Climatic change deepens the challenge. Warmer air and water temperature extends the amoeba’s breeding season and nourishes the bacteria it feeds on. Rise in temperature is crucial. Even a minor rise of one degree Celsius can increase risks.

The mortality rate exceeds 90 per cent. In Kerala, this once rare threat is now a seasonal danger. Dozens of cases have been reported in a single year in Kerala. It is a extraordinary jump from the handful reported earlier. Kerala's vulnerability stems from more than biology. It is dotted with five million wells and thousands of ponds providing water to millions of households.

These natural sources cannot be fully chlorinated without harming eco system or disrupting livelihoods. People bathe, swim and perform religious nasal rinses in these esters creating countless entry points for infection.

Warning signboards and emergency chlorination drives help only at the margins. The most effective defence remains knowledge which would involve cleaning storage tanks, using nose plugs while swimming and avoiding stagnant or polluted water. Kerala's experience is therefore not a local anomaly. It is a preview of global trends.

As temperature climbs, organisms once confined to tropical ponds may emerge in temperate lakes. And diseases once considered medical curiosities, may become public health crises.

Reducing greenhouse gas emissions, strengthening sanitation and expanding research into rapid treatment are all part of the same fight. Kerala's health workers are attempting a delicate balance

They are educating citizens without inducing panic. Precautions are being urged without demonising water use. But no state can tackle without climate -driven diseases alone. It's success in tackling this disease rests on community participation as well as medical breakthrough.

Kerala's beautiful water bodies remind us that boundaries between environment and health are dissolving. Vigilance must flow as steadily as the water on which life depends. (IPA Service)