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Epidemiology of and Risk Factors for Amebic Meningoencephalitis, Kerala, India, 2025
Abstract:
Amebic meningoencephalitis (AME) is a highly fatal central nervous system infection caused by various free-living amebae. We describe epidemiology of AME cases from Kerala, India, during January 1-November 11, 2025, and identify behavioral risk factors associated with real-time PCR-confirmed Acanthamoeba spp. infection through a matched case-control study. We identified 159 AME case-patients, of which 67 (42.1%) tested positive for Acanthamoeba spp. amebae. Most AME cases were reported from 4 districts, peaking during the monsoon and postmonsoon periods. Exposure to natural water bodies for swimming or bathing and using nonchlorinated water for domestic purposes were associated with AME. History of maxillofacial injury or nasal surgery with subsequent exposure to natural water bodies and washing ulcers or skin lesions in natural water bodies were associated with higher odds of disease. Targeted risk communication about safe water practices and routine chlorination of domestic water sources could help reduce AME risk in affected communities.
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