FIRST INFECTION DEATH FROM BRAIN-EATING AMOEBA IN SOUTH KOREA

The man in his 50s came back to Korea on December 10 after a four-month stay in the Southeast Asian country and was admitted to a hospital the next day. He died on Tuesday last week, reports Yonhap news agency. This is the first known infection from the disease in the country, which was first reported in the United States in 1937.

The KDCA said the odds of human-to-human transmission of Naegleria fowleri are low but asked local residents to refrain from swimming in the areas where the disease has broken out. A total of 381 Naegleria fowleri cases have been reported as of 2018 in the world including in the US, India, and Thailand.

Naegleria fowleri ( also known as brain-eating amoeba) is a free-living amoeba (a single-celled living organism). It is so small that it can only be seen with a microscope. The amoeba is inhaled through the nose and travels to the brain to destroy brain tissue.

Naegleria fowleri infects people when water containing the ameba enters the body through the nose. This typically happens when people go swimming or diving, or when they put their heads under fresh water, like in lakes and rivers, using contaminated tap water to cleanse their noses during religious practices. The ameba then travels up the nose to the brain, where it destroys the brain tissue and causes a devastating infection called primary amebic meningoencephalitis (PAM).

The amoeba can be found in- Warm fresh water, such as lakes and rivers, Geothermal (naturally hot) water, such as hot springs, Warm water discharge from industrial or power plants, Untreated geothermal (naturally hot) drinking water sources, Swimming pools, splash pads, surf parks, or other recreational venues that are poorly maintained or don’t have enough chlorine in them, Tap water, Water heaters, Soil, including sediment at the bottom of lakes, ponds, and rivers. Naegleria fowleri is not found in salt water, like the ocean.

When amoeba enters the body it takes around 2 to 15 days for symptoms to appear. Whereas, death usually occurs 3 to 7 days after the symptoms appear. Some symptoms include- Headache, Fever, Stiff neck, Coma, Vomiting, Loss of taste, Blurred vision, Loss of appetite, Hallucinations, and Seizures.

Since Naegleria fowleri infects people when water containing the ameba enters the body through the nose, it is critical to prevent water from going up the nose- Hold your nose shut, use nose clips, or keep your head above water when in bodies of warm freshwater, Do not allow water to go up your nose or sniff water into your nose when bathing, showering, washing your face, or swimming in small hard plastic/blow-up pools, Do not allow children to play unsupervised with hoses or sprinklers, as they may accidentally squirt water up their nose. Avoid slip-n-slides or other activities where it is difficult to prevent water from going up the nose.

The core antimicrobial treatment consists of the antifungal drug amphotericin B, which inhibits the pathogen by binding to its cell membrane sterols, thus leading to cell membrane disruption and pathogen death; However, even with this treatment, the fatality rate is greater than 95%. New treatments are being sought. Miltefosine, an antiparasitic drug that inhibits the pathogen via disrupting its cell survival signal pathway PI3K/Akt/mTOR, has been used in a few cases with mixed results.