How an Indian state is battling a rare disease

On the eve of Anam, the happiest festival in Kerala state in India, 45 -year -old Subana was trembling at the back of an ambulance, drifting into the subconscious when her family rushed to the College of Medicine Hospital.

A few days ago, the Dalit Women (previously known as the outbreaks), to which the living fruit juices gained in a village in the Malaburam area, were more disturbing than dizziness and high blood pressure. Doctors described birth control pills and sent her home. But her condition rises at a terrifying speed: I was uncomfortable with fever, fever on violent tremors, and on September 5 – the main day of the festival – Matt Subana.

The perpetrator was Naegleria Fowleri – known as the amoeba that takes the brain – the infection is usually contracted across the nose in freshwater and so rare that most doctors have not faced a condition in their entire career. “We were unable to stop him. We learned about illness only after the death of Sobana,” says Ajta Kadradat, the cousin of the victim and a prominent social worker.

In the state of Kerala this year, more than 70 people were diagnosed and 19 amoeba eating the brain died. Patients ranged from three months old to a 92 -year -old man.

These single -cell organisms usually feed on bacteria in warm fresh water, causing infection in the brain close to deadly, known as the primary amino encephalitis (PAM). It enters through the nose while swimming and destroys the brain tissue quickly.

Kerala began to discover cases in 2016, only one or two per year, and until recently it was almost all fatal. new Ticket Only 488 cases have been reported in the world since 1962 – most of them in the United States, Pakistan and Australia. 95 % of the victims died of the disease.

But in Kerala state, survival appears to be improving: last year, there were 39 cases with a 23 % death rate, and this year, nearly 70 cases were reported with about 24.5 % of deaths. Doctors say the high numbers reflect a better discovery, thanks to modern laboratories.

“The cases are increasing but deaths are hanging. Aggressive tests and early diagnosis have improved – a unique strategy in Kerala,” said Aravind Reagukomar, head of the Department of Infectious Diseases at the Medical and Hospital College of Theovannanthapuram, said the state capital. Early detection allows dedicated treatment: a drug cocktail can save from antimicrobials and stimulants targeting amoeba lives.

Scientists have identified about 400 types of free amoebus, but only six are known to cause a disease in humans – including Naegleria Fowleri and Acanthamoeba, both of which can affect the brain. In Kerala, public health laboratories can now discover the five -pathogenic species, officials say.

The strong dependence of the southern state on groundwater and natural water makes it especially weak, especially since many ponds and wells are contaminated. For example, a small group of cases in the past year was linked to young people who abandoned boiled cannabis mixed with nigella water – a risky practice that confirms how contaminated water can become a canal for infection.

Kerala has approximately 5.5 million wells and 55,000 pools – and millions derive their daily water from wells alone. This absolute contraction makes it impossible to treat wells or ponds as simple “risk factors” – they are the backbone of life in the state.

“Some infections have occurred in people who bathe in the ponds, others of swimming pools, and even through nasal rinsing with water and it is religious rituals. Whether in contaminated pool or a well, the danger is real,” says Anish Ts, a pioneer epidemic specialist.

So public health authorities tried to respond widely: in one campaign at the end of August, 2.7 million wells were assigned to chlorine.

Local governments have developed banners on bathing or swimming pools and raised the public health law to impose regular chlorine in swimming pools and water tanks. But even with such measures, the ponds cannot be realisticly expensive – the fish will die – and every water source in the village has decreased in a state of more than 30 million inappropriate people.

Officials are now aware of awareness of the ban: families are urged to clean tanks and swimming pools, use clean, clean water of the nasal tiles, keeping children away from garden machine guns and avoiding unsafe basins. September is advised to protect their noses by maintaining their heads over the water, using nasal plots and avoiding stimulating sediments in stagnant or non -treated water.

However, achieving a balance between the public’s education about the real risks – to use fresh, unforgivable water – and avoid fear that may disrupt daily life is a challenge. Many say, despite the instructions issued for more than a year, enforcement is still incomplete.

“This is a difficult problem. In some places [hot springs]The signs are published to warn of the possibility of amobae in the water source. This is not practical in most situations, as the amoebay can be present in any source of inappropriate water [lakes, ponds, pools]Dennis Kyle, professor of infectious diseases and cellular biology at the University of Georgia, told the BBC.

He said: “In the most controlled environments, it can reduce the frequent monitoring of the proper chlorine in a great deal of infection. These swimming pools, starting platforms and other human -made entertainment activities include.”

Scientists warn that climate change is risk amplification: warmer water, the longest summer and high temperatures create perfect conditions for ampia. “Even the height of 1 C leads to its spread in the tropical climate in Kerala state and water pollution is further nourishing it by feeding the bacteria that amoeba consumes,” says Professor Ech.

Dr. Kyle adds a note of caution, noting that some previous cases may simply be unknown, with amoeba not identifying as the cause.

Understanding can make treatment more difficult. Dr. Kyle explains that the current cocktails of drugs are “optimal”, adding that in rare survivors, the system becomes the standard. “We lack adequate data to determine whether all medications are useful or really required.”

Kerala may hunt more patients and provide more lives, but the lesson reaches beyond its limits. Climate change may be rewriting the map of the disease – and even the rarest pathogens may not remain rare for a long time.