Teen survives rare brain-eating amoeba

An Indian teenager is now one of the few people in the world to survive a rare brain-eating amoeba, thanks in part to his father stumbling upon a public awareness campaign on social media.

Afnan Jasim, 14, is believed to have been infected in June after swimming in a local pond in the southern Indian state of Kerala.

Doctors said the amoeba – called Naegleria fowleri – likely entered his body from contaminated water.

Primary amebic meningoencephalitis (PAM), a disease caused by amoebas, has a mortality rate of 97%.

According to the US Centers for Disease Control and Prevention, from 1971 to 2023, only eight people survived the disease in four countries — Australia, the United States, Mexico and Pakistan.

In all cases, the infection was diagnosed between nine hours and five days after symptoms appeared – this played a crucial role in the patient’s recovery.

Medical experts say prompt treatment is key to a cure. Symptoms of PAM include headache, fever, nausea, vomiting, disorientation, stiff neck, loss of balance, seizures and/or hallucinations.

Afnan began experiencing symptoms five days after he went swimming in a local pond in Kozhikode district. He suffered convulsions and began complaining of severe headaches.

Afnan’s parents took him to see a doctor, but his condition did not improve.

Luckily, the boy’s father, MK Siddiqui, 46, was able to link his son’s symptoms to information he read on social media.

Mr Siddiqui, a dairy farmer, said he had read about the impact of the Nipah virus – a young boy recently die for it in Kerala – on social media when he stumbled upon information about the deadly brain-eating amoeba.

“I read that the seizure was caused by an infection. As soon as Afnan had the seizure, I took him to the local hospital,” said Mr. Siddiqui.

When the seizures did not stop, he took his son to another hospital, but this hospital did not have a neurologist.

They eventually reached the Children’s Hospital in Kozhikode, where the boy was treated by Dr Abdul Rauf, a pediatric intensive care specialist.

“The disease is diagnosed within 24 hours of symptoms appearing,” Dr Rauf told the BBC.

Dr Rauf credited Mr Siddiqui with alerting doctors to Afnan’s swimming in a local pond and his subsequent symptoms, which helped them make a timely diagnosis.

The amoeba enters the human body through the nose and travels through the cribriform plate – located at the base of the skull and carrying olfactory nerves that help the sense of smell – to the brain.

“The parasite then releases various chemicals and destroys the brain,” says Dr. Rauf.

Most patients die from intracranial pressure [exercised by fluids inside the skull and on the brain tissue].

This amoeba is found in freshwater lakes, especially in warm water, he added.

“People should not jump or dive into water. That is a sure way for the amoeba to enter the body. If the water is contaminated, the amoeba will enter through your nose,” he said.

The best thing to do, he said, is to stay away from contaminated water sources. Even in swimming pools, people are advised to keep their mouths above water.

“Chlorination of water sources is very important,” added Dr. Rauf.

A study published in the state of Karnataka has also reported cases of newborns locally and in places like Nigeria getting infections from bath water.

Since 1965, about 400 cases of PAM have been reported worldwide, while India has reported less than 30 cases so far.

“Kerala reported one case of PAM in 2018 and 2020,” the doctor said.

This year alone, six cases have been reported in Kerala. Of them, three have died and one is in critical condition. While Afnan has been discharged, the sixth person has also responded to treatment and is recovering.

Dr Rauf said that before Afnan was taken to the hospital, three people in Kerala had died from the disease.

“After two deaths at our hospital, we informed the government as it was a public health issue and an awareness campaign was launched,” said Dr Rauf. Mr Siddiqui came across the awareness campaign on social media.

Doctors ran tests on Afnan to help detect the presence of amoebas in his cerebrospinal fluid – which is found in the brain and spinal cord – and then administered a combination of antibiotics by injection into his spine.

The treatment also includes the use of Miltefosine – a drug that the state government imports from Germany.

“This drug is used for rare diseases in India but is not very expensive,” said Dr Rauf.

“On the first day, the patient was not very alert due to seizures. But within three days, Afnan’s condition started to improve,” he added.

A week later, the doctors did another test and found that the amoeba was no longer in his body. But he will continue taking the medication for a month, after which he plans to resume his studies.

The experience left a profound impact on Afnan, who says he now wants to get a nursing degree.

“He told the doctor that the nurses work very hard for the patients,” said Mr. Siddiqui.