19 June 2019
Bhubaneswar: Acute Encephalitis Syndrome (AES) has claimed lives of 108 children in Bihar’s Muzaffarpur causing nationwide concern. A case of AES is defined as a person of any age, at any time of year, who has an acute onset of fever and a change in mental status - with symptoms ranging from confusion, disorientation, coma or the inability to talk.
It is believed that the children in Bihar were infected by consuming litchis. It has triggered panic and the Odisha State Health Minister Nabakishore Das immediately directed testing of samples of litchi imported from other states for sale here.
But, it is very important to know that how is AES connected to litchis and will anyone consuming toxic litchi would contract encephalitis.
1) In Bihar, litchi was a triggering factor for malnourished children who went to bed on an empty stomach and ate the fruit in good quantity.
2) As litchi always contained a toxin called MCPG, and people have been consuming since ages, the fact that consumption of the fruit will cause AES is totally a myth.
3) Bihar’s Muzaffarpur district is a leading grower of litchi with orchards all around. The poor, malnourished children stay hungry and they pick up to eat anything they find in the gardens like litchis. Moreover, they went to bed on an empty stomach and fell ill in the pre-monsoon season between 4 am to 7 am.
4) The toxin MCPG has the potential to cause hypoglycaemia, a condition where a person's blood glucose level (BGL) drops making a person seriously unwell.
5) While well-nourished children who eat the fruit remain unaffected even if they go to bed on an empty stomach, the under-nourished ones are at grave risk. Blood glucose falls sharply causing severe brain malfunction (encephalopathy), leading to seizures and coma, and death in many cases.
6) This is because under-nourished children lack sufficient glucose reserve in the form of glycogen and the production of glucose from non-carbohydrate source is blocked midway leading to low blood sugar level. This causes serious brain function derangement and seizures.
7) Children suffering from acute hypoglycaemic encephalopathy can be saved only by infusing 10% dextrose within four hours of illness onset.
8) If encephalopathy was indeed the cause of death, this simple medical intervention could have saved many lives. Dextrose infusion could have been done even as children were being transported to hospitals in ambulances.
9) Children suffering from fever and convulsion early in the morning are brought to health centres after 6-8 hours. Some children are safe because they reach on time, while the rest attempt to make it to a nearest government hospital, thus reducing the chance of survival.