Brain-eating amoeba: Why Karnataka has warned pilgrims visiting Sabarimala

Kerala's sharp rise in Naegleria fowleri infections has led Karnataka to caution Sabarimala pilgrims, urging awareness of symptoms, risks, water-safety measures to prevent the highly fatal infection

Kerala’s rising cases of the deadly “brain-eating amoeba” Naegleria fowleri have prompted Karnataka to issue a fresh safety advisory for Sabarimala pilgrims. The advisory from the Commissionerate of Health and Family Welfare Services warns devotees to be cautious around warm, stagnant freshwater, where the amoeba is commonly found.  Health officials say the infection, though rare, is highly fatal. As thousands prepare for the Sabarimala Yatra, which will take place between mid-November and mid-January, Karnataka authorities are urging pilgrims to understand the risks, recognise early symptoms and take precautions.

 

Naegleria fowleri is a free-living amoeba found naturally in warm freshwater like ponds, lakes, stagnant pools, poorly maintained swimming pools and even some natural water bodies like hot springs. It does not spread from person to person, and drinking contaminated water does not cause infection. It is spread when contaminated water enters the nasal cavity when people swim or submerge their heads in warm freshwater.

 

When inhaled, the microbe can travel along the nasal passages and reach the brain, causing primary amoebic meningoencephalitis (PAM), a rare but extremely aggressive infection that destroys brain tissue. According to the US Centers for Disease Control and Prevention, the infection is highly fatal, and death usually occurs within 5 days (range 1 to 18 days) of the start of symptoms.

Why has Karnataka issued an advisory for Sabarimala pilgrims?

Kerala has reported a notable spike in PAM cases this year, with around 69 infections and 19 deaths so far, including children as young as three months. While Karnataka has not reported any cases, the state sees high inter-state pilgrim traffic during the Sabarimala season. This proximity, combined with ritual bathing practices, prompted authorities to release a precautionary advisory.

 

Officials describe Naegleria fowleri as “highly virulent”, especially in warm, stagnant water sources that pilgrims may encounter en route. 

What symptoms should pilgrims watch for?

Health officials urge anyone who has been in freshwater within the past seven days and develops the following symptoms to seek emergency care immediately:

• Sudden high fever
• Severe headache
• Nausea or vomiting
• Stiff neck
• Confusion, irritability or unusual behaviour
• Altered mental status or drowsiness

These early signs can mimic viral meningitis, which is why rapid medical attention is critical.

How can pilgrims protect themselves from the amoeba?

The advisory includes the following precautions:

• Use nose clips or hold your nose firmly shut when entering natural water.
• Avoid dipping your head in ponds, lakes or stagnant water bodies.
• Do not swim in warm, still freshwater during the Yatra.
• Choose running water over stagnant pools for ritual cleansing whenever possible.
• If any symptom appears within a week of water exposure, visit the nearest government hospital without delay.

 

Kerala authorities have already begun chlorinating public wells and water bodies as an added preventive measure.