Foreign News
Battling a rare brain-eating disease in an Indian state
On the eve of Onam, the most joyous festival in India’s Kerala state, 45-year-old Sobhana lay shivering in the back of an ambulance, drifting into unconsciousness as her family rushed her to a medical college hospital.
Just days earlier, the Dalit (formerly known as untouchables) woman, who earned her living bottling fruit juices in a village in Malappuram district, had complained of nothing more alarming than dizziness and high blood pressure. Doctors prescribed pills and sent her home. But her condition spiralled with terrifying speed: uneasiness gave way to fever, fever to violent shivers, and on 5 September – the main day of the festival – Sobhana was dead.
The culprit was Naegleria fowleri – commonly known as the brain-eating amoeba – an infection usually contracted through the nose in freshwater and so rare that most doctors never encounter a case in their entire careers. “We were powerless to stop it. We learnt about the disease only after Sobhana’s death,” says Ajitha Kathiradath, a cousin of the victim and a prominent social worker.
In Kerala this year, more than 70 people have been diagnosed and 19 have died from the brain-eating amoeba. Patients have ranged from a three-month-old to a 92-year-old man.
Normally feeding on bacteria in warm freshwater, this single-cell organism causes a near-fatal brain infection, known as primary amoebic meningoencephalitis (PAM). It enters through the nose during swimming and rapidly destroys brain tissue.
Kerala began detecting cases in 2016, just one or two a year, and until recently nearly all were fatal. A new study has found only 488 cases have been reported globally since 1962 – mostly in the US, Pakistan and Australia. And 95% of the victims have died from the disease.
But in Kerala, survival appears to be improving: last year there were 39 cases with a 23% fatality rate and this year, nearly 70 cases have been reported with about 24.5% mortality. Doctors say the rise in numbers reflects better detection, thanks to state-of-the-art labs.
“Cases are rising but deaths are falling. Aggressive testing and early diagnosis have improved survival – a strategy unique to Kerala,” said Aravind Reghukumar, head of infectious diseases at the Medical College and Hospital in Thiruvananthapuram, the state’s capital. Early detection allows customised treatment: a drug cocktail of antimicrobials and steroids targeting the amoeba can save lives.
Scientists have identified around 400 species of free-living amoebae, but only six are known to cause disease in humans – including Naegleria fowleri and Acanthamoeba, both of which can infect the brain. In Kerala, public health laboratories can now detect the five major pathogenic types, officials say.
The southern state’s heavy reliance on groundwater and natural water bodies makes it particularly vulnerable, especially as many ponds and wells are polluted. A small cluster of cases last year, for example, was linked to young men vaping boiled cannabis mixed with pond water – a risky practice that underscores how contaminated water can become a conduit for infection.
Kerala has nearly 5.5 million wells and 55,000 ponds – and millions draw their daily water from wells alone. That sheer ubiquity makes it impossible to treat wells or ponds as simple “risk factors” – they are the backbone of life in the state.
“Some infections have occurred in people bathing in ponds, others from swimming pools, and even through nasal rinsing with water which is a religious ritual. Whether in a polluted pond or a well, the risk is real,” says Anish TS, a leading epidemiologist.
So public health authorities have tried to respond at scale: in a single campaign at the end of August, 2.7 million wells were chlorinated.
Local governments have put up sign boards around ponds warning against bathing or swimming and evoked the Public Health Act to enforce regular chlorination of swimming pools and water tanks. But even with such measures, ponds cannot realistically be chlorinated – fish would die – and policing every village water source in a state of more than 30 million people is unworkable.
Officials now stress awareness over prohibition: households are urged to clean tanks and pools, use clean warm water for nasal ablutions, keep children away from garden sprinklers and avoid unsafe ponds. Swimmers are advised to protect their noses by keeping their heads above water, using nose plugs and avoiding stirring up sediment in stagnant or untreated freshwater.
Yet, striking a balance between educating the public about real risks – of using untreated freshwater – and avoiding fear that could disrupt daily life is challenging. Many say despite guidelines issued for more than a year, enforcement remains patchy.
“This is a difficult problem. In some places [hot springs], signs are posted to warn of the possibility of the amoebae in the water source. This is not practical in most situations since the amoebae can be present in any source of untreated water [lakes, ponds, pools],” Dennis Kyle, a professor of infectious diseases and cellular biology at the University of Georgia, told the BBC.
“In more controlled environments, frequent monitoring for proper chlorination can significantly reduce chances of infection. These include pools, splash pads and other man-made recreational water activities,” he said.
Scientists warn climate change is amplifying the risk: warmer waters, longer summers and rising temperatures create ideal conditions for the amoeba. “Even a 1C rise can trigger its spread in Kerala’s tropical climate and water pollution fuels it further by feeding bacteria the amoeba consumes,” says Prof Anish.
Dr Kyle adds a note of caution, noting that some past cases may simply have gone unrecognised, with the amoeba not identified as the cause.
That uncertainty can make treatment even harder. Current drug cocktails are “sub-optimal,” Dr Kyle explains, adding that in rare survivors, the regimen becomes the standard. “We lack sufficient data to determine if all the drugs are actually helpful or needed.”
