Wild swimmers' nightmare: the deadly "brain-eating bug" disease.

On July 6, 2020, the BBC reported that a case of "brain-eating worm" disease, the pathogen of the Fauphne Naeriagle progeni, was found in Florida, USA, as part of the Amoeba original family.
is this "brainworm" really feeding on human brain tissue as its popular name? In fact, "brainworm" is just an image of the statement, Fuchs Negri Amoeba progenitor simply can not really eat the brain, but through the invasion of the meninges and the essence of the brain after rapid reproduction, causing pus sepsis meninges, vascular bleeding and brain essential necrosis and other lesions, thereby damaging brain tissue.
the Fuchs Negri amoeba is the scientific name for brain-eating worms, commonly referred to as amoeba protozoa, mainly divided into parasitic and free-form two categories.
amoeba parasites that are parasitic in the human body can cause a variety of tissue organ lesions such as amoeba dysentery, liver abscess, pulmonary abscesses and meningitis.
free-born amoeba progenitors are often found in freshwater water bodies, silt, dust and corrupt plants, there are two stages of life, nourishing body is divided into amitaand type and double whip type two, in which the amoeba-type nourishment is a disease-causing form, it usually invades the nasal cavity when a person comes into contact with contaminated water, through the nasal mucosido and sieve plate, and eventually causes the primary amemine(primary)
PAM is a rare but high lying rate worldwide, with short courses and poor prognosis, and patients often die within a week of infection.
, a recent review published in Clinical Journal of The United States examined the literature on PAM case reports published worldwide as of 2018, and included the CDC's Amoeba case monitoring report as a way to comprehensively assess THE occurrence of PAM globally.
the study defines confirmed cases as: patients who test positive in cerebrospinal fluid or brain tissue slicing using laboratory techniques such as immunohistochemistry, IHC, second-generation sequencing (next-sequencing, NGS), indirect immunofluoration (indirect immuneluorescence, IIF), polymerase chain reaction (polymerase chain reaction, PCR).
the definition of a case of possible infection (probable)/suspect) is that the results of sumo-seinred red staining or amoeba culture for cerebrospinal fluid or brain tissue slices have been positive but there is no conclusive molecular diagnostic evidence.
further through epidemiological history and clinical manifestations, patients who are exposed to the disease dispensed with acute and rapid progression of fever, headache, vomiting and/or other meningitis symptoms within 14 days are classified as possible infection (probable) cases, and the remaining cases that do not meet this epidemiological and clinical manifestation are classified as suspicious."
study analyzed 381 cases of primary amoeba meninges, mainly male (75%), median age of 14 years (1-85 years).
182 were confirmed cases, 89 were probable infections and 110 were suspicious cases, notably, only 7 survivors of 381 PAM cases.
confirmed cases and potential infections/suspected cases performed similarly in survival rates, course of disease and cerebrospinal fluid testing.
as shown in table 1, the most common exposure factors associated with PAM are swimming/diving (58%), followed by bathing (16%), then water sports (e.g. water skiing, jet skiing, etc.) (10%), and cleaning noses (9%), the most common water sources are lakes/ponds/reservoirs (45%), followed by swimming pools (13%), tap water (12%), and then rivers/ditches/sinkholes (12%).
as shown in figure 1, the global cases are mainly in 33 countries, with the United States (41 per cent), Pakistan (11 per cent) and Mexico (9 per cent) reporting higher number of cases.
global PAM cases are growing at a slow pace, with an average annual increase of 1.6% from 1965 to 2016.
as shown in figure 2, the number of confirmed cases has increased by an average of 4.5 per cent per year over 51 years, while the number of probable infections/suspicious cases has not increased.
the final article points out that early diagnosis and timely treatment are very important to save the lives of PAM patients, and for such rare but high-fatal diseases, a full understanding of their epidemiological laws, risk factors, clinical manifestations and laboratory test characteristics will help early diagnosis and intervention, thereby improving the survival rate of patients.
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