ISLAMABAD: The Ministry of National Health Services (MNHS) on Friday asked the Capital Development Authority (CDA), the Islamabad district administration and the Capital Administration and Development Division (CADD) to take precautionary measures against the deadly Naegleria Fowleri, commonly known as the brain-eating amoeba.

A letter issued on July 24 by MNHS Joint Secretary Dr Amer Sheikh (available with Dawn) says it is a matter of serious concern that the disease has claimed six lives in Sindh since May of this year.

With a 95 per cent fatality rate, the disease first surfaced in Pakistan in 2012, killing 22 people in the South of the country within a week.

Naegleria Fowleri is almost always fatal and is transmitted only if contaminated water goes up the nasal cavity

The amoeba thrives in warm bodies of freshwater such as ponds, lakes, rivers, and hot springs as well as soil, poorly chlorinated swimming pools and stagnant water.

The microorganism can invade the human nervous system and brain, causing a condition known as primary amoebic meningoencephalitis (PAM), with death occurring in 3–10 days after exposure.

The amoeba is transmitted to the brain through the nasal cavities, so people who dip their faces in the water while bathing in poorly-chlorinated swimming pools or use contaminated water to clean their noses during ablutions, are at risk of contracting the disease.

Currently, the disease has only been reported in Sindh. However, there is an imminent risk of its spillover to other parts of the country.

Precautions

According to the MNHS letter, the public at large should be told to adopt preventive measures. Through the letter, the ministry has advised citizens against swimming in stagnant water and told them to avoid submerging their heads in water while bathing.

The ministry has particularly cautioned against ingesting water through the nose during ablutions.

In the letter, the CDA has been advised to instruct the Water and Sanitation Department (Wasa) to ensure an optimal level of chlorination in the water supply.

Moreover, the letter directs the concerned authorities to keep tabs on water supply lines that are in close proximity to pools of stagnant water, including waste water discharged by industrial plants, and asks them take immediate measures to repair or replace such pipes in case of leakages.

The district administration has been advised to prohibit people from bathing in pools of stagnant water.

Urban slums and congested localities are at a greater risk of such an epidemic because of old, rusty or damaged pipes that run alongside open sewage lines, the letter says.

According to the US Centre for Disease Control (CDC), the amoeba cannot infect humans drinking water contaminated with Naegleria, nor can the infection be spread from one person to another.

The CDC recommends that while swimming, people must hold their noses shut, use nose clips, or keep their heads above water when taking part in water-related activities in bodies of warm freshwater, including activities in warm water discharged from industrial plants.

The CDC also warns against water-related activities in warm freshwater during periods of high water temperatures and low water levels.

It also recommends avoiding digging in, or stirring up, the sediment while taking part in water-related activities in shallow, warm freshwater areas.

Symptoms

Pakistan Institute of Medical Sciences (Pims) Vice Chancellor Dr Javed Akram told Dawn the symptoms of the disease include a high fever, headaches and vomiting.

“If a person has the symptoms he/she should immediately visit a hospital where a blood test, a brain scan and certain other tests would be held to determine whether the person has been infected,” he said.

Published in Dawn, July 26th, 2014