Kerala may be catching more patients and saving more lives, but the lesson reaches far beyond its borders. Climate change may be rewriting the map of disease – and even the rarest pathogens may not stay rare for long.
[BBC]
The Philippine Coast Guard says it has recovered 41 bodies from the wreckage of a ferry that caught fire this week, bringing the total death toll to 76.
More than 130 people were on board the MV June Aster when the blaze erupted on Wednesday as it neared its destination at the tourist hotspot of Coron, after departing from Manila.
The coast guard said on Saturday the number of survivors remained 43, with many receiving treatment in hospital, but 13 people remain unaccounted for.
Recovery of bodies had been hampered due to toxic fumes and lingering heat, which meant authorities were unable to board until Friday.
Geronimo Tuvilla, an official for the Philippine Coast Guard, said the priority was identifying victims and determining the cause of the blaze.
Kristine Ablana, a tourism official in Coron, said relatives were being asked to help identify family members through personal items and DNA testing.
“Once someone is able to verify that this photo or these belongings are indeed those of their relative, they will be asked to provide a DNA sample,” she said.
Coast Guard spokesperson Commodore Noemie Cayabyab said the fire began in a cargo hold before spreading.
She said survivors had described hearing a loud explosion, “the appearance of smoke and then fire. It spread very quickly”. She added that those who had made it off the ship did not have time to put on lifejackets.
A survivor who was hauled to safety on a rescue boat told the BBC he had heard frantic cries onboard when the fire erupted, and was trampled by panicked people as he tried to escape.
The ferry, built in 2002, held valid safety certificates and passed an enforcement inspection in March, but investigators are looking into potential manifest discrepancies, cargo loading integrity, and crew emergency response protocols, the Palawan Daily reported.
The vessel was carrying 117 passengers and 17 crew members.
Atienza Interisland Ferries, the vessel’s operator, has pledged full co-operation with the inquiry.
[BBC]
A dress worn by Princess Diana to a party in London hours after a documentary was televised in which the then-Prince Charles admitted to committing adultery during their marriage is going up for auction.
Her dramatic arrival at the Serpentine Gallery in 1994 in a custom-made black silk evening dress by designer Christina Stambolian became an iconic pop-culture moment.
The media dubbed her outfit the “revenge dress”.
Auction house Sotheby’s expects the dress to sell for up to £220,000 ($300,000) when it goes under the hammer on 9 December.
A press release from Sotheby’s said it is the first time the dress has been offered at auction since 1997, when the late princess sold 79 of her dresses to raise money for charities.
Morgane Halimi, Sotheby’s Global Head of Handbags and Fashion, said in a statement that Princess Diana “understood instinctively” that fashion can be a language in its own right.
“On her own terms, Princess Diana turned the dress into one of the most powerful messages she ever made, during one of the most scrutinised and emotionally charged episodes of her life,” Halimi said.
“She walked into a moment in which so much of her story was being told for her and, through what she chose to wear, reclaimed the narrative for herself.”
According to Sotheby’s, Anna Harvey, her stylist at the time, said Diana “wanted to look a million dollars”.
The princess made a last-minute wardrobe change for the fundraising dinner and chose the strapless evening dress by the Greek designer Christina Stambolian – which she accessorised with a royal jewel, a black clutch and black heels.
The vintage Jaguar XJ40 car that Diana arrived in at the event was sold at auction earlier this year for £66,250.
The revenge dress is expected to fetch a considerably higher price.
If it does, it will not be the first time an item from the princess’s wardrobe has sold for a significant sum.
Princess Diana’s sweater featuring a black sheep among rows of white ones was sold for £920,000 at an auction by Sotheby’s in New York in 2023.
[BBC]
A Pakistan Under-19 cricket team suddenly became the centre of focus when it was mistaken for a group of asylum seekers in Portsmouth. A group of protesters gathered outside the Marriott Hotel in Portsmouth after reports that asylum seekers were staying there. The situation had to be later diffused when it was ascertained that the hotel was hosting the Pakistan Under-19 team.
According to the Guardian, the situation became tense when a crowd gathered outside the Marriott hotel after reports that about 40 men who did not seem to be English arrived at the hotel. George Madgwick, a Reform councillor, called the hotel to mediate between the Pakistan Under-19 staff and the assembled crowd, following which the crowd dispersed.
“I spoke to the coach of the team, who was very understanding,” Madgwick told the Guardian. “I went out to the protesters and told them, ‘You’ve got it wrong guys, it’s a cricket club.’ They left within a couple of minutes. It was a massively unfortunate incident.
“From the perspective of the people of Portsmouth who are already on high alert, this was a coach from the same company which was turning up with about 40 foreign men.”
The ECB has been in touch with the Pakistan management following the incident and is reviewing security arrangements.
The Pakistan Under-19 team played a four-day game against England Under-19 in Arundel from September 2 to 5, which they lost by ten runs. The two teams faced off in a Youth ODI on September 9, with Pakistan winning by 177 runs. Pakistan’s senior men’s team are also playing the third and final Test against England at Edgbaston.
[Cricinfo]
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