Increasing cases of Naegleria fowleri during the time of COVID 19; an emerging concern of Pakistan

Tabassum, Shehroze; Naeem, Aroma; Gill, Saima; Mumtaz, Nimra; Khan, Maleeka Zamurad; Tabassum, Shehram; Naeem, Risha; Mukherjee, Dattatreya

doi:10.1016/j.ijsu.2022.106881

Cited by 15 publications

(13 citation statements)

References 9 publications

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“…This is in line with previous reports from the USA using data from 1978 until 2018, in which the incidence of PAM associated with water activities ranged between 0 and 6 cases per year (n = 85 cases in total; [ 43 ]). However, certain geographical areas may possess a slightly higher risk for transmission to occur, as evidenced by four more cases in 2022 reported in Pakistan alone [ 44 ]. Regardless of transmissibility, measuring the true burden of the infection remains difficult, as highlighted in previous papers that concluded that officially reported cases are typically an underestimation [ 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Brain-Eating Amoeba: A Decade Update

Zamzuri

Majid

Mihat

et al. 2023

IJERPH

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Introduction: Primary amoebic meningoencephalitis (PAM) is a rare but lethal infection of the brain caused by a eukaryote called Naegleria fowleri (N. fowleri). The aim of this review is to consolidate the recently published case reports of N. fowleri infection by describing its epidemiology and clinical features with the goal of ultimately disseminating this information to healthcare personnel. Methods: A comprehensive literature search was carried out using PubMed, Web of Science, Scopus, and OVID databases until 31 December 2022 by two independent reviewers. All studies from the year 2013 were extracted, and quality assessments were carried out meticulously prior to their inclusion in the final analysis. Results: A total of 21 studies were selected for qualitative analyses out of the 461 studies extracted. The cases were distributed globally, and 72.7% of the cases succumbed to mortality. The youngest case was an 11-day-old boy, while the eldest was a 75-year-old. Significant exposure to freshwater either from recreational activities or from a habit of irrigating the nostrils preceded onset. The symptoms at early presentation included fever, headache, and vomiting, while late sequalae showed neurological manifestation. An accurate diagnosis remains a challenge, as the symptoms mimic bacterial meningitis. Confirmatory tests include the direct visualisation of the amoeba or the use of the polymerase chain reaction method. Conclusions: N. fowleri infection is rare but leads to PAM. Its occurrence is worldwide with a significant risk of fatality. The suggested probable case definition based on the findings is the acute onset of fever, headache, and vomiting with meningeal symptoms following exposure to freshwater within the previous 14 days. Continuous health promotion and health education activities for the public can help to improve knowledge and awareness prior to engagement in freshwater activities.

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Section: Discussionmentioning

confidence: 99%

Systematic Review of Brain-Eating Amoeba: A Decade Update

Zamzuri

Majid

Mihat

et al. 2023

IJERPH

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“… 37 There is also a high risk of the emergence of a Congo fever outbreak yet again in Pakistan in the flood‐affected areas due to contact with the blood and body fluids of affected livestock which will make the situation worse for flood‐affected people and overburden the healthcare system. 37 Since the outbreak of cholera 38 and N. fowleri 39 has already been recorded in Pakistan in this year, authorities are worried about another Congo fever outbreak amidst these floods.…”

Section: Congo Fever In the Context Of Recent Floods In Pakistanmentioning

confidence: 99%

Crimean‐Congo hemorrhagic fever outbreak in Pakistan, 2022: A warning bell amidst unprecedented floods and COVID 19 pandemic

Tabassum

Naeem

Khan

et al. 2023

Health Science Reports

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Crimean‐Congo hemorrhagic fever (CCHF) is an infection caused by a tick‐borne virus (genus: Nairovirus, family: Bunyaviridae). The most important vector for CCHF is the ixodid tick. Along with tick bite, direct contact with the virus‐affected animal is responsible for its spread. Pakistan witnessed its first case of CCHF in 1976 and has been a major victim of CCHF for years, but spikes in cases are seen after Eid‐ul‐Adha, an Islamic festival involving the sacrifice of cattle. The disease, in particular, is common among butchers, veterinarians, and livestock workers. From the start of this year till June 22, 2022, a total of four cases have been reported across the country. Pakistan faces major challenges in combating CCHF every year due to its specific geographical position and a majority of the population being involved with animal husbandry. There is no approved vaccine for its prevention. All these factors contribute to the burden on the already weakened healthcare system of Pakistan. Strict actions should be taken to contain the spread of the disease. The need of the hour is to engage the general population, raise awareness, and develop policies to ensure disease surveillance. This should be accompanied by fostering collaboration among animal and human health departments for efficient communication and early intervention. The focus should be on medical research to find an efficacious treatment and prophylaxis for the CCHF virus, which will be the cornerstone of future CCHF prevention and control strategies.

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“…Case reports have suggested a possible expansion of the worldwide geographic distribution of reported PAM and GAE cases, as cases have been reported for the first time in several countries including South Africa and Italy [21][22][23][24]. However, it remains unclear whether this represents a true change in the locations where these diseases can occur or rather may be attributed to increased awareness and improved diagnostic capabilities.…”

Section: Free-living Amebae Worldwidementioning

confidence: 99%

Amebic encephalitis and meningoencephalitis: an update on epidemiology, diagnostic methods, and treatment

Haston

Cope

2023

Current Opinion in Infectious Diseases

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Purpose of reviewFree-living amebae (FLA) including Naegleria fowleri, Balamuthia mandrillaris, and Acanthamoeba species can cause rare, yet severe infections that are nearly always fatal. This review describes recent developments in epidemiology, diagnosis, and treatment of amebic meningoencephalitis. Recent findingsDespite similarities among the three pathogenic FLA, there are notable variations in disease presentations, routes of transmission, populations at risk, and outcomes for each. Recently, molecular diagnostic tools have been used to diagnose a greater number of FLA infections. Treatment regimens for FLA have historically relied on survivor reports; more data is needed about novel treatments, including nitroxoline. SummaryResearch to identify new drugs and guide treatment regimens for amebic meningoencephalitis is lacking. However, improved diagnostic capabilities may lead to earlier diagnoses, allowing earlier treatment initiation and improved outcomes. Public health practitioners should continue to prioritize increasing awareness and providing education to clinicians, laboratorians, and the public about amebic infections. Keywords amebic meningoencephalitis, encephalitis, free-living ameba &&]. PAM is a rapidly progressive disease acquired when water containing the ameba enters the nose allowing the amebae to travel to the brain, causing diffuse inflammation, cerebral edema, and ultimately, herniation. Initial signs and symptoms can include fever, headache, vomiting, and meningismus, and progresses to death in a median of 5 days. It most commonly occurs in healthy adolescent male individuals in warm, summer months. GAE, in contrast, is more common among adults, has a more insidious onset and course, and likely results from hematogenous spread of amebae to the brain after exposure through inhalation or skin exposure. GAE can present with fever, headache, altered mental status, or seizures, and progresses over weeks to months. The recommended treatment

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Increasing cases of Naegleria fowleri during the time of COVID 19; an emerging concern of Pakistan

Cited by 15 publications

References 9 publications

Systematic Review of Brain-Eating Amoeba: A Decade Update

Systematic Review of Brain-Eating Amoeba: A Decade Update

Crimean‐Congo hemorrhagic fever outbreak in Pakistan, 2022: A warning bell amidst unprecedented floods and COVID 19 pandemic

Amebic encephalitis and meningoencephalitis: an update on epidemiology, diagnostic methods, and treatment

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