ISLAMABAD - The ministry of national health services, regulations and coordination intimating about the probable outbreak of primary amoebic menigoenephalitis (PAM) has asked the provinces to take urgent measures to mitigate risk posed by highly fatal disease caused by Naegelria fowleri.The advisory has been issued to provincial governments to avert any possible outbreak as since May 2014 the disease has claimed six lives. The disease with case fatality rate at 95 per cent was first observed in Pakistan during the year 2012 causing death of 22 people in the southern part of Pakistan within a week. Naegleria fowleri, commonly referred to as the “brain-eating amoeba”, is a free-living microscopic amoeba, (single-celled living organism). It can cause a rare and devastating infection of the brain called primary amoebic meningoencephalitis (PAM). The disease causing amoeba is typically found in warm bodies of fresh water such as ponds, lakes, rivers and hot springs. It is also found in soil, near warm water discharges of industrial plants and in poorly chlorinated or unchlorinated swimming pools, ponds and stagnant water.Naegleria fowleri can invade and attack the human nervous system and brain, causing a condition known as Primary Amoebic Meningoencephalitis (PAM). Naegleria fowleri enters the body through the nose and travels to the brain, where it destroys brain tissue and causes swelling and death.Although this occurs rarely, such an infection nearly always results in the death of the victim. Infections have been associated with people submerging their head in contaminated water or cleaning nose by using contaminated tap water. According to officials, currently the disease has only been reported from Sindh province however, there is an imminent risk of spill over to other areas and provinces.There are no scientific reasons and causes available of the diseases as it’s been recently discovered thus the guidelines have been issued while observing the history of infected patients, health officials say.For effective prevention and control of PAM caused by Naegelria fowleri, the advisory suggests to take steps on urgent basis: the people be educated to adopt preventive measures; avoid swimming in stagnant water; avoid dipping face or submerging head in water while bathing and avoid taking water too deep into nostrils while performing ablution.The guidelines ask the provincial authorities to direct to water and sanitation departments to ensure optimal level of chlorination of water supply at 5 ppm.The health advisory also urges the provincial governments to direct the concerned authorities to check water supply lines that are in close proximity with stagnant water including water discharged by industrial plants and take immediate measures to repair or replace such pipes in case of leakage.This news was published in The Nation newspaper. Read complete newspaper of 26-Jul-2014 here.