Everything you need to know about Naegleria (Bain-Eating Amoeba)
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00:00We have with us, Assistant Professor, Infectious Diseases, Dr. Tehreem Ansari.
00:06Thank you so much for joining us, Tehreem.
00:08Please tell me, basically, we talk about symptoms, but first of all,
00:16does it happen by going to swimming pools or by doing ablution?
00:21Basically, how does it…
00:22Madam, it is the same in the water of our house's tank as well as in the swimming pool.
00:26Okay, first of all, thank you for bringing up such an important topic.
00:29It is a hot topic as well, I think.
00:31You have brought it up and are working for the public's awareness.
00:36Yes, you had two questions in this.
00:37So, I will answer the first question later to tell you about the symptoms.
00:41But, where does it happen?
00:42In the soil, in the water, in the spring waters, in the swimming pools,
00:47in the water of the tank, shallow water, lakes, rivers, swimming pools,
00:50it can be present everywhere.
00:52Okay.
00:53How does it enter?
00:54One special thing about it is that as the temperature increases,
00:58it survives at higher temperatures.
01:01Oh, is it a Pakistani virus?
01:03You can say that it is a Pakistani virus.
01:06Anyway, but not in that sense.
01:09It survives at 42 degrees centigrade or 115 degrees Fahrenheit,
01:13even at higher temperatures.
01:15So, you will see that most of the cases occur in the summer,
01:19when the temperature is high.
01:20So, this is one thing.
01:22The second thing is that where does it enter?
01:25You are right, it enters through the nostrils.
01:27Especially, when we put a lot of water in the nose,
01:30it goes through the base of the skull,
01:33where there is a bone.
01:35It is like where you get the smell and everything.
01:37It crosses that and enters into the brain.
01:40Brain-eating amoeba is said to infect very quickly.
01:45It is a deadly virus.
01:47Sorry, it is not a virus, it is a deadly amoeba.
01:49So, it can kill.
01:51The studies that have been done all over the world,
01:54out of 100, 95 to 99% of the cases can't survive,
01:57but they still survive.
01:59Some cases have been reported that have survived.
02:02Last year, in our PNS Shifa, one case has survived.
02:05If it is diagnosed early, but what are the symptoms initially?
02:08Now, we come to the symptoms.
02:10So, basically, the early symptoms include severe headache, fever.
02:15Some people's smell can be altered.
02:18They can't smell.
02:20It involves those nerves.
02:22As the disease progresses, the headache worsens,
02:25there is a coma.
02:27How long is the onset?
02:29After acquiring the onset, the symptoms last for 2 days.
02:34Maximum is 15 days.
02:36But usually, most of the cases are present within 3 to 5 days.
02:39There is not much of an incubation period.
02:41Yes, it doesn't give you much time.
02:42There is a range of incubation period,
02:44but most of the cases are present within 5 days.
02:46One more thing.
02:47In this Pakistani society,
02:49everything is available over-the-counter.
02:51From anti-allergies to antibiotics,
02:55we take the entire course and then go to the doctor.
02:58This is one reason.
03:00This is one reason.
03:01Firstly, our primary health care is not as developed as it should be.
03:05So, people usually go to the quack
03:08or do home treatment.
03:09And plus the availability of antibiotics.
03:11And they take the antibiotics themselves.
03:13Exactly.
03:14So, they also present late in many cases.
03:17When the patient becomes comatose from 3 to 4 places,
03:20then they go to a tertiary care or hospital.
03:23So, usually the main cause of mortality
03:26is due to the late presentation.
03:30Is there a test for this when you go to a doctor?
03:32Yes, there is a test for this.
03:33You cannot detect it that way.
03:35For this, you have to do brain imaging
03:38to see if there is a lot of fusion.
03:41And then there is a lumbar puncture test
03:43in which the water of the spine is tested.
03:46In that, in the early stage,
03:48in the CSF, the water of the spine,
03:50you can see the fat in it.
03:52But for this, you need expertise.
03:54And you have to see it immediately.
03:55We call it VECT mount.
03:56Secondly, its PCR is available.
03:58But again, that is also in your CSF.
04:01The water of the spine.
04:03So, on this basis, its diagnosis is done.
04:05So, what are the immediate treatments?
04:07For this, there are multiple antibiotics,
04:10antibacterials,
04:11antifungals.
04:13So, this is a combination of 4 to 5 drugs.
04:16All these have to be mixed.
04:18They have to be started.
04:19Their dosage is also slightly higher than usual.
04:22So, they have to be started.
04:23As soon as possible, you will be diagnosed.
04:25As soon as you start the treatment,
04:27there are some chances of your survival.
04:29You said that in 2 days, its symptoms are obvious.
04:31Then all those tests will be done.
04:33The doctor will also take time.
04:35So, in how many days is the treatment?
04:37How much time does he have?
04:39In 2 days or 3 days?
04:41It depends.
04:43The sooner you go in the setup,
04:45the sooner the doctor will be able to diagnose you.
04:47Our doctors also become sensitized.
04:49If someone is coming like this in summer,
04:51then we try immediately
04:53to do the test of the water of the spine.
04:55It is next to impossible.
04:57I would say because the reason is
04:59that when someone comes to you,
05:01you will take it as a cold first.
05:03You will not say immediately to get brain imaging done.
05:05Because the symptoms are the same.
05:07If you get covid,
05:09cold, flu,
05:11symptoms come with headache,
05:13cold, etc.
05:15The headache is very severe.
05:17Plus, there is a time duration.
05:19At this time, you are sensitized.
05:21At this time, the cases are increasing.
05:23So, if a patient comes to me with a severe headache,
05:25a young patient,
05:27there is no other reason,
05:29headache or smell altering,
05:31then I will definitely think about it.
05:33And he can also tell that he felt that the water
05:35was very cold.
05:37This is not that common.
05:39But doctors are told a lot.
05:41But when you go to the pool,
05:43should we be careful there too?
05:45Yes, you should be careful there.
05:47The pools should be chlorinated.
05:49Chlorination is an important thing
05:51to prevent this.
05:53Secondly, we say that you should avoid
05:55such activities.
05:57But if you have to go,
05:59then use a nose clip.
06:01The water should not enter.
06:03Keep your head above the water.
06:05Use ear clips.
06:07Usually, there is not much report in the air.
06:09Most of the reports are from here.
06:11So, do these things.
06:13If you have to go outside for ablution,
06:15then take a water bottle from home.
06:17For distilled water or boiled water.
06:19You can also use this water for ablution.
06:21For ablution, you can at least put water in your nose.
06:23By the way, avoid a lot of tightness.
06:25But if you have to go,
06:27then take your water bottle with you.
06:29Some people need water to clear sinuses.
06:31For that, they use tap water or faucet water.
06:33So, for that also,
06:35you should use distilled water or boiled water.
06:39In boiled water,
06:41this parasite will die.
06:43What is recommended by CDC is
06:45that you should boil it for 1 minute.
06:47Then cool it and save it.
06:49But chlorination is the...
06:51Especially, to clear sinuses,
06:53do not make your nose a suction pump.
06:55Yes, do not do that.
06:57And use distilled water.
06:59By the way, it was a very nice thing to say
07:01that it should be chlorinated water.
07:03In our pools, may Allah forgive us,
07:05it is mostly urinated water.
07:07So, be very careful.
07:09There is a lot you can do for your hygiene.
07:11Thank you so much, Dr. Tarim.