AT least eight people died in Karachi due to primary amoebic meningo-encephelitis (PAM) this year. This is a micro-organism which lives in bodies of warm fresh water like swimming pools, rivers, lakes and storage of water supply.

It is also found in soil, near warm water discharges of industrial plants, and unchlorinated swimming pools in an amoeboid or temporary flagellate stage.

It is a heat-resistant organism and survives even at 46 degrees of temperature. It is observed in the months of July, August and September.

The disease starts with fever, headache, nausea and vomiting. It progresses in three to seven days and affects the brain. A patient develops a symptom of confusion, hallucinations and fits. The mortality rate is 98 per cent because the drugs available are not so effective. Amphotericin B is used which is not completely effective and, therefore, a combination of drugs play a little role if administered in time.

Naegleria enters the nose of a person while swimming, diving, taking a bath in the river and the lake. It causes necrosis of nasal mucosa and reaches brain by climbing along nerves through the cribriform plate via the floor of cranium and starts affecting the brain.

The organism begins to consume cells of the brain piecemeal by means of a unique sucking apparatus extended from its cell surface. Hence called as ‘brain eating amoeba’.

This infection is diagnosed by the examination of cerebrospinal fluid on microscope by staining and culture. Culture takes time and, hence the delay in diagnosis: the fast method nowadays to diagnose this disease is PCR test.

How to prevent it? The answer is to avoid the entry of water into nose while swimming, taking a bath and cleaning the nose. If unavoidable, then do not clean it by forceful sucking of water into the nose.

Water in swimming pools, water- supply storage tanks, water parks at entertainment places should be thoroughly chlorinated and this is not a difficult job. The government should act on time before hundreds and thousands die.

DR MURLIDHAR Karachi