Brain-Eating Amoeba: Need for Water Chlorination Stressed

KARACHI, Oct 8: Keeping in view scientific literature and international agencies’ investigations, a meeting of lawmakers, health officials, medical experts, town administrators and representatives of the civil administration, civic agencies and the water board on Monday said that the much-dreaded ‘brain-eating amoeba’ — Naegleria fowleri — was a waterborne organism causing frequent deaths in the city and as such all precautions should be taken while using piped water, particularly during ablutions.

The participants in the emergency meeting convened by the Sindh health department in the wake of at least 10 confirmed Naegleria-related deaths of mostly young people also asked the Karachi Water and Sewerage Board (KWSB) to increase chlorine concentrations in water at its major treatment and pumping stations further so that it had not less than 0.5 parts per million (ppm) when received at the users’ end.

Sindh Health Minister Dr Sagheer Ahmad chaired the meeting, which was informed that Naegleria fowleri causing primary amoebic meningoencephalitis (PAM) had taken lives of 10 people in the city since May 2012.

Although there had been deaths due to Naegleria infection in previous years, EDO Health-Karachi Imdadullah Siddiqui said that data prior to 2012 was not available.

Results of water samples collected from different parts of the city by the quality control and regulation department of the health group offices of the KMC were also shared during the meeting.

According to laboratory results, about 22 per cent of 913 samples, which were drawn from various sources as well as KWSB pumping stations between July and October after reports about Naegleria deaths in the city surfaced, were found to be non-chlorinated or with insufficient quantity of chlorine in it.

Chlorination rate in the samples collected in September was found at around 90 per cent, while in August it was about 70 per cent.

Speaking at a press conference after the meeting, provincial health minister Dr Ahmad said that the participants in the meeting had a thorough discussion and inputs of experts were taken and it was resolved that preventive measures were the only option to tackle the ‘brain-eating’ infection.

“There is no reason to panic and citizens should stay calm and take precautions,” he said, adding that little could be said about the arrival and spread of this infection in the city at the moment but what could be said in the light of already undertaken researches and studies was that it was a waterborne infection.

He said that the water board had already been asked to have a proper surveillance and monitoring of its water system and improve its quality as per internationally practiced norms and methods.

But at the same time, in line with experts’ recommendations it was suggested that people use boiled water for ablutions, particularly for nasal wash, while use chlorine tablets to purify the daily use water at their end, he said.

He said that different committees were being formed to address the situation and increase public and physicians’ awareness of the subject.

During the press conference, KWSB managing director Misbahuddin Farid said that the reason behind the “Naegleria fatalities” in the city was yet to be verified.

However, the KWSB had decided to increase the chlorine concentration at its pumping stations and reservoirs up to 2 ppm, he said. Replying to a question, he said that the KWSB also had sampling of water and found that chlorine concentrations ranged from 0.15 to 0.17 in certain areas, including Federal B Area, which reported a maximum number of deaths due to Naegleria.

The KWSB would ensure water sampling and reporting on a daily basis, as had been decided in the meeting, and would ensure that chlorine concentration in water was not less than 0.5ppm, he said.

He further said that the water board had also approached the PCSIR on the subject and guidance from them. He said that people might mix 2.2 grams of chlorine in 1,000 gallons of water for purification purposes at homes.

He further said that in order to raise the public confidence further in the piped water, the KWSB would start supply of equally treated drinking water, at par with international standards, in all parts of the city in the next two days.