Kerala’s tragedy and resilience: Teen cheats death amid unfolding brain-infection crisis

Kerala is now living through two sharply contrasting medical stories—an extraordinary survival that has entered global medical history, and the grim confirmation of yet another case of amoebic encephalitis in a child, highlighting the scale of the health crisis unfolding in the state.

In what doctors have hailed as a world first, a 17-year-old boy has recovered after simultaneously battling two deadly brain infections: amoebic meningoencephalitis and a fungal invasion by Aspergillus flavus. Both conditions, even on their own, are known to carry a mortality rate of nearly 99 per cent.

The teenager underwent two neurosurgical procedures and endured three months of intensive treatment. His survival was made possible through the timely identification of the pathogens in a district laboratory in Alappuzha and the swift transfer of his care to Thiruvananthapuram Medical College, where surgeons performed critical interventions.

Landmark for global medicine

Health authorities have described his recovery as a landmark not just for Kerala, but for global medicine, since no similar case has previously been documented.

“In the past two years, 86 cases have been reported. Cases are being properly detected in Kerala, which is why more cases are being reported here. There is a clear treatment protocol in place. At present, 22 patients—11 in Thiruvananthapuram and 11 in Kozhikode—are undergoing treatment for amoebic meningoencephalitis,” said Veena George, the state health minister.

“The claim that diagnosis is not possible in Kerala is false propaganda. The presence of amoeba in Kerala’s water sources had been detected years ago. All efforts are being made to identify the source of the disease,” the minister added.

Also read: ‘Brain-eating amoeba’ claims 3 Kerala children’s lives: What is Naegleria fowleri?

Negligible survival rate

Even as this rare triumph brought hope, news emerged from Malappuram that a 10-year-old boy had been diagnosed with amoebic encephalitis and is currently under treatment at Kozhikode Medical College Hospital. The confirmation came on Wednesday (September 3) following detailed testing. This new case brings the state’s total to four within the past two months, reflecting a disturbing rise in incidence.

Over the past eight years, at least 13 people have died in Kerala due to the infection, giving the state the highest concentration of such cases in the country. Globally, the survival rate is negligible, with only a handful of children known to have lived through the disease.

What is amoebic meningoencephalitis?

Amoebic meningoencephalitis, also called primary amoebic meningoencephalitis (PAM), is caused by the brain-eating amoeba Naegleria fowleri. The organism thrives in stagnant and warm freshwater and infects humans when contaminated water enters the nasal passages, from where it travels to the brain. Once there, it destroys brain tissue rapidly, causing swelling, seizures, and, in most cases, death.

Symptoms usually begin within a few days of exposure, starting with severe headache, fever, nausea, and vomiting, before progressing to stiff neck, seizures, loss of consciousness, and memory loss. The disease develops at a frightening pace, often proving fatal within a week or two of onset.

Also read: Kerala: Fourth case of rare brain-eating amoeba infection reported

Tragedy and resilience

Kerala’s experience this year has been marked by both tragedy and resilience. Several children and even an infant have fallen victim to the infection, and yet the state has managed to bring down the otherwise devastating global mortality rate of 97 per cent. Through early detection, the strengthening of laboratory facilities within the state, and the use of aggressive treatment regimes, including imported drugs such as Miltefosine, the fatality rate in Kerala has narrowed to around 50 to 60 per cent.

The government has responded to the surge with a public campaign titled “Water is Life”. It focuses on community awareness, school-based education programmes, and efforts to improve water safety, such as chlorinating household wells and storage tanks. Authorities are repeatedly urging people to remain cautious, especially during the monsoon months when stagnant water sources are most common. Special emphasis is being placed on ensuring that untreated or poorly maintained water sources are not used for bathing or swimming, particularly by children, who have been the most vulnerable victims so far.

Experts blame environmental changes

Health experts have been warning that environmental changes may be playing a decisive role in the rise of cases. Warmer temperatures, stagnant water, and increasing levels of pollution create conditions in which organisms like Naegleria fowleri flourish. They caution that climate change could be intensifying the risks, pointing to the need for preventive efforts that go beyond immediate medical responses.

Kerala’s story is thus unfolding along two starkly different lines. On one hand, the survival of a teenager from two infections that almost always prove fatal demonstrates what timely diagnosis, advanced medical expertise, and coordinated action can achieve. On the other, the state continues to grapple with the relentless spread of amoebic encephalitis, as another child’s diagnosis brings home the urgency of vigilance. The triumph of one case offers hope, but the growing list of new infections is a reminder that the threat is far from over.