Eleven children have died of primary amoebic meningoencephalitis (PAM) in Kerala since 2016 across six districts, according to the latest figures presented in the assembly by the Health Minister. The disease was reported in 2016, 2019, 2020, 2023 and 2024.

The highest number of child fatalities due to PAM was reported in Malappuram, with five cases recorded—one death in 2019, followed by two deaths in Malappuram in 2020 and 2024.

Kerala reported as many as 27 PAM cases in 2024 until the first week of October. Seventeen cases were confirmed in Thiruvananthapuram, and others were reported in Kozhikode, Thrissur, Kannur, Malappuram, and Palakkad.

Six PAM deaths were reported in the state this year. Health Minister Veena George said that Kerala was able to bring down the mortality rate of PAM in the state to 26 per cent owing to proper interventions like preventive measures, awareness and treatment protocol. The Government has also ensured the availability of the medicine Miltefosin, which has a 97 per cent mortality rate in treating PAM. 

PAM is an exceptionally uncommon occurrence resulting from CNS (central nervous system) invasion of the host by N fowleri. In a period of a few days to two weeks after inoculating a patient who had been swimming, diving, bathing, or playing in warm, usually stagnant, freshwater, the amoebae migrate through the cribriform plate, along the fila olfactoria and blood vessels and into the anterior cerebral fossae, where they cause extensive inflammation, necrosis, and haemorrhage in the brain parenchyma and meninges, according to the state health department. 

Kollam recently reported that the first case of PAM is a 10-year-old boy from Nadutheri, Thalavoor, in Kollam. Health officials are currently investigating another suspected PAM case at Nedumbana in Kollam. An eight-year-old child is being treated at SAT, Thiruvananthapuram.