Know What Exactly Is Encephalitis (AES) Outbreak and How Is It Related To Litchis?

19 June 2019

Sangita Agarwal

BhubaneswarAs Bihar, mainly Muzaffarpur, is reeling under the outbreak of acute encephalitis syndrome (AES), litchi goes out of market in the coastal state of Odisha, hours after its Health Minister Naba Kishore Das asked the public food safety commissioner to test the quality of litchis procured from Bihar.

It triggered panic and the traders of Odisha stopped obtaining the berry fruit, believing that it was infected and the disease would spread in the State also. But, is that the case?

Let’s have a clear idea of acute encephalitis syndrome (AES) which caused 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. But, it is very important to know that how is AES connected to litchis and will anyone consuming toxic litchi would contract encephalitis.  

1)   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.

2) 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 according to researchers.

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 litchi toxins (MCPG) present in their bodies affects the metabolism of the fatty acids and the breakdown of glucose, and in many cases, leads to the inflammation of the brain, which is called encephalitis. It 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 reach quite late, thus reducing the chance of survival.

Although the fruit is held responsible for the AES outbreak and numerous deaths, but it has been common since 2013 during the litchi season.