A Medical Board has been constituted for the treatment of patients afflicted with Amoebic Meningoencephalitis (brain fever), a rare but lethal central nervous system infection caused by free-living amoebae in freshwater, lakes, and rivers. Seven in Thiruvananthapuram have tested positive for the infection. One of them, Akhil, 27, had died on July 23. The infection is not contagious.

Four under treatment at the special ICU in Thiruvananthapuram Medical College - Aneesh, Achu, Hareesh, and Dhanush - are Akhil's friends. Six of the infected seven, including Akhil, are from Kannaravila village in Neyyatinkara Taluk, Thiruvananthapuram. Two from Kannaravaila - Sajeev, 26, and Aji, 25 - had tested positive on August 6. 

It is presumed that all six from Kannaravila had contracted the infection from a moss-infested public pond (Kaavinkulam) in the village. The disease-bearing amoebae, according to Health Department officials, is found in water bodies like ponds, rivers, lakes, and even swimming pools that are moss-infested, unclean and used for bathing animals. It is said that the victims could have been infected whey they swam, or took a dive, in the Kannaravila pond. 

The amoeba would have entered the body through the ears and mouth while swimming. The amoebae that live in the sludge at the bottom of the water body is kicked up when the bed is disturbed by divers and swimmers. These protozoans that are thus sent floating up in the water then enters human bodies through ears, nose and mouth.  

However, confusing health experts, the sample taken from the pond did not throw up traces of the amoeba. So the water samples have been collected once again and sent for further analysis.

The seventh patient, V Nijith, 37, has thrown up a bigger mystery. A driver by profession, Vijith hails from Peroorkada, some 25 kilometres from Neyyatinkara. He has not taken a dip in unclean ponds like the others. His relatives have told doctors that he had never taken a dip in public ponds or rivers. On August 2, Nijith fell unconscious after a sudden seizure. 

Doctors say that the amoebae could have entered his body while washing his face, rinsing his mouth, or irrigating his nose with water from a pipe that could have been fed by a water body contaminated by the protozoans.

The other source of Nijith's infection could be the well in his house. Nijith had reportedly gone down the well to clean it. The contamination could have happened while sloshing around at the bottom of the well. The water from Nijith's well has also been sent for analysis. 

People in the area who use the pond that feeds wells in Nijith's area have also been put under surveillance. Anyone with headache, stiffness of the neck, fever, and nausea has been asked to seek medical help immediately. At Kannaravila, 33 people who had come into contact with the public pond have been identified and have been put under close watch. 

As per the standard operation procedure (SOP) drawn up for the disease, it is a combination of five medicines that have been used for treatment. There is an adequate supply of all the medicines, Health Department official said. Further, Health Minister Veena George has instructed the Kerala Medical Services Corporation (KMSCL) managing director to stock more supplies. 

The Health Department has warned people, especially those with wounded ears, against bathing in stagnant pools. It has also issued reminders to local bodies and private organisations to chlorinate swimming pools owned by them.