanks at least once a year. A 20-gramme chlorine tablet is enough to keep water in a 1000-gallon tank safe for 15 days. The tablet is easily available at medical or chemist stores.”

Over 100 cases reported in 11 years

Popularly known as ‘brain-eating amoeba’, Naegleria fowleri is responsible for the disease called Primary Amoebic Meningoencephalitis (PAM). The infection is fatal in 98 per cent of the cases.

Since 2012, according to health department officials, over 100 cases of Naegleria fowleri have been reported in Karachi. Of them, only one patient survived for three months. In another case reported this year, the patient recovered well and is still alive.

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 PAM.

The first symptoms of PAM usually start about five days after infection that 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.

Published in Dawn, October 31st, 2023