In the last couple of days, more than 60 children have reportedly died in Bihar after getting high fever. While some died in the hospital, others died before they could undergo any treatment.
A fever, locally known as the ‘chamki bukhar’, has caused panic in and around Bihar's Muzaffarpur. The name is used to refer to encephalitis or brain fever, characterised by inflammation of the brain.
Speaking to FIT, Dr Chandril Chugh, Senior Consultant and Head, Interventional Neurology, Max Super Speciality Hospital, Saket, shared that between 2008 and 2014, there have been more than 44,000 cases and nearly 6,000 deaths from encephalitis in India, particularly in Uttar Pradesh and Bihar.
Factors like the season and location have a role to play in the incidence and severity of the disease.
Some common symptoms of encephalitis, as mentioned by Dr Chugh are drowsiness, confusion, lethargy, decreased feeding, headaches, seizures or fits, inability to respond, fever, neck pain or stiffness, or weakness on one side of the body.
To find out the main reason for encephalitis at any place, including Muzaffarpur, the need for a strong study remains.
Doctors and government officials have been hesitant in linking the children’s deaths to encephalitis. According to reports, they believe that hypoglycemia (loss of sugar in the blood) and shortage of sodium in their bodies have together been responsible for the unfortunate incidents, and not encephalitis.
To understand if hypoglycemia and encephalitis could be linked in any way, FIT spoke with Dr Ashwini Setya, a Gastroenterologist and Programme Director at Delhi’s Max Super Speciality Hospital.
This could be why the children who are showing encephalitis-like symptoms are also showing signs of hypoglycemia. The doctor further clarified that hypoglycemia in itself is rarely a cause of death.
In conversation with FIT, Dr Shailesh Prasad Singh, Civil Surgeon of Muzaffarpur, said that the children who are unwell in Muzaffarpur indeed have low blood sugar (hypoglycemia) or deficiency of sodium and potassium. He further mentioned other conditions which have also been noticed in the unwell children.
To understand the possible connection between hypoglycemia and these cases, it is important to know what hypoglycemia is and why it happens.
According to Mayo Clinic, it is a condition caused by a very low level of blood sugar (glucose) which is the body's main energy source. It is often associated with diabetes.
The report further adds that like fever, hypoglycemia isn’t a disease itself. It is an indicator of a health problem.
When blood sugar is at 70 mg per deciliter, hypoglycemia needs immediate treatment. This would require high-sugar food and drinks or medicines.
Not treating it can result in seizures, unconsciousness and in severe cases, death.
Bihar’s Muzaffarpur is popular for its litchi. Every year since 1995, the incidence of encephalitis has been coinciding with the litchi season.
In 2014, the Indian Academy of Pediatrics’s article titled ‘Misery of Mystery of Muzaffarpur’ stated that some experts had hypothesised the link between litchi and the city’s brain fever from April to July.
On the potential link between litchi and hypoglycemia, nutritionist Vishruta Biyani wrote for FIT, “Avoid eating litchi, especially the unripe ones, on an empty stomach since they contain hypoglycin A and methylenecyclopropyl-glycine (MCPG); these toxins may result in vomiting and fever. Hypoglycin inhibits the body's ability to produce glucose and may cause hypoglycemia.”
According to media reports, the Rajendra Memorial Research Institute of Medical Sciences (RMRI), Patna and National Center for Disease Control (NCDC) will take special initiatives to detect the main reason behind the encephalitis-like symptoms. Team of RMRI Patna's experts will visit the affected villages of Muzaffarpur and conduct studies on the living standards and food intake of the children there.
Expressing some hope, Dr Shailesh Singh said that relief from heat and humidity is likely to decrease such cases. “The situation should improve after the 12 June rains”, he added.
(This story was originally published on Fit Hindi. It has been translated to English by Saakhi Chadha)
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