In the past few weeks, more than 140 children have died in Muzaffarpur, a district in Bihar due to the outbreak of a disease called Acute Encephalitis Syndrome. Many have attributed the deaths to consumption of litchis. But is that the sole reason? Our contributor Manish Shandilya brings us this ground report from Muzzafarpur.
What is Encephalitis? It is a disease wherein the inflammation of the brain takes place mostly in the case of children and people with weak immune system. It is also referred to as Acute Viral Encephalitis or Acute Encephalitis Syndrome (AES).
According to a report “Association of acute toxic encephalopathy with litchi consumption in an outbreak in Muzaffarpur, India, 2014: a case-control study” published in a medical journal, during the mid May and June, the cases of encephalitis peak in the Muzaffarpur district which is also one of the largest harvesting regions of litchi in the country. They also identified factors that make children susceptible to AES such as malnutrition, poor sanitation and lack of hygiene and clean drinking water.
Therefore, often, the children belonging from the economically weaker section are vulnerable to encephalitis. Researchers contest that litchi along isn’t responsible for the syndrome to be triggered but malnutrition and poverty add to it. According to them, consuming unripe litchi fruits on an empty stomach triggered a biochemical process due to the presence of a toxin which blocks gluconeogenesis which leads to hypoglycemia in children which further compounds the issue. “It contains a toxin and if eaten by a malnourished child it leads to a sudden drop in glucose which affects the brain," Arun Shah, a paediatrician who has researched extensively on the issue, told The Suno India Show.
Add to this a failing health system with massive gaps in the number of doctors and infrastructure, AES is also a symptom of an ailing and neglected public health system. “There are only around 2,700 regular doctors working against a sanctioned strength of 11,393 in health services,” Dr Ranjit Kumar, general secretary of the Bihar Health Services Association told the Hindustan Times in January this year. “As per WHO recommendation, there should be one doctor per 1,000 of population. However, in Bihar, there was one doctor for a population of over 50,000.”