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Rising cases of Acute Encephalitis Syndrome (AES) in Bihar

Rising cases of Acute Encephalitis Syndrome (AES) in Bihar

Bihar’s Muzzafarpur district has recently seen unprecedented growth in cases of encephalitis, a vector borne diseases. The death toll rose to 54.

This disease is concentrated in only one district, Muzzafarpur.

Though the exact cause has not yet been confirmed, health professionals suspect the deaths to be linked to toxins present in lychees (also spelt as litchis).

The children showed symptoms of acute encephalitis syndrome (AES), a neurological illness that involves inflammation of the brain. AES is colloquially known as "chamki bukhar" (chamki = seizure).

The symptons include high fever, vomiting, losing consciousness and seizures. The deaths have been reported from Sri Krishna Medical College and Hospital and Kejriwal Hospital.

Is it linked to Lichi?

Muzaffarpur is the bowl of Lichis and known for its quality.

Every year around this time scores of children fall ill. Since January Sri Krishna Medical College and Hospital and Kejriwal Hospital in Muzaffarpur have registered 179 cases.

This is also the season when lychees ripen, are plucked and sent to mandis. According to media reports in 2014 the number of AES cases reported was 1,028 and in 2015 it was 390. Over the next two years the numbers dipped: only one in 2016 and nine in 2017.

The cause of death in children is hypoglycaemia -- low levels of glucose in the blood. These children are from the poorer sections of society. Malnourishment is rampant. The children spend the day in lychee orchards eating lychees -- sometimes unripe or half-ripe ones too.

The children return home in the evening and sometimes skip dinner. This leads to night-time hypoglycaemia.

According to the researchers lack of food (missing dinner) combined with toxins hypoglycin A and methylenecyclopropylglycine (MCPG) present in lychee seeds was the cause of the illness. The delay in taking children to hospital and thus administering and correcting glucose levels was the cause of death.

However, Muzaffarpur may not be the only region to suffer from this mysterious disease. Lychee-growing areas in neighbouring Bangladesh and Vietnam have also reported outbreaks of acute encephalitis syndrome in the past.

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