Dozens of children in one Indian state are reported to have died in the last two weeks from a little-understood brain disease linked to eating lychee fruits on an empty stomach.
The death toll of children who have died from Acute Encephalitis Syndrome (AES) has been rising in the Bihar state, with First Post reporting on June 13 that authorities had reported over 50 deaths in children since January.
The deaths were reported from two hospitals in Muzaffarpur in northeast India—known for its lush orchards of lychees.
Past studies have linked lychees with outbreaks of AES. The disease, which is characterized by sudden swelling around the brain, can be caused by a number of other factors, but the reason for the outbreak is not fully understood.
According to the Hindustan Times, health authorities did not attribute the childrens’ deaths to AES, but rather to hypoglycemia (low blood sugar). However, the hypoglycemia diagnosis is a known symptom associated with AES caused by lychee toxins.
The fragrant, sweet, translucent lychee fruits can be fatal to children in a malnourished state, according to the Telegraph.
Toxins in the fruit are believed to lower blood sugar levels by blocking the body’s production of sugar. If eaten in the evenings, they can cause blood sugar levels to drop to lethal levels when the effects combine with the natural fall in blood sugar that occurs during sleep.
However, the link between AES and lychees is also not fully understood.
— LatestLY (@latestly) June 13, 2019
The toxins in lychees are similar to those in the Jamacian fruit ackee, which causes the acute encephalopathy disease called Jamaican vomiting sickness (JVS).
The illness can lead to seizures, an altered mental state, and death in more than a third of all cases.
A 2017 medical journal report into a 2014 AES outbreak in the same region recommended minimizing lychee consumption, ensuring the consumption of an evening meal, and implementing rapid glucose correction for suspected AES cases.
“Our investigation suggests an outbreak of acute encephalopathy in Muzaffarpur associated with both hypoglycin A and MCPG toxicity,” the report noted.
An earlier report in May 2014 noted that AES had also been observed in the lychee-growing regions of Bangladesh and Vietnam.
“Investigators in Vietnam believed that the disease was caused by some unknown virus, while in Bangladesh the disease was not thought to be infectious but was attributed to pesticides used in the orchards. Curiously, both these studies and the one from Muzaffarpur showed a positive correlation between the number of cases and amount of lychee harvest,” the report read.
According to the Telegraph, AES outbreaks have occurred in the area for over 20 years and is known as Chamki Bukhar.
The outbreaks typically occur during lychee season. However, the season also corresponds to the worst time for mosquitos.
In 2011, researchers speculated that the deaths were caused by mosquitos introducing a germ to the lychees, according to the Telegraph.
Ashok Kumar Singh, a senior health official, told AFP, “The health department has already issued an advisory for people to take care of their children during the hot summer when day temperature is above 40C (104F).”
According to Singh, most of the children who died at hospitals in Muzaffarpur had suffered a sudden drop in blood sugar.