Initial questioning led to assumptions that the victims, believed to be nine so far this year, were infected after swimming in a pool at a farmhouse or some other water body. However, the family of victim Farhan Tauseef Khan, who passed away at the Liaquat National Hospital on July 11 after being hospitalized for 24 hours, said that this was unlikely.
He was a devout Muslim and used to pray five times a day at home and at the mosque close to his flat in Gulshan-e-Iqbal. The family members denied that Khan went to any water park or swimming pool which is why they speculated that the only way the virus could have entered him was while he performed ‘wuzu’. He also used to attend a Thursday overnight ‘ijtimah’ where other men of his family said there is a water reservoir for ablution. They doubted the water tanks in the flats were infected as no one else got sick from this source.
Khan was 36 years of age and worked as a network engineer for NUST at its Karsaz office, according to one of his siblings.
The parasite apparently enters the system if the water hits the roof of the nose with some pressure and you don’t contract it by drinking water. This is how the parasite affects the human brain. The method of transmission bears similarities to how wuzu is performed.
Rehan, the brother of another victim Irfan Sheikh, 27, who expired on July 14, said that his brother had gone to the Hawkesbay beach but that was five months ago and he was already ill with Naegleria when the family recently went for a picnic to a farmhouse. “My brother was very religious and I think that he fell sick by using the water in our home taps,” he said. No other member of the family has, however, fallen ill.
Irfan also used to go to the neighbourhood mosque, Masjid-e-Uqba in Korangi, but his brother said that they use running water from taps which makes him doubt his brother got sick there. “I think it’s the water being supplied to Korangi,” Rehan said. “My brother’s work place was also in Korangi.”
The third victim, Fahad, 22, was reported to have gone to a farmhouse off the highway a few days before he fell sick, which made the doctors immediately suspect that the pool was infected.
The health minister has tasked the senior director Dr Imdadullah Siddiqui and deputy secretary Dr Nadeem Sheikh with collecting patient data from the hospitals. They plan to complete their report by Tuesday, said a spokesperson.
Dr Naseem Salahuddin, the head of the infectious diseases at Indus Hospital, has pointed out that with such little awareness and research on the disease, no particular reason can be quoted as a sure cause and no place can be declared infected or disinfected.
Pathogenicity of Naegleria
A few Naegleria species have been shown to be pathogenic in humans and animals most notably N. fowleri. This amoeba is a facultative pathogen capable of living many generations without infecting a host. Trophozoites are thought to enter the nose during swimming in warm water and thereafter the brain by locomotion and destruction of neurons.