A rise in cases of a rare yet deadly form of encephalitis has prompted health authorities in Kerala, India, to heighten surveillance and expand testing, calling it a significant public health concern. Since January, the state has recorded about 69 infections of primary amoebic meningoencephalitis (PAM) and 19 related deaths, caused by Naegleria fowleri—commonly referred to as the “brain-eating” amoeba—according to Kerala’s health minister, Veena George, who addressed the state assembly on Wednesday (Sept 17). Three of these deaths, including that of a three-month-old infant, occurred in the past month.

George noted that unlike the previous year, cases are not clustering around specific water sources but appearing as isolated incidents, complicating investigations. Kerala had reported 36 PAM cases and nine deaths last year, NDTV reported. A government document described amoebic encephalitis as a rare, often fatal infection of the central nervous system caused by free-living amoebae present in freshwater bodies such as lakes and rivers. In Kerala, the infections have been specifically linked to Naegleria fowleri.

To contain the spread, authorities have started chlorinating wells, water tanks, and public bathing areas. Globally, PAM has a survival rate of only around 3%, but Kerala has achieved a 24% rate through improved testing and faster diagnosis, George said. The government also warned that rising water temperatures due to climate change, coupled with more people seeking relief in recreational waters, could increase the risk of exposure to the pathogen.