Amoebic fever alert: Health Department cautions against using contaminated water bodies

The Health Department has issued a public warning against bathing, swimming, or even washing the face in unclean ponds, stagnant water bodies or water collected in rock crevices. The advisory has been issued in the wake of concerns over amoebic meningoencephalitis. Authorities have also directed that swimming pools ensure proper scientific chlorination. The warning comes amid the increased likelihood that children will enter such water bodies during the ongoing summer vacation.

Contaminated water sources are more likely to harbour pathogens that can cause amoebic brain fever. Bathing or swimming in such waters carries the risk of these organisms entering the body and reaching the brain, leading to infection. The amoeba can gain access to the brain through tiny openings in the thin membrane separating the nose from the brain, or through perforations in the eardrum. 

Symptoms
The early symptoms include fever, headache, nausea, vomiting, loss of consciousness, difficulty or pain with neck or back movement, and back pain. In later stages, seizures, fainting, and disoriented or incoherent speech may also occur.

If the fever does not subside even after taking medication, or if any of these symptoms are present, specialist medical attention should be sought immediately. If the patient has recently bathed or swam in a pond or similar water body, this information must also be shared with the doctor, informed Palakkad District Medical Officer Dr T V Rosh.

Mandatory hygiene measures for swimming pools
• The water should be completely drained and replaced once a week
• The sides and floor of the pool must be thoroughly scrubbed with a brush, cleaned and properly dried
• Filters must be cleaned regularly
• Freshly filled water should be used only after proper chlorination
• Chlorination should be done in the prescribed ratio (5 grams of bleaching powder per 1,000 litres of water)

Preventive measures
• Swimmers and those learning to swim should use nose clips to prevent water from entering the nose.
• Water in theme parks and swimming pools must be properly chlorinated and maintained in a hygienic condition.
• Drinking water storage systems and water tankers should be chlorinated at regular intervals.
• In water distribution networks, chlorine levels should be maintained at 0.5 mg per litre.
• All water sources must be kept free from pollution.
• Well water should be chlorinated at fixed intervals, as advised by health workers.

Frequently Asked Questions
1. What is PAM or amoebic fever?
Primary amebic meningoencephalitis (PAM) is a brain infection caused by Naegleria fowleri. Of late, Kerala has been repeatedly experiencing various cases of the infection among people of different ages.

2. What are the symptoms of amoebic fever?
Its symptoms aren't uniform across everyone, but here are some of the commonly noticed signs. 
1) Strong headache
2) Fever
3) Disorientation
4) Motor deficit
5) Unresponsiveness of one side of the body
6) Seizures (A PAM symptom shown in the advanced stage of the disease)

3.  Who is most susceptible to amoebic fever?
According to doctors, those with genetically wide nasal turbinates, the portion inside our nose that filters and warms the air we breathe, trap dust and help detect smell, can be affected by amoebic fever. In its trophozoite form (the form that causes amoebic meningoencephalitis), the amoeba can enter the olfactory nerve and spread to the brain, causing Primary Amoebic Meningoencephalitis (PAM). Those with weak immune systems, who have had brain surgeries, and those developing nasal turbines can also be affected by it.

4. Is climate change a reason for the increasing occurrence of amoebic fever?
Many healthcare experts opine that climate change in Kerala can be a factor in the number of amoebic fever cases going up. This is apparently because lukewarm water creates a perfect home for the kind of amoeba that is dangerous to our health.

5. Do all polluted waterbodies have the presence of amoeba?
According to experts, it is quite possible. Therefore, it is better to avoid non-chlorinated waterbodies for bathing or swimming.