Karachi: With expiry of the sixth Naegleria fowleri patient in Karachi this year, the need of launching a comprehensive awareness drive in the city, especially in its mosques is being felt urgently, as the Naegleria fowleri enters the human body though nose, and its chances are greatly high when one irrigates his nose while performing Wudu (ablution) with un-chlorinated water.
Naegleria is an amoeba (single-celled living organism) commonly found in warm freshwater (for example, lakes, rivers, and hot springs) and soil. Only one species (type) of Naegleria infects people: Naegleria fowleri.
In Karachi potable water is supplied by Karachi Water and Sewerage Board (KWSB) through an extensive network of reservoirs, water tanks, pumping stations and pipelines. However, it is complained that this water more than often is not properly chlorinated. Though the KWSB every year tags funds for chlorination of water but its corrupt officers allegedly embezzle these funds, putting the public health at risk. Due to acute shortages of water people store this water in underground and overhead tanks. In homes and mosques the underground tanks are not generally properly cleaned and even if chlorinated water is stored in them with passage of time its chlorination potency goes weak.
Naegleria fowleri infects people when water containing the amoeba enters the body through the nose. This typically occurs when people go swimming or diving in warm freshwater places, like lakes and rivers. The Naegleria fowleri amoeba then travels up the nose to the brain where it destroys the brain tissue.
You cannot be infected with Naegleria fowleri by drinking contaminated water. In very rare instances, Naegleria infections may also occur when contaminated water from other sources (such as inadequately chlorinated swimming pool water or contaminated tap water) enters the nose, for example when people submerge their heads or cleanse their noses during religious practices like Wudu and Gusl, and when people irrigate their sinuses (nose) using contaminated tap water.
The Karachi Metropolitan Corporation (KMC), KWSB, health department and other concerned agencies should set up a taskforce on emergency basis that check the water quality of underground water tanks of each and every mosque and seminary in the city and properly chlorinate them where required. An aggressive awareness campaigning should also be launched in mosques to tell people about the risks of performing Wudu with unchlorinated water. These people should also be advised how to chlorinate water at their homes and use it for irrigating nose during Wudu and Gusil. This is a very serious issue and the government departments despite knowing full risks involved are giving focus on it. In Karachi tens of millions of people perform Wudu and Gusil daily and they use this risky water to clean their nose during these religious procedures for washing body parts.
The fatality rate is over 97%. Only 3 people out of 132 known infected individuals in the United States from 1962 to 2013 have survived. There is no such available for Karachi or Pakistan. As there is no cure after the Naegleria fowleri enters the nasal cavity and travels towards brain, precaution – strictest precaution – is the only way to save innocent lives from this rare disease, which may even take an epidemic shape due to negligence of our government departments and civic agencies.
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