Harikumar Sivanandan, Jeromie Wesley Vivian Thangaraj, Ala Saritha, Anitha Bhaskar, Aravind Reghukumar, Asuma A Rahim, Bindu Vadakkayil, Chintha Sujatha, Karthika Meenakshy Amma, Manoj Arayakandy Thali, Prathibha M Thankamoni Amma, Priya Chandran, Rekha Melathuparambil Ravindran, Remya Prakash, Sabitha Rose Jacob, Shameer Vadekkandiyil, Shubin Chenayil, Unnikrishnan Bhaskarannair, Abhishek Gopalakrishnan Saraswthy, Anitha Puduvail Moorkoth, Bhagyalakshmi Mahavan Kanchana, Biju George, Dinesh Gopal, Heera Hassan, Jincy Johnson, Kiran Raj Divakaran, M C Sathya Bhama, Megha Shaju, Minu Abraham, Neetha T Ramankutty, Pressy Sankar, Priyanka Sajeev, Saritha Narayanankutty, O Sasikumari, Sujina Cheraparambil Muthukutty, Thekkumkara Surendran Anish, Vishnunath Kadavath, Aruna Raman, Bindu Gopalakrishnan Santhakumari, Gayathri Ramakrishnan, Geetha Panarkandy, Jayakrishnan Machinery Puthanpurayil, Mohandas Nair Karippoth, Shameem Anathan Mohammed, Sheeja Sugunan, Sindhu Thekkile Gangadharan, Anuja Ushakumari, Chandni Radhakrishnan, Easwaran Sreekumar, Naveen Anaswara, Pillaveetil Sathyadas Indu, Reetha Kakkarakandiyil Pareri, Sahadevan Sunija, Sajeeth Kumar Keeriyatt Govindan, 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, AME Study Group
Amebic meningoencephalitis (AME) is a highly fatal central nervous system infection caused by various free-living amebae. We describe epidemiology of AME cases from Kerala, India, during January 1-November 11, 2025, and identify behavioral risk factors associated with real-time PCR-confirmed Acanthamoeba spp. infection through a matched case-control study. We identified 159 AME case-patients, of which 67 (42.1%) tested positive for Acanthamoeba spp. amebae. Most AME cases were reported from 4 districts, peaking during the monsoon and postmonsoon periods. Exposure to natural water bodies for swimming or bathing and using nonchlorinated water for domestic purposes were associated with AME. History of maxillofacial injury or nasal surgery with subsequent exposure to natural water bodies and washing ulcers or skin lesions in natural water bodies were associated with higher odds of disease. Targeted risk communication about safe water practices and routine chlorination of domestic water sources could help reduce AME risk in affected communities.