Muzaffarpur, fourth populous district of Bihar, known only for its leechi production, but recent outbreak of suspected Acute Encephalitis Syndrome (AES) has brought the district in top news on every news platform. Killing 130 children in Bihar, this disease has left the country with terror. Cases of children affected with this disease were recorded between January and third week of June. Over 600 diseased children have been reported in the state and many have been treated as well.

Every year, the outburst of the disease happens during summer months in Muzzafarpur and part of Uttar Pradesh since 1995.  The disease is locally called as Chamki Bukhar (Brain fever). The breakout of AES is seen in 11 districts of Bihar namely - Vaishali, Sitamarhi, Sheohar, East Champaran, Patna, Nalanda, Muzaffarpur, Jehanabad, Gaya, Bhojpur and Aurangabad. But the death of children has been reported only in Muzaffarpur.    

The exact cause of death is debatable among government and people. Many are addressing it as encephalitis, other are saying it hypoglycemia – abnormally low level of sugar in the blood or deficiency of sodium or potassium or both. People are getting confused with both diseases as they have similar symptoms.   

An advisory has been issued urging parents to prevent their children from playing under the sun when temperature is hovering between 42 to 43 degrees Celsius to prevent dehydration that might lead to AES.   

A team of health department experts led by Director-in-Chief, R D Ranjan have arrived in the Muzaffarpur to take charge over the prevailing situation of the area on Wednesday (12th June). They will be looking after the AES cases in Kejriwal hospital (private hospital), Sri Krishna Medical College and Hospital, Muzaffarpur. Darbhanga Medical College and Hospital, Patna Medical College and Hospital, Anugrah Narayan Magadha Medical College and Hospital, Gaya, Sadar hospital, Motihari, Sadar hospital, Hajipur and Referral hospital Rajauli, Nawada.   

Acute Encephalitis Syndrome (AES) or Japanese Encephalitis (JE) is a group of clinically similar neurologic manifestation. It is caused by several different bacteria, viruses, parasites, toxins etc. Encephalitis outbreak coincides with the monsoon and post monsoon period as the density of mosquitoes increases during this period. AES affects only children and young adults.    

The eruption of AES in northern and eastern India have been linked to children eating unripe litchi fruit on empty stomach. Unripe fruits contain toxins which causes severe vomiting, altered mental state leading to lethargy, unconsciousness, coma and eventually death. These toxins cause sudden high fever and seizures serious enough to require hospitalisation in young, severely malnourished children. The disease can be seen with an acute onset of fever and clinical neurological manifestation which also include mental confusion, disorientation, delirium, or coma.   

Children are known as the future of the country, but this everyday rise in death toll is definitely endangering this fact. The situation of highly populated state raises question on the health system of the country and puts authority in spotlight. Though, some are accusing the climate change but there must be an impactful solution to turn the current scenario of the country.