**Executive Summary**
This document presents the answer to Unstarred Question No. 989 in Lok Sabha regarding cases of Primary Amoebic Meningoencephalitis (PAM) in India, with a focus on Kerala. The question was to be answered on December 5, 2025. The document outlines case numbers, government interventions, and actions taken in response to the increase in PAM cases.
**Key Points / Main Content**
* **PAM Cases in Kerala:** The State Surveillance Unit (SSU) reported the following PAM cases and deaths in Kerala:
* 2023: 2 cases, 2 deaths
* 2024: 39 cases, 9 deaths
* 2025 (until Nov 27th): 170 cases, 42 deaths
* **Government Interventions:**
* The National Centre for Disease Control (NCDC), Kozhikode branch, investigated the PAM incidence in July 2024 with District Health Authorities' help.
* A high-level meeting was conducted by Secretary, Department of Health Research/Director General, ICMR, with National and State experts.
* National Acute Encephalitis Syndrome (AES) surveillance was reinforced through 18 Virus Research & Diagnostic Laboratories (VRDLs).
* Cross-validation of tests, improved environmental surveillance, and evidence-based treatment guidance were implemented.
* **Collaboration and Communication:**
* The Government of India continues to support Information, Education, and Communication (IEC) activities with Kerala for research, prevention, and preparedness.
* NCDC conducted detailed epidemiological assessments, reinforcing surveillance and strengthening IEC activities.
* A revised Communicable Disease (CD) alert was issued by NCDC, New Delhi, in October 2024 on Primary Amoebic Meningoencephalitis.
**Impact Analysis**
**Stakeholder:** Ministry of Health and Family Welfare
* **Impact:** The ministry is responsible for addressing the PAM outbreak, overseeing investigations, supporting research and surveillance, and coordinating with state authorities.
* **Action Required:** Continue to provide support, guidance, and resources to the State of Kerala, and to monitor the effectiveness of implemented strategies.
**Stakeholder:** Kerala State Government/State Surveillance Unit (SSU)
* **Impact:** The state government is dealing with the surge in PAM cases, implementing control measures, and collaborating with the Union Government.
* **Action Required:** Continue to report accurate data, collaborate with the Union Government on interventions, and implement prevention and control measures.
**Stakeholder:** National Centre for Disease Control (NCDC)
* **Impact:** NCDC is responsible for conducting investigations, reinforcing surveillance, and issuing alerts.
* **Action Required:** Continue to monitor the situation, conduct detailed epidemiological assessments, and issue timely alerts and guidance.
**Stakeholder:** Indian Council of Medical Research (ICMR)
* **Impact:** ICMR is responsible for research, supporting the Department of Health Research, and collaborating with National and State experts.
* **Action Required:** Review the surge in amoebic meningoencephalitis cases in Kerala.
Key Entities Referenced
Kerala: The state experiencing a surge in PAM cases and the location of investigations.
Ministry of Health and Family Welfare: Primary central government ministry responsible for health and family welfare.
Primary Amoebic Meningoencephalitis (PAM): The disease that is the subject of the parliamentary question, including its prevalence and interventions.
National Centre for Disease Control (NCDC): The organization involved in the investigation and response to the PAM outbreak.
National Health Mission: The scheme under which allocations were made for the study and diagnostics of PAM.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 989
TO BE ANSWERED ON05.12.2025
CASES OFAMOEBIC MENINGOENCEPHALITIS
989. SHRIK C VENUGOPAL:
ADVDEAN KURIAKOSE:
Will the Ministerof HEALTH AND FAMILYWELFAREbe pleased tostate:-
(a) the number of confirmed cases and deaths due to Primary Amoebic
Meningoencephalitis (PAM) across the country during the last three years (2023-25), State
-wise;
(b) the details of interventions undertaken by the Union Government to combat the PAM
outbreak, including allocations under the National Health Mission for its study and
enhanceddiagnostics, State-wise;
(c)whether a high-levelexpert teamhasbeendeputed toKerala since the surgeincases, to
investigate patterns, support contact tracing and formulate an action plan and if so, the
detailsthereofalongwiththeoutcomesoftheirassessments andifnot,thereasonstherefor;
and
(d) whether the Union Government intends to send a team in future and if so, the details
thereof?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH & FAMILY
WELFARE
(SHRIPRATAPRAO JADHAV)
(a) As per the report communicated by the State Surveillance Unit (SSU), Kerala, year
wise details of confirmed cases and deaths due to Primary Amoebic Meningoencephalitis
(PAM)inlast three yearsare annexed.
(b) to (d) An investigation on the incidence of Amoebic Meningoencephalitis was
conducted by the National Centre for Disease Control (NCDC), Kozhikode branch which
comes under the Ministry of Health & Family Welfare with the help of concerned District
HealthAuthoritiesinthemonthofJuly,2024.
A high-level meeting was conducted by Secretary, Department of Health
Research/Director General, Indian Council of Medical Research (ICMR) with National
and State experts to review the surge in amoebic meningoencephalitis cases in Kerala.
National Acute Encephalitis Syndrome (AES) surveillance was reinforced through 18
Virus Research & Diagnostic Laboratories (VRDLs), with emphasis on cross-validationof tests, improvedenvironmental surveillance,andevidence-basedtreatment guidance.
The Government of India continues to support Information, Education and
Communication (IEC) activities and collaboration with the State of Kerala for research,
prevention, and preparedness. Detailed epidemiological assessments were conducted by
NCDC, reinforcing surveillance and strengthening IEC activities. Accordingly, a revised
Communicable Disease (CD) alertwas issued byNCDC, New Delhi onPrimaryAmoebic
Meningoencephalitis in October 2024 highlighting management, preventive and control
measures.
(Source:https://ncdc.mohfw.gov.in/wp-content/uploads/2025/11/CD-Alert-Primary-Amoe
bic-Meningo-Encephalitis.pdf)
*****ANNEXURE
ANNEXURE REFERRED TO IN REPLYTO PART (a) OF THE LOK SABHAUNSTARRED
QUESTION NO. 989 FOR 05.12.2025 REGARDING CASES OF AMOEBIC
MENINGOENCEPHALITIS;
Yearwise detailsof Amoebic
Meningoencephalitis cases anddeaths
reported inKeralainlast 3years
Year No. of Cases Deaths
2023 2 2
2024 39 9
2025* 170 42
*- As on27thNovember, 2025