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Published on: June 21, 2024
Primary amoebic meningoencephalitis caused by Naegleria fowleri: an old enemy presenting new challenges
Ruqaiyyah Siddiqui1, Naveed Ahmed Khan1
1Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan.
Abstract:
First discovered in 1899, Naegleria fowleri is a protist pathogen, known to infect the central nervous system and produce primary amoebic meningoencephalitis. The most distressing aspect is that the fatality rate has remained more than 95%, despite our advances in antimicrobial chemotherapy and supportive care. Although rare worldwide, most cases have been reported in the United States, Australia, and Europe (France). A large number of cases in developing countries go unnoticed. In particular, religious, recreational, and cultural practices such as ritual ablution and/or purifications, Ayurveda, and the use of neti pots for nasal irrigation can contribute to this devastating infection. With increasing water scarcity and public reliance on water storage, here we debate the need for increased awareness of primary amoebic meningoencephalitis and the associated risk factors, particularly in developing countries.
Insights
Naegleria fowleri causes primary amoebic meningoencephalitis with a >95% fatality rate. Increased awareness of risk factors, especially in developing nations, is crucial due to cultural practices and water storage.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Environmental Health
Background:
- Naegleria fowleri, a protist pathogen, causes primary amoebic meningoencephalitis (PAM).
- PAM has a high fatality rate (>95%) despite medical advancements.
- Cases are reported globally but underdiagnosed in developing countries.
Purpose of the Study:
- To highlight the underdiagnosis of Naegleria fowleri infections in developing countries.
- To discuss risk factors associated with PAM in these regions.
- To advocate for increased public awareness of PAM.
Main Methods:
- Literature review and case analysis.
- Epidemiological data assessment.
- Risk factor identification through cultural practice analysis.
Main Results:
- Naegleria fowleri infections are underreported in developing nations.
- Cultural practices like ritual ablution and nasal irrigation are potential transmission routes.
- Water scarcity and storage increase exposure risks.
Conclusions:
- There is a critical need for enhanced awareness of PAM and its risk factors in developing countries.
- Public health initiatives should address cultural practices and water safety.
- Further research is needed to understand the epidemiology in underreported regions.
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