Important factors causing high fatal cases of Naegleria fowleri primary amoebic meningoencephalitis in Pakistan

Karim, Asad Mustafa; Yasir, Muhammad; Ullah, Irfan; Lee, Jung Hun; Lee, Sangeun

doi:10.1016/j.ijid.2020.05.094

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…In addition, contaminated water usually contains other pathogens such as E. coli (51%), Giardia lamblia(27.66%), Enterobacter(64%), Salmonella, Cyclosporin coetaneities, and Clostridium [ [31] , [32] , [33] , [34] ]. In addition, Naegleria fowleri infections are common in Karachi, in 2019 there were 96 confirmed cases (92% males, 8% females) [ 35 ]. Conclusively, these diseases cause harmful effects and unfortunately most people are unaware of the potential risks of using unsafe water for domestic uses such as drinking.…”

Section: Diseasesmentioning

confidence: 99%

Water sanitation problem in Pakistan: A review on disease prevalence, strategies for treatment and prevention

Qamar

Nchasi

Mirha

et al. 2022

Annals of Medicine &Amp; Surgery

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Section: Diseasesmentioning

confidence: 99%

Water sanitation problem in Pakistan: A review on disease prevalence, strategies for treatment and prevention

Qamar

Nchasi

Mirha

et al. 2022

Annals of Medicine &Amp; Surgery

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“…3,4,6 The increasing global warming and higher authorities' negligence towards WHO recommended chlorination (0.1-10 mg/L) of domestic water supply are contributing factors to the higher burden of Naegleria fowleri cases in Karachi, the largest metropolitan city of Pakistan. 5 The new lethal strain of N. fowleri, named as Karachi-NF001, has been found in one patient who travelled from Saudi Arabia to Karachi in 2019. 2 These emerging cases concern strict actions against this problem and the need to alert the Karachi Water and Sewerage Board (KWSB) regarding consistent chlorination from April to October.…”

mentioning

confidence: 99%

“…2 These emerging cases concern strict actions against this problem and the need to alert the Karachi Water and Sewerage Board (KWSB) regarding consistent chlorination from April to October. 5 The monsoon season (May to September) is the best time to spread awareness regarding its prevention and update the current status of N. fowleri in our country. The general public should be encouraged to use boiled or sterilised water for ablution and avoid aquatic activities in nonchlorinated water during the summer season.…”

mentioning

confidence: 99%

Naegleria fowleri in 2023: A rising threat to Pakistan

Varsha,

Dev Kumar,

Hersha

2024

J Pak Med Assoc

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Madam, Naegleria fowleri, i.e., brain-eating amoeba, is a single-cell, free-living parasite that resides in soil and warm freshwater bodies such as lakes, rivers, and hot springs. It enters the nasal cavity from contaminated water, uses the olfactory nerve to reach the brain, and causes a deadly infection called primary amoebic meningoencephalitis (PAM), with a mortality rate higher than 97% even with treatment. (1,2) It causes symptoms similar to those of other bacterial and viral meningitis, such as fever, headache, vomiting, altered level of consciousness and coma, followed by death in the span of a week to 10 days. (1) There are 20 strains of Naegleria world worldwide, but only N. fowleri is dangerous to humans. (1) In 2008, the first case was reported from Karachi, Pakistan. (2) By 2019, the number had reached 146, (2) and the cases have been increasing until now. In 2023, eight cases have been reported from May to August, among which seven are from the province of Sindh and one from Punjab. (3, 4, 6) The available data shows that two deaths were due to recreational water activities and others because of contaminated tap water.(3,4) This pathogenic amoeba commonly infects men, and the majority of cases were in people aged 26 to 45 years.(1) Of all the reported cases this year, one was a 32-year-old female, and seven were males in the aged 19-45 years.(3,4, 6) The increasing global warming and higher authorities’ negligence towards WHO recommended chlorination (0.1-10 mg/L) of domestic water supply are contributing factors to the higher burden of Naegleria fowleri cases in Karachi, the largest metropolitan city of Pakistan .(5) The new lethal strain of N. fowleri, named as Karachi-NF001, has been found in one patient who traveled from Saudi Arabia to Karachi in 2019. (2) These emerging cases concern strict actions against this problem and the need to alert the Karachi Water and Sewerage Board (KWSB) regarding consistent chlorination from April to October. (5) The monsoon season (May to September) is the best time to spread awareness regarding its prevention and update the current status of N. fowleri in our country. The general public should be encouraged to use boiled or sterilised water for ablution and avoid aquatic activities in non-chlorinated water during the summer season. (3) Besides that, all underground and overhead water tanks in homes, hospitals, shopping malls, schools, offices, etc. should be cleaned once a year. (3)

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Isolation and identification of potentially pathogenic free-living amoeba in dialysis fluid samples of hydraulic systems in hemodialysis units

Biglarnia

Solhjoo

Rezanezhad

et al. 2021

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Background Free-living amoeba (FLA), including Acanthamoeba, Naegleria, Balamuthia and Vermamoeba, have been isolated from water, sand, soil, dust and air. Numerous studies considered that FLA are a significant cause of neurological and ocular complications in high-risk groups, including immunocompromised individuals. The present study aimed to identify morphological and molecular characteristics of FLA isolates in dialysis fluid samples of hydraulic systems in hemodialysis units in Iran. Methods A total of 328 dialysis fluid samples were collected from 16 dialysis machines, including 164 samples before hemodialysis sessions (after cleaning) and 164 samples after hemodialysis sessions (before cleaning). Filtration and cultivation were performed on non-nutrient agar medium. Also, PCR and sequencing were applied by using the genus-specific primers along with a common primer set on positive samples. Results Both morphology and molecular investigations showed that 22.5% (74/328) of dialysis fluid samples were positive for FLA. There was a positive relationship between the high frequency of FLA after hemodialysis sessions (before cleaning) compared with before hemodialysis sessions (after cleaning) (OR=2.86; 95% CI 1.5 to 5.45). Considering the PCR assay, 16.46% (54/328) samples were identified as Acanthamoeba spp. (belonging to T3 and T4 genotypes), 5.18% (17/328) as Vermamoeba vermiformis and 0.91% (3/328) as Vahlkampfiidae family (Naegleria australiensis, Naegleria pagei and Allovahlkampfia). Conclusion The present results support a need to improve filtration and purification methods for dialysis fluid of hydraulic systems in hemodialysis units. They also highlight the relevance of periodic screenings for FLA-related diseases in hemodialysis patients.

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Important factors causing high fatal cases of Naegleria fowleri primary amoebic meningoencephalitis in Pakistan

Cited by 3 publications

References 6 publications

Water sanitation problem in Pakistan: A review on disease prevalence, strategies for treatment and prevention

Water sanitation problem in Pakistan: A review on disease prevalence, strategies for treatment and prevention

Naegleria fowleri in 2023: A rising threat to Pakistan

Isolation and identification of potentially pathogenic free-living amoeba in dialysis fluid samples of hydraulic systems in hemodialysis units

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