Naegleria Fowleri is Eating Brains of Our People: Are we Aware of That?

which we face challenges every day. On one hand, we are concerned with common communicable diseases like influenza, measles, chicken pox, malaria, where we have been able to protect our people with reasonable success, however, number of emerging diseases like dengue, COVID-19 and now Naegleria Fowleri infection is diverting our attention and resources. These emerging infections not only indicate a change in disease agents and host immunity but also reflect the climate change, which in turn is transforming the ecological settings where disease agents live. Man has manipulated nature for his sustenance in the name of development and at the expense of habitat of other living organisms. In doing so, he has exposed himself to certain dangers to his health and well-being. Even behaviors that are adopted for recreation has put him at risk of contracting unusual infections such as Naegleria Fowleri (brain-eating amoeba). Naegleria Fowleri is a free-living amoeba found in warm freshwater environments worldwide. It is a rare but highly lethal pathogen that can cause a devastating brain infection known as primary 1 amoebic meningoencephalitis (PAM). The amoeba enters the body through the nasal passages usually during activities such as swimming or diving in contaminated water. Once inside, it migrates to the brain, where it rapidly multiplies and causes severe inflammation, leading to neurological damage and 2 death. Naegleria Fowleri infections are exceedingly rare, with only a few cases sporadically reported worldwide each year. However, the infection carries an alarmingly high fatality rate and it is estimated to 3 be over 97%. Early symptoms, which could mimic bacterial meningitis, include headache, fever, nausea, and vomiting. As the disease progresses, patients may experience neurological symptoms like seizures, hallucinations, and altered mental status, often leading to a rapid deterioration within a few 1 days. There are almost 20 strains of Naegleria known but only Naegleria Fowleri is pathogenic in humans. Owing to the fact that it has unknown and possibly multifactorial mechanisms of pathogenesis, a deep insight into its genetic background can reveal the reason for severe and rapidly fatal disease. Identification of unique genetic markers (e.g., singletons, novel genes), novel paralogues of known genes or protein families, and genes obtained via horizontal gene transfer will be crucial for understanding the mechanism of disease caused by this deadly pathogen. A genomic approach involving searching whole genome of Naegleria Fowleri could identify novel locations for its clinical manifestations. NaÉgleria Fowleri is a rare infection and infection progresses quickly. The effective treatments pose challenge to the scientific community. Curêently, PAM is treated with a combination of drugs including amphotericin B, azithromycin, f luconazole , r i fampin, mil tefosine, and dexamethasone. Miltefosine is the newest of these drugs. It has been shown to kill Naegleria Fowleri in the laboratory and has been used to treat three 3 survivors. Developing countries do not invest much on recreational facilities such as swimming pool, playing grounds, gymnasiums for the public, therefore children and adults resort to use any water source, even rain water, for swimming and expose themselves to many disease such as gastrointestinal infections and brain eating amoeba. Naegleria Fowleri thrives in warm freshwater environments, such as lakes, rivers, hot springs, and poorly 1 2 Shahid Mahmood Sethi, Muhammad Arslan Tariq NAEGLERIA FOWLERI IS EATING BRAINS OF OUR PEOPLE: ARE WE AWARE OF THAT? EDITORIAL JAIMC