Post-Covid, surge in deadly infections

Tuberculosis, India’s enduring scourge, continues to exact a heavy toll, with the country accounting for approximately 26–27% of the global burden. Annually, millions contract TB, and over 400,000 succumb despite widespread treatment programmes, reflecting persistent challenges in early detection, adherence, and drug-resistant strains.

Encephalitis, recurring episodically in Uttar Pradesh and Bihar, has claimed thousands over decades, disproportionately affecting children. Its insidious onset—fever, headache, and vomiting—can escalate to seizures, confusion, disorientation, coma, and death, caused by Japanese encephalitis virus or a spectrum of viral, bacterial, and parasitic pathogens.

Together, these outbreaks reveal a sobering pattern: mucormycosis exposed Covid-linked vulnerabilities; dengue and leptospirosis magnified ecological and systemic fragilities; TB endures silently; and encephalitis underscores how routine monsoon cycles can precipitate tragedy.

Now, a new menace looms. Kerala is grappling with a surge in Primary Amoebic Meningoencephalitis (PAM), caused by Naegleria fowleri, reporting 69 confirmed infections and 19 deaths in 2025. Nationally, 72 cases and 19 deaths have been reported, with sporadic referrals in Karnataka and Tamil Nadu.

The amoeba thrives in warm freshwater, entering through the nasal passages during swimming or bathing, and swiftly migrating to the brain to devastate tissue. Early signs—fever, headache, nausea, and vomiting—can accelerate to seizures, stiff neck, hallucinations, confusion, coma, and death, with a staggering global fatality rate of 95–98%. Treatment relies on Amphotericin B, sometimes intrathecally, with miltefosine employed in early interventions.

Kerala’s 2024 reprieve—29 cases with 24 survivors—was credited to rapid diagnosis and intensive care. In 2025, however, the outlook has darkened: sporadic spread has replaced cluster outbreaks, underscoring the persistent vulnerability of populations and the human cost behind every statistic.