A Silent public health threat, from 36 to 69: Kerala sees sharp rise in Naegleria Fowleri infections

Kerala, September 21 : An invisible killer is making waves in Kerala, as the state grapples with a rapidly escalating public health threat from a rare but highly fatal brain infection Naegleria fowleri, the so-called “brain-eating amoeba.” This year, Naegleria fowleri cases in Kerala are no longer limited to isolated pockets. Districts such as Kozhikode, Malappuram, Alappuzha, Thiruvananthapuram, and Kollam have all reported infections, emphasizing that warm freshwater bodies across the state present a persistent and widespread danger to public health. In 2025 alone, Kerala has recorded 69 confirmed cases and 19 fatalities, nearly double last year’s 36 infections and 9 deaths. The rising cases, highlight the widespread vulnerability of warm freshwater sources including lakes, rivers, wells, and poorly maintained swimming areas underscoring the urgent need for vigilance and safety measures.

This microscopic predator thrives in warm, stagnant water and infects humans when contaminated water enters the nose. Once inside, the amoeba attacks the brain, causing Primary Amoebic Meningoencephalitis (PAM)an aggressive infection with a near 97% fatality rate worldwide that destroys brain tissue within days. The speed and severity of the disease make even common water activities, such as swimming or ritual bathing in lakes, rivers, and wells, extremely risky.

The infection progresses at an alarming pace, often resulting in death within a week of symptom onset. Symptoms of Naegleria fowleri infection usually appear within 1 to 12 days after exposure, the Initial signs such as severe headache, fever, nausea, and vomiting can quickly escalate to stiff neck, confusion, seizures, hallucinations, and coma. Globally, survivors are exceptionally rare, numbering only about twenty. The Centers for Disease Control and Prevention (CDC) reports that most individuals succumb to the infection within 1 to 18 days after symptoms begin, with a median survival time of about 5 days. Even with aggressive treatment, which may include antifungal and anti-inflammatory medications, the fatality rate remains exceedingly high. Survivors often experience severe neurological deficits, underscoring the devastating impact of the disease. 

Kerala’s health authorities have intensified water safety efforts in response to the outbreak. Authorities are chlorinating freshwater bodies, conducting regular inspections, and running awareness programs to educate people about safe water practices. Public pools, lakes, and rivers are being thoroughly sanitized, and monitoring has increased to detect infections early. Officials are urging citizens to avoid warm, stagnant waters and take precautions such as using nose clips. Communities are also encouraged to maintain clean water supplies and seek medical help immediately if any warning signs appear.

Staying safe starts with awareness and simple habits. People should avoid swimming in lakes, rivers, or pools with warm, stagnant water and use protective gear such as nose clips whenever exposure is unavoidable. Early signs like persistent headache, fever, or vomiting require immediate medical attention, as the infection progresses rapidly. Ensuring clean water for drinking, cooking, and daily use is equally vital, since even minor lapses can increase exposure risk. In addition to personal vigilance, community awareness and hygiene practices play a crucial role in preventing infection. Together, informed choices, careful routines, and shared awareness form the strongest shield for individuals and families against this invisible, lethal threat.

Naegleria fowleri’s presence in Kerala’s waters is a reminder that even familiar environments can be deceptive. Prevention depends on mindful water use, prompt recognition of symptoms, and community vigilance. Families, local authorities, and communities must ensure clean water, avoid risky exposure, and act swiftly if symptoms appear, turning awareness and preparedness into the strongest defense against this invisible threat. By combining personal caution with collective responsibility, Kerala can reduce the impact of this deadly amoeba and safeguard its citizens from an otherwise unseen danger.