PAKISTAN recently reported its first fatality of 2025 due to Naegleria fowleri, commonly known as the brain-eating amoeba.
The victim, a 36-year-old woman from Karachi, was admitted to a private hospital after experiencing symptoms and passed away on February 23.
The presence of the amoeba was confirmed posthumously on February 24.
Naegleria fowleri is a rare but deadly amoeba that thrives in warm freshwater environments such as lakes, rivers, and poorly chlorinated water sources.
It causes Primary Amoebic Meningoencephalitis (PAM), a brain infection with a 98% fatality rate.
The infection occurs when contaminated water enters the nasal cavity, allowing the amoeba to travel to the brain and destroy brain tissue.
Interestingly, the deceased had not participated in any water-related activities like swimming or bathing in contaminated water.
Her only known exposure was through ablution (wuzu) at home, a religious practice performed five times a day.
Pakistan has seen a rise in Naegleria fowleri cases in recent years.
The first instance of this brain-eating amoeba in Pakistan was documented in 2008.
It has since resulted in numerous fatalities and the available data indicates that six died in 2017, 01 in 2018, 15 in 2019, six in 2021, four each in 2022 and 2023 and five fatalities reported in 2024.
According to officials, there is a higher rate of unreported deaths from Naegleria fowleri in Pakistan due to limited healthcare facilities and lack of awareness.
The brain-eating amoeba, which enters the body through the nasal passages—typically when someone swims, dives or rinses their nose with contaminated water.
Once inside, it travels to the brain via the olfactory nerve, where it destroys brain tissue, triggering severe inflammation and neurological damage.
The initial symptoms of PAM typically appear around five days after infection and may include headache, fever, nausea or vomiting.
As the disease progresses, additional symptoms can develop, such as a stiff neck, confusion, disorientation, seizures, hallucinations and coma.
Once symptoms begin, the condition deteriorates quickly, often leading to death within five days.
The amoeba cannot survive in cool, chlorinated or clean water, which reduces the risk of infection in such environments.
And water contamination is a major issue in Pakistan, affecting millions of people.
Studies show that over 60% of drinking water sources in the country are unsafe for consumption due to bacteriological, chemical and toxic metal contamination.
Studies have also found that in Karachi, 95% of water samples are unfit for human consumption.
Several factors contribute to the poor water quality in Karachi.
One of the major issues is inadequate chlorination, as many water sources lack proper treatment, making them vulnerable to contamination.
Additionally, aging infrastructure plays a role, as old pipelines develop leaks and cracks, allowing pollutants to seep into the water supply.
Industrial waste is another significant concern, with factories discharging harmful chemicals and toxins directly into rivers and lakes.
Furthermore, poor sanitation practices lead to sewage mixing with drinking water sources, increasing the risk of waterborne diseases.
The health risks associated with contaminated water in Karachi are severe.
One of the most common consequences is diarrheal diseases, which remain a leading cause of child mortality in the region.
Waterborne infections such as Hepatitis A and E are prevalent, spreading rapidly due to polluted water consumption.
The brain-eating amoeba (Naegleria fowleri) has been detected in poorly chlorinated water, posing a deadly threat to residents who come into contact with it through nasal exposure.
Scientists are investigating the possibility that genetically distinct strains of Naegleria fowleri may be responsible for the recent deaths in Pakistan.
Typically, the amoeba primarily affects children and young adults, but in Pakistan, an unusually high number of adult cases have been reported, raising concerns about a potential strain variation.
Another intriguing factor is Pakistan’s saline water, which is generally unsuitable for Naegleria fowleri’s survival.
However, researchers speculate that the amoeba may have adapted to these conditions, developing resistance to saline environments.
This has led to hypotheses that unique strains of N.
fowleri exist in Pakistan, possibly contributing to the rising number of infections despite unfavorable survival conditions.
Pakistan’s infectious disease surveillance system remains ineffective and unreliable, falling short of the standards necessary for early detection and containment.
As a result, the country continues to grapple with widespread outbreaks of diseases such as dengue, tuberculosis, malaria, and hepatitis B and C.
The escalating cases of Naegleria fowleri infections or brain-eating amoeba, further underscore the systemic gaps in monitoring and prevention, with incidence rates steadily rising.
— The writer is an educator, based in Sindh. ([email protected])
