Alanazi Awadh, Younas Sonia, Ejaz Hasan, Alruwaili Muharib, Alruwaili Yasir, Mazhari Bi Bi Zainab, Atif Muhammad, Junaid Kashaf
Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia.
HKU-Pasteur Research Pole, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; Centre for Immunology and Infection (C2i), Hong Kong Science and Technology Park, Hong Kong.
J Infect Public Health. 2025 Apr;18(4):102690. doi: 10.1016/j.jiph.2025.102690. Epub 2025 Feb 1.
Naegleria fowleri is a rare but deadly pathogen that has emerged as an important global public health concern. The pathogen induces primary amoebic meningoencephalitis (PAM), a rapidly progressive and almost always fatal life-threatening brain infection. The devastating impact of N. fowleri and the high mortality rate underscores a deeper understanding and the development of innovative strategies to tackle this issue. Despite various studies that have been conducted on N. fowleri, a comprehensive review that integrates recent findings and addresses critical gaps in understanding remains lacking. This review provides a detailed overview of N. fowleri epidemiology, transmission dynamics, phylogenetic diversity, state-of-the-art diagnostic techniques, therapeutic approaches, and preventive measures. We identified 488 PAM cases globally, reported since 1962, with the highest numbers in the US, Pakistan, and Australia. A phylogenetic analysis of 41 N. fowleri ITS-1, 5.8S, ITS-2 region-based sequences showed genotypic diversity, with genotypes II and III being the most prevalent in Asia, North America, and Europe. Effective approaches to preventing N. fowleri transmission include applying free chlorine to water in storage tanks, taking precautions while swimming, and performing ablution with sterilized water (e.g., boiled or distilled) while avoiding deep inhalation of water, especially in regions with high water contamination. This review highlights the global impact of N. fowleri, future surveillance strategies, prompt diagnosis, potential therapeutic options, and vaccine development to prevent PAM outbreaks. It highlights the importance of joint government and public health efforts to combat this deadly pathogen.
福氏耐格里阿米巴是一种罕见但致命的病原体，已成为全球重要的公共卫生问题。该病原体可引发原发性阿米巴脑膜脑炎（PAM），这是一种进展迅速且几乎总是致命的危及生命的脑部感染。福氏耐格里阿米巴的毁灭性影响和高死亡率凸显了深入了解并制定创新策略来解决这一问题的必要性。尽管已针对福氏耐格里阿米巴开展了各种研究，但仍缺乏一项整合近期研究结果并填补关键认知空白的全面综述。本综述详细概述了福氏耐格里阿米巴的流行病学、传播动态、系统发育多样性、最新诊断技术、治疗方法和预防措施。我们确定了自1962年以来全球报告的488例PAM病例，其中美国、巴基斯坦和澳大利亚的病例数最多。对41条基于福氏耐格里阿米巴ITS-1、5.8S、ITS-2区域的序列进行的系统发育分析显示出基因型多样性，其中基因型II和III在亚洲、北美和欧洲最为普遍。预防福氏耐格里阿米巴传播的有效方法包括向储水箱中的水添加游离氯、游泳时采取预防措施，以及用无菌水（如煮沸或蒸馏的水）进行净身，同时避免深度吸入水，尤其是在水污染严重的地区。本综述强调了福氏耐格里阿米巴的全球影响、未来监测策略、及时诊断、潜在治疗选择以及预防PAM暴发的疫苗开发。它凸显了政府和公共卫生部门联合抗击这种致命病原体的重要性。
