The suspected Acute Encephalitis Syndrome (AES) outbreak in Muzaffarpur has killed over 150 children. Amidst the fear and paranoia among the residents over ‘chamki fever’ (as it is called locally), the Supreme Court has issued a notice to the Central, Bihar and Uttar Pradesh governments in connection with these deaths.
A list of remedies and symptoms associated with encephalitis is being circulated on social media. FIT spoke with Dr Rafat Trivedi, Consultant Pediatric Neurologist at Max Hospital, Gurgaon, to verify these claims.
First of all, Dr Trivedi clarified that there is still a lot of dispute over the actual cause of ‘chamki bukhar’. While some consider heat stroke responsible, others are asserting that litchis could have caused the disease.
Talking about the need of protection from the sun and drinking more water, she said that it is always recommended to make sure children are well hydrated during the summer season.
It can’t be said for certain whether protection from heat is directly related to encephalitis or not. But yes, because of susceptibility to heat strokes and dehydration, it is better to limit children’s exposure to the sun and ensure that they have enough water.
Secondly, it is important to keep children away from junk food because proper nutrition is crucial in such cases. It has been observed that most of the children affected by encephalitis had been malnourished.
Is Litchi Responsible?
The suspected association between litchi and ‘chamki bukhar’ or AES is because of a toxin in the fruit called methylenecyclopropylglycine (MCPG), which can lead to a decrease in the sugar level in the body. So, if a malnourished child consumes raw litchi, or has too much of it, then he/she may become prone to hypoglycemia (low blood sugar level).
Dr Trivedi explains that our liver has glycogen (works as a form of energy storage), which breaks into glucose when needed — this way the glucose level in our body is always maintained. However, malnourished kids do not have enough glycogen stored in their liver. So when the toxin enters the body, it isn’t able to turn into glucose. That’s one theory.
We cannot be 100 percent sure and say it is being caused by litchi. But it is definitely related to malnutrition.Dr Rafat Trivedi
On consuming sugar after eating food, Dr Trivedi clarifies that there is absolutely no relationship between this and encehpalitis However, it is advisable to give children a good, healthy and balanced diet at night before they sleep.
In conversation with FIT, Dr Shailesh Singh, Civil Surgeon in Muzaffarpur, had said that in most cases, it had been observed that exposure to the sun all day and going to sleep without eating at night had been making children vulnerable to the fever.
According to him, children are getting sick due to excessive heat, humidity, hunger and malnutrition.
In the message, repellents, nets, and other ways to protect oneself from mosquitoes have also been recommended as ways to avoid the fever. The guidelines given by the Health Department of Bihar government mentions these, along with vaccination for Japanese encephalitis, cleanliness and using boiled water for drinking and cooking.
Dr Trivedi also points out that in these cases of chamki bukhar or AES in Bihar, the tests for bacteria or virus have been negative.
Preventing water accumulation at one place and using mosquito repellents have been recommended for protecting people from mosquito borne diseases such as dengue fever or Japanese encephalitis. But even in general, cleanliness and hygiene is important in order to avoid infection.Dr Rafat Trivedi
As far as not feeding rotten or spoiled food is concerned, it is applicable to everyone everywhere.
Fever, cramps, fainting, shivering, occasional rashes on the body and low blood sugar may be symptoms of encephalitis.
Dr Rafat Trivedi explains that in most of the Muzaffarpur cases, it has been observed that the children are okay the night before, and suddenly they have fever. They seem fine before sleeping, and the next morning, their body is stiff, shivering — or they have fainted.
It is true that encephalitis affects children up to the ages of 10 or 15, and the moment any symptoms are observed, they should be rushed to a doctor so that they get prompt treatment.
How to Protect Children from Encephalitis?
Dr Trivedi says that it is most important to treat malnutrition because encephalitis is usually observed in malnourished kids. Our primary healthcare doctors and workers should educate parents about nutrition and the need for a balanced diet among their children.
Cleanliness, hygiene, clean water — everything should be taken care of.
Policies and efforts on the part of the government are needed for those affected by the fever and others who are vulnerable.
(This story was originally published on Fit Hindi. It has been translated to English by Saakhi Chadha)
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