In 2025, the southern Indian state of Kerala has witnessed a troubling rise in cases of Primary Amoebic Meningoencephalitis (PAM), a rare and almost always fatal brain infection caused by the amoeba Naegleria fowleri. As of now, there are roughly 69 confirmed cases, including 19 deaths.

This pathogen typically lives in warm freshwater – lakes, rivers, ponds, and poorly maintained water bodies. Infection occurs when contaminated water enters the body through the nose, after which the amoeba can travel to the brain, causing rapid tissue destruction. Early symptoms resemble meningitis: fever, headache, nausea, vomiting, progressing swiftly to seizures, hallucinations, and coma.

Kerala authorities are responding: increased water chlorination, awareness campaigns, diagnostic improvements, and advisories to avoid bathing in or using stagnant/unfiltered freshwater. Medical teams are trying combinations of amphotericin B, miltefosine and other drugs, but survival remains rare.