Summers are about Mangoes and Litchis but this time things did not seem well ever since the reports of children dying in Bihar has come. As per the reports ‘Litchi Havoc’, ‘Chamki Bhukar’, ‘Killer Encephalitis’, ‘Deadly Litchi Toxin’ whatever you may call it is causing the epidemic in Bihar. Up till now 309 children in Muzaffarpur have been hospitalized and 85 have died.
Dr. TJ John, former president of the Indian Association of Pediatrics (IAP) and Emeritus Professor of Virology at the Christian Medical College in Vellore, has called AES “a meaningless term” given that “any brain disease in the child may be called AES”.
He explained: “AES is a term used by untrained health workers to say that a child has some brain disease like convulsion, unconsciousness, etc. But when a doctor examines the child, he must conclude which kind of AES disease it is: encephalitis (virus causing brain inflammation), meningitis (swelling of the protective membranes covering the brain and spinal cord), encephalopathy (broad term for any brain disease that alters brain function or structure) or cerebral malaria (severe neurological complication of infection with Malaria),”
Union Minister Harsh Vardhan promised to set up a “multi-disciplinary institute” to “identify the reason behind the disease”.
In Muzaffarpur, despite intensive study by experts from the National Centre for Disease Control (NCDC), New Delhi and the Center for Disease Control (CDC), Atlanta (USA), there are two possible theories of the epidemic: one, caused by heat stroke, and two, caused by a toxin in locally-grown fruit, litchi.
Dr Vipin Vashishtha, a member of the team that studied the epidemic in Muzaffarpur along with NCDC and CDC from 2011 to 2013, forwarded the litchi theory.“Whether it is a litchi toxin or some mixed illnesses, the deaths have a strong relation with litchi cultivation,” he said.
Dr John, who was also part of one expert team that identified the epidemic, said that malnourished children who ate litchis and went to sleep without a meal fell ill in the pre-Monsoon season between 4 am to 7 am.
Dr Gopal Shankar, the acting HOD of the SKMCH, to understand the recent death of children in Muzaffarpur claimed that deaths occurred due to “acclimatisation failure in children” and instead were caused by “environmental factors” such as the heat wave and poor rainfall in the area.
“Earlier people thought that outbreak is caused by a virus. But it is a case of heat stroke causing these deaths. In the years 2005, 2011, 2013, 2014 and 2019, when temperature and humidity were recorded over consecutive days at more 38 degrees Celsius and 50 per cent respectively, the epidemic had been at its worse with over 700 dying in 2014 alone,” he said.
Refuting the litchi theory, Dr Shankar asked if people had stopped eating litchis during the years when there were no cases of AEC in Muzaffarpur. “Sick children also do not have symptoms of abdominal pain to prove the litchi theory,” he pointed out.
Another doctor described: “The human angle has always been ignored. It is criminal to say that the deaths are not a case of AES,” he said. “These deaths have had the same symptoms from the past two decades. Poor, malnourished children stay hungry and they pick up to eat anything they find in the gardens like litchis. The government in Bihar is trying to divert the issue of malnutrition instead of taking it up seriously.”
He also added: Beyond deaths, for those who survive the disease, malnutrition also pushes them towards “a survival with neurological deficit”.
The National Human Rights Commission (NHRC) on Monday also sent notices to the health ministry and Bihar government over the increasing deaths of children in Muzaffarpur.