Primary Amebic Meningoencephalitis, Pakistan | CDC EID

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Volume 17, Number 2–February 2011
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Primary Amebic Meningoencephalitis Caused by Naegleria fowleri, Karachi, Pakistan
Sadia Shakoor, Mohammad Asim Beg, Syed Faisal Mahmood, Rebecca Bandea, Rama Sriram, Fatima Noman, Farheen Ali, Govinda S. Visvesvara, and Afia Zafar

Author affiliations: Aga Khan University Hospital, Karachi, Pakistan (S. Shakoor, M.A. Beg, S.F. Mahmood, F. Ali, A. Zafar); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (R. Bandea, R. Sriram, G.S. Visvesvara); and Liaquat National Hospital, Karachi (F. Noman)

Suggested citation for this article

Abstract
We report 13 cases of Naegleria fowleri primary amebic meningoencephalitis in persons in Karachi, Pakistan, who had no history of aquatic activities. Infection likely occurred through ablution with tap water. An increase in primary amebic meningoencephalitis cases may be attributed to rising temperatures, reduced levels of chlorine in potable water, or deteriorating water distribution systems.

Primary amebic meningoencephalitis (PAM) is a fatal disease caused by the thermotolerant free-living ameba Naegleria fowleri. Found worldwide in moist soil and freshwater, these amebae proliferate during summer when ambient temperature increases. The organism enters the nasal cavity when water contaminated with amebae is aspirated. Subsequently, it invades the central nervous system through the olfactory neuroepithelium and causes a fatal infection that clinically resembles acute bacterial meningitis. We report 13 cases of N. fowleri PAM in a period of 17 months in the coastal city of Karachi, Pakistan.

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Primary Amebic Meningoencephalitis, Pakistan | CDC EID


Suggested Citation for this Article
Shakoor S, Beg MA, Mahmood SF, Bandea R, Sriram R, Noman F, et al. Primary amebic meningoencephalitis caused by Naegleria fowleri, Karachi, Pakistan. Emerg Infect Dis [serial on the Internet]. 2011 Feb [date cited]. http://www.cdc.gov/EID/content/17/2/258.htm

DOI: 10.3201/eid1702.100442


Comments to the Authors
Please use the form below to submit correspondence to the authors or contact them at the following address:

Syed Faisal Mahmood, Department of Medicine, Aga Khan University Hospital, Karachi 75800, Pakistan; email: faisal.mahmood@aku.edu