Of Encephalitis, Litchis and Blood Sugar: Bihar's AES Outbreak Explained

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published Published on Jun 24, 2019   modified Modified on Jun 24, 2019

Over a 100 children have died in Bihar due to AES – or acute encephalitis syndrome – a deceptively straightforward umbrella term for infections that cause swellings on the brain.

An outbreak of infections classified as acute encephalitis syndrome (AES).

* What is AES?

AES is an umbrella term of infections that cause swellings on the brain. Its symptoms typically include headache, vomiting, confusion and seizures, and complications include memory loss, coma and even death.

* Can we treat AES?

It depends. Since AES is an umbrella term for a variety of infections, doctors need to know the specific type of infection before they can consider treatment options. Not all forms of AES can be treated equally well. For example, Japanese encephalitis, caused by the Japanese encephalitis virus, can be prevented using a vaccine of the same name; once it has infected a person, treatment is usually only of the symptoms, not of the cause itself.

Other viruses known to cause encephalitis include the Nipah virus and the Chandipura virus.

* Why are some people talking about litchi?

Following outbreaks between 2012 and 2015, different research groups from India and the US were able to determine that many of those diagnosed with AES – used as an umbrella term – had a specific condition called hypoglycaemic encephalopathy. Encephalitis and encephalopathy sound the same because of their common root, enképhalos, Greek for ‘brain’, but otherwise play out differently different.

As T. Jacob John, a retired professor of virology from the Christian Medical College, Vellore, wrote in The Hindu on June 19, the primary pathology of encephalitis is in the brain where of encephalopathy, it is not. And with encephalopathy, researchers found that the litchi fruit, grown aplenty in Bihar, could be one of the causes, particularly because the outbreak overlaps with the fruit’s harvest season.

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