With more cases of amoebic meningoencephalitis surfacing in the State, the Health department has given the directive to all clinicians that cerebrospinal fluid samples of all patients suspected to be having meningitis be tested for amoebic meningoencephalitis.

At a meeting of the State Rapid Response Team held here on Monday, it was pointed out that Kerala had already proved that even in the case of a disease with a high mortality as amoebic meningoencephalitis, early diagnosis and treatment can save lives. In the recent weeks, 10 persons admitted at Thiruvananthapuram Medical College with the disease had been managed well, so that the mortality was sharply brought down.

Hence, even if the number of amoebic meningoencephalitis cases go up, every case can be treated and cured, Health officials said.

Health Minister Veena George who chaired the RRT meeting said that all drugs for treating amoebic encephalitis, including a steady supply of Miltefosin, which was found to give the most positive response, will be ensured so that all cases can be managed well.

Meanwhile, even though the new crop of amoebic meningoencephalitis cases in the State are suspected to be due to Acanthamoeba spp., a type of free living amoeba (FLA) found everywhere in the environment including in the air, water and soil and not due to Naegleria fowleri ( which is deadly and primarily associated with contact to contaminated water bodies), the IEC (information-education-awareness) regarding this species change will be confined to clinicians, a senior Health official said.

“Our early cases of amoebic meningoencephalitis were due to the highly lethal Naegleria fowleri, or the “brain-eating amoeba”, which is clearly associated with contact with water bodies. Our IEC was thus focussed on making people aware about the dangers of entering water bodies in the neighborhood because infection with N. fowleri is fast-progressing, with little room for clinical interventions. However, Acanthamoeba is a ubiquitous organism and it is impossible to pinpoint a source of infection or to suggest any preventive measures. Hence our advisory this time is only for the clinicians, so that they are alert to the possibility that any meningitis case could be due to a FLA. At this point, we are still unsure how to explain this learning to the general public, without creating a major scare,” he added.

The Health department has already initiated steps to take up detailed research studies as well as environmental studies on the spurt in meningoencephalitis cases caused by FLA, rooted on the One Health platform.

Indian Council of Medical Research, Institute of Advanced Virology , AV Institute in Pondicherry, the Indian Institute of Science in Bangalore and the Pollution Control Board have been roped in for the research studies which will be initiated soon.

The State RRT meeting was attended by the Additional Chief Secretary (Health), State Mission Director of National Health Mission, Director of Health Services and senior Health officials.