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Global Warming Favors Pathogenicity of the Brain-Eating Amoebae

There is an established relationship between the recent trend of mercury rising with the incidences of patients affected by encephalitis caused by Naegleria fowleri in the US and south east Asia. This parasitic amoeba is known to assume a trophozoite form (infective state) in heated environment [1] (Fig. 1A) when the mercury touches between 4245 o C. Accidental entry of water deep into the nose initiates a cascade in the trophozoites that reach the brain by traversing the cribriform plate (Fig. 1B) located at the root of the nose. The affected patients are known to suffer Primary amoebic meningoencephalitis (PAM), the mortality rate of which has remained around 98%, with less than 5 survivors in the past 50 years [2]. Two other related FLA, Acanthamoeba and Balamuthia mandrillaris are also heat-loving parasites that acquire a pathogenic trophozoite state in heated environment [3] (Fig. 1). Though, a bit less flared-up than PAM, both these pathogens can also cause a central nervous system disease called Granulomatous Amoebic Encephalitis (GAE) [1, 3]. The mortality rate of the later infection has also remained around 95% [3]. Additionally, the Acanthamoeba spp. behaves as a host to many environmental bacteria in its trophozoite form [3] (Fig. 1D), a state being favored by high temperatures [1]. Here we highlight the overt and covert roles played by the FLA that are favored by the high temperatures and global warming. Of the FLA, the Naegleria fowleri thrives in fresh waters like ponds, lakes, rivers and pools [1, 2]. This microbe acquires a cystic form (Fig. 1A, A2) in winters, to revert into a pathogenic form in heated summers with above-mentioned temperatures [1]. Mostly, the patients with PAM have a history of exposure to fresh water in activities like swimming (Fig. 1B), water sports, nasal irrigation (Fig. 1B) and ablution [1, 2]. Public awareness regarding the mode of infection in PAM by altered environmental influences remains the only hope in reducing the incidence of this fatal disease [2]. As entry of contaminated water higher up in the nose is the solitary mode of infection by Naegleria fowleri to cause PAM [2] (Fig. 1B-B1), avoidance of introducing