What Is Encephalitis? Brain Disease Linked to Fruit Toxins Kills 100 Children in India

Almost 100 children have now succumbed to an outbreak of encephalitis in a mass outbreak in northern India, which is being linked to toxins in local fruit.

Ninety-seven children have died of suspected acute encephalitis syndrome (AES) in and around the city of Muzaffarpur in the northern state of Bihar since the outbreak began in mid-May, the BBC reported.

Twenty of the children who have died passed away within just 24 hours, according to the Times of India.

AES is a viral or bacterial infection which inflames the brain, impairing function. The onset of the hot summer months typically mark a rise in cases of AES, but this year the toll has been unusually severe and has brought the worth death toll since 2014, according to The Washington Post.

At least 97 have died so far, most under the age of 7 years old, senior Muzaffarpur government official Alok Ranjan Ghosh said. At least 200 more remain in hospital, the BBC said.

The symptoms of AES include a rapid onset of fever, followed by disorientation and seizures. It can also cause vomiting, inflammation of the heart and kidneys, and comas. A fifth of those who survive must live with permanent neurological defects, the BBC noted.

The virus can be transmitted in many ways, including by mosquito bites, human contact, bacterial infections, parasites and other toxins. Treatment options include antiviral and anti-inflammatory medication, as well as replenishment of fluids and bed rest.

Though the Bihar state health department has blamed the deaths on hypoglycemia—low blood sugar—it also suggested that lychee consumption is playing a role, CNN reported. When the body's blood sugar is too low, the liver releases glycogen to compensate. But when the liver has no extra glycogen and is storing a high level of lychee toxins, these are released instead.

"International experts have told us that lychee has some kind of toxin that goes and deposits in the liver of these children, and when the temperatures go up, those toxins get released," Sanjay Kumar, a senior state health official, said last week.

"The fact is that [Muzaffarpur] is a lychee-growing area. We suspect that there is some kind of role that lychee has in the case. But it is also true that once the temperature comes down and the rains come, lychee or no lychee, there are no more cases."

A study from India's National Center for Disease Control conducted with the U.S. Centers for Disease Control and Prevention found that the consumption of naturally-occuring toxins in lychees were a possible source of the illness, especially when affected children did not eat a meal the evening before falling ill.

Without other food in their stomachs, the children are especially vulnerable to the toxins. Many of those affected come from poor and rural families, the researchers noted, so may not have access to sufficient meals.

Indian Health Minister Harsh Vardhan, who visited the area on Sunday, said the government would give "all possible help" to the local authorities battling the outbreak. He said he was confident the government would "soon be able to contain the rise" in cases.

children, brain, encephalitis, india, lychees, disease
In this file photo, lychees are pictured at a market in Tel Aviv-Yafo, Israel on 13 July, 2018. Getty/Michael Jacobs/Art in All of Us/Corbis