Deadly Naegleria in ‘piped water’ infects man

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A 38-year-old man, recently admitted to Ziauddin Hospital’s intensive care unit, was found to be infected with Naegleria fowleri.

Zeeshan is married and a resident of North Karachi.This is the seventh case of Nageleria fowleri in the city this year.Sources said the patient had earlier been to a couple of private hospitals but could not get treatment; one healthcare facility had insufficient staff while the other denied him admission on grounds that there was no vacant hospital bed.

Initially, sources said, the patient had symptoms of severe headache, high-grade fever, nausea, vomiting and mental confusion/disorientation, seizure and cranial nerve abnormalities developed within three to four days.

According to a report prepared by the Regional Disease Surveillance and Response Unit, the risk factor in Zeeshan’s case was piped water.“There is an urgent need to assess the process of chlorination and level of chlorine at all major water reservoirs supplying water to the city as per the WHO recommendation. Cleanliness must be maintained at all reservoirs, overhead tanks/other reservoirs of households, pumping stations and hydrants on a regular basis,” the report says.

It suggests inspection of pipelines to check leakages and avoid contamination of water with sewage, engagement and training of local healthcare workers in terms of surveillance and early identification of Naegleria cases and launch of public awareness drive.

Earlier, six people including a neurosurgeon and an eight-year-old child had died of the same infection called Primary Amoebic Meningoencephalitis (PAM) caused by Naegleria fowleri, a deadly organism often referred to as ‘brain-eating amoeba’.It’s found in freshwater sources including poorly chlorinated piped water.

The organism enters the nasal cavity when water contaminated with amebae is aspirated. Subsequently, it invades the central nervous system and causes a fatal infection that clinically resembles acute bacterial meningitis.

The infection progresses rapidly and frequently leads to coma and death in one to 18 days (on an average 5 days) after symptom onset.

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