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Epidemiology of and Risk Factors for Amebic Meningoencephalitis, Kerala, India, 2025
Harikumar Sivanandan
1, Jeromie Wesley Vivian Thangaraj
1, Ala Saritha
2, Anitha Bhaskar
2, Aravind Reghukumar
2, Asuma A. Rahim
2, Bindu Vadakkayil
2, Chintha Sujatha
2, Karthika Meenakshy Amma
2, Manoj Arayakandy Thali
2, Prathibha M. Thankamoni Amma
2, Priya Chandran
2, Rekha Melathuparambil Ravindran
2, Remya Prakash
2, Sabitha Rose Jacob
2, Shameer Vadekkandiyil
2, Shubin Chenayil
2, Unnikrishnan Bhaskarannair
2, Abhishek Gopalakrishnan Saraswthy
3, Anitha Puduvail Moorkoth
3, Bhagyalakshmi Mahavan Kanchana
3, Biju George
3, Dinesh Gopal
3, Heera Hassan
3, Jincy Johnson
3, Kiran Raj Divakaran
3, M.C. Sathya Bhama
3, Megha Shaju
3, Minu Abraham
3, Neetha T. Ramankutty
3, Pressy Sankar
3, Priyanka Sajeev
3, Saritha Narayanankutty
3, O. Sasikumari
3, Sujina Cheraparambil Muthukutty
3, Thekkumkara Surendran Anish
3, Vishnunath Kadavath
3, Aruna Raman
4, Bindu Gopalakrishnan Santhakumari
4, Gayathri Ramakrishnan
4, Geetha Panarkandy
4, Jayakrishnan Machinery Puthanpurayil
4, Mohandas Nair Karippoth
4, Shameem Anathan Mohammed
4, Sheeja Sugunan
4, Sindhu Thekkile Gangadharan
4, Anuja Ushakumari
5, Chandni Radhakrishnan
5, Easwaran Sreekumar
5, Naveen Anaswara
5, Pillaveetil Sathyadas Indu
5, Reetha Kakkarakandiyil Pareri
5, Sahadevan Sunija
5, Sajeeth Kumar Keeriyatt Govindan
5, Jaichand Johnson, Ajan Maheswaran Jaya, Abey Sushan, Raman Swathy Vaman, Lakshmi Geetha Gopalakrishnan, Arun P. Vijayalekshmi, Dinesh Kumar Harikrishnan, Sabarinathan Ramasamy, Navaneeth S. Krishna, Viswanathan V. Kollengode, Reena K. Joseph, Vinay Goyal, Rajan Khobragade, Manoj V. Murhekar

, and
AME Study Group
Author affiliation: Government of Kerala Directorate of Health Services, Thiruvananthapuram, India (H. Sivanandan, M.A. Thali, R.M. Ravindran, S. Chenayil, U. Bhaskarannair, A.G. Saraswthy, K.R. Divakaran, M. Abraham, P. Sajeev, R.K. Pareri, A.M. Jaya, A. Sushan, R. Vaman, L.G. Gopalakrishnan, A.P. Vijayalekshmi, R.K. Joseph); Indian Council of Medical Research National Institute of Epidemiology, Chennai, India (J.W.V. Thangraj, A. Saritha, D. Gopal, M. Shaju, V. Kadavath, D.K. Harikrishnan, S. Ramasamy, N.S. Krishna, M.V. Murhekar); Government Medical College, Thiruvananthapuram (A. Bhaskar, A. Reghukumar, K.M. Amma, R. Prakash, B.M. Kanchana, H. Hassan, J. Johnson, M.C.S. Bhama, N.T. Ramankutty, S. Narayanankutty, O. Sasikumari, A. Raman, B.G. Santhakumari, S. Sugunan); Government Medical College, Kozhikode, India (A.A. Rahim, B. Vadakkayil, S. Vadekkandiyil, A.P. Moorkoth, P. Sankar, G. Ramakrishnan, G. Panarkandy, J.M. Puthanpurayil, M.N. Karippoth, S.A. Mohammed, S.K.K. Govindan); Government Medical College, Kollam, India (C. Sujatha, P.M. Thankamoni Amma); Government Medical College, Manjeri, India (P. Chandran, S.R. Jacob, B. George, S.C. Muthukutty); Kerala One Health Centre for Nipah Research and Resilience, Kozhikode (T.S. Anish); Government Medical College, Kasaragod, India (S.T. Gangadharan); Directorate of Medical Education, Kerala, India (A. Ushakumar, V.V. Kollengode); Government Medical College, Wayanad, India (C. Radhakrishnan); Institute of Advanced Virology, Thiruvananthapuram (E. Sreekumar); Kerala Centre for Disease Control and Prevention, Thiruvananthapuram (N. Anaswara); Government Medical College, Thrissur, India (P.S. Indu); State Public Health and Clinical Lab, Thiruvananthapuram (S. Sahadevan); National Health Mission, Government of Kerala, Thiruvananthapuram (V. Goyal); Health & Family Welfare, Government of Kerala, Thiruvananthapuram (R. Khobragade)
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Figure 2

Figure 2. Epidemic curve of AME cases by onset of illness, Kerala state, India, 2025. Cases were confirmed by real-time PCR as caused by Acanthamoeba spp. or Naegleria fowleri amebae or confirmed via wet-mount microscopy of cerebrospinal fluid. AME, amebic meningoencephalitis.
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