Bihar encephalitis deaths: Centre to send expert team of doctors, paramedics

Over 100 children have died in the state due to AES, according to the Centre

Bihar encephalitis deaths: Centre to send expert team of doctors, paramedics Children showing symptoms of acute encephalitis syndrome undergo treatment at Sri Krishna Medical College Hospital in Muzaffarpur | AP

Ten pediatricians and five paramedics from government hospitals in Delhi will be travelling to Muzaffarpur to bolster the state government’s efforts in tackling the rising deaths of children due to an outbreak of acute encephalitis syndrome (AES). “The teams will strengthen clinical care (given) to existing patients in the hospitals. They will also strengthen surveillance of cases from the peripheral areas,” Union Health Minister Dr Harsh Vardhan said.

The decision to sent a medical team came after the review meeting held at the Union ministry of health and family welfare on Wednesday to take stock of the efforts to manage the ongoing public health crisis in Bihar. Over 100 children have died in the state due to AES, according to the Centre.

The ministry also said that experts from the Centre's team would be studying factors such as the socio-economic profile of the households that have reported these cases, their nutrition profiles, issues such as the ongoing heatwave, high percentage of hypoglycemia reported in the children who have died, prevailing health infrastructure in the districts and other factors that could have a significant bearing on the cause and the progression of the disease.

Vardhan also said that a high-level central team led by a senior bureaucrat had been stationed in the area for three days now. “Teams have also been constituted for socio-economic survey in these areas to identify and pinpoint causes linked with the economic status”, he said.

Deaths of children in an outbreak such as this in the district of Muzaffarpur and adjoining areas in Bihar are not unprecedented. Similar outbreaks of the disease have occurred in the previous years as well. Though the Union health ministry is terming the disease as “encephalitis” (infectious, caused by virus), experts say that the children are afflicted by lychee-associated acute hypoglycemic encephalopathy (a biochemical disease).

The deaths of the children in Bihar is the result of lychee fruit consumption after a prolonged fast by the undernourished children, according to Dr T. Jacob John, pediatric infection specialist, CMC, Vellore and Dr Mukul Das, CSIR-Indian Institute of Toxicology Research, Lucknow. In their research, published in the journal, Current Science, in 2014, the two found the culprit to be methylene cyclopropyl glycine (MCPG), a hypoglycemic agent present in the fruit.

Children—undernourished and hungry—involved in the harvesting of the fruit eat a large quantity during the day, and end up skipping their evening meal due to the harvesting schedule. By early morning, the malnourished kids are hypoglycemic, the presence of the toxin in the fruit hampers the brain from getting glucose, and the life-threatening sickness (vomiting, seizures) sets in. 

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