It's not just the Litchi

- Jayali Wavhal

More than 100 children, all aged below 10 years, have succumbed to what is medically known as the acute encephalitis syndrome (AES), a disease categorised by drop in blood sugar level which affects consciousness.

Multiple medical studies and nutrition experts have linked this disease with consumption of litchis as the AES outbreak first occurred in 1995 in and around Muzaffarpur during the litchi season, and has continued to do so. According to reports, the deceased children suffered from a sudden drop of glucose in the blood and also showed symptoms similar to AES, one of them being inflammation of brain.

“Fasting for longer hours causes a drop in your blood sugar levels. And litchi contains a chemical called Methylene cyclopropyl-glycine (MCPG) which affects brain functioning and consciousness when blood sugar levels are low. It’s that simple, yet dangerous. Litchi isn’t the problem, the way it is being consumed is”, said a Mumbai-based nutrition expert Mandar Sadhye.

Amongst all the cases, it was discerned that only malnourished children from rural areas have been affected by the encephalitis syndrome. Parents of the affected kids reportedly shared that their children often consumed litchis on an empty stomach and frequently skipped meals, which made them more vulnerable to hypoglycaemia (drop in blood sugar levels). The toxins in litchi weakened the glucose synthesis in the body, leading to a drop in blood sugar and inflammation of brain, medical officials say.

Paediatric officials at Sri Krishna Medical College in Muzaffarpur stated that litchis aren’t the only reason for the AES outbreak; the temperature plays a major role too. “When the temperature goes over 37-38 degree Celsius, it aids the toxins in litchi to affect the patient. In simpler terms, the litchi toxins are stored in the liver; but when the temperature rises, these toxins are released in the body which leads to high fever, swelling of the brain and inflammation in the brain thus causing seizures”, said one of the paediatric official at SKMC.

Besides the litchi toxins and high temperature, families of the victims have also blamed the lack of infrastructure and medial facilities. Vijay Kumar, who recently lost his 9-year-old son to AES, stated in a Facebook post that the hospitals were short staffed. “The hospital lobbies are flooded with parents like us with their ailing children but there aren’t enough doctors and nurses to treat them. An immediate short-term remedy is injecting glucose, but the medical staff also suffered a shortage of glucose bottles and antiviral medicines”, he said in his post.

Through the comments on his post, it was determined that multiple hospitals did not have enough beds to admit the children thus leading to an atmosphere of apathy and a delay in treatment. Some parents claimed that they were suggested to opt for expensive neurological procedures whereas the treatment for AES includes administration of glucose, plenty of liquids and antiviral medicines before it is too late.

Union health minister Dr. Harsh Vardhan and state health minister Mangal Pandey recently announced that a new and separate building with 100 beds and sufficient supplies will be built for the paediatric ward soon.

Another perspective to look at these deaths would be of how within the country there is a replication of colonial behaviour. A poor state like Bihar, produces a crop like Litchi, which is not necessarily consumed on a large scale within its boundaries but has become a staple in the baskets of urban consumers. While it produces this fruit, it lacks the basic amenities, protocols or even general awareness that is required to be built around this crop. While generating cash for the farmers, the Litchi crop has generated deaths for the poor labour children, year after year. 

Besides Bihar, states like Uttar Pradesh, Assam, Jharkhand, Manipur and Odisha have also reported cases of AES recently.

Jayali is an intern with Indie Journal.