Two years ago, experts decided that they had found the cause of the illness, but now he has returned with a new force.
Since the beginning of June, children in the poor areas of the Indian city of Muzaffarpur have been rapidly dying from an unknown infection (presumably, it is an acute form of encephalitis). It causes fever and swelling of the brain, leading to convulsions, seizures and, in some cases, death within 24-36 hours. Many doctors just do not have time to help.
Two years ago, it seemed to the researchers that they had defeated the disease, finding the reasons for its development in the fruits of the local lychee fruit, which is also called the “Chinese plum”. However, now experts have doubts about this. They cannot agree with the authorities on the same opinion as to what illness they are facing. Meanwhile, the number of deaths exceeded 150 people – mostly children under ten years old.
The authorities decided that they had conquered the disease, but she returned after a short break.
For many years, for many residents of Muzaffarpura, May was the most terrible and terrible month. With him began about a two-month wave of mysterious diseases in children. They woke up at night crying and crying, and the next day they convulsed, fell into a coma and, about 40% of cases, died. Being powerless before an unknown infection, doctors only advised parents to give children as much water as possible, but this did not always help.
According to unofficial statistics, in total thousands of victims of the disease. Although the first cases of the disease were recorded back in 1995, the long years of death from it were explained by the banal dehydration of children. But in early 2014, the epidemic intelligence service of India began searching for an answer with the support of the American Center for Disease Control and Prevention.
After a year of intensive work, the authorities in India called the culprit of infections – the fruit of lychee, which children from poor areas of the city eat on an empty stomach. Lychee contains hypoglycine A, an amino acid that can disturb the metabolism and lower blood sugar levels, and when the brain lacks glucose, it turns to other sources of energy. They are quickly depleted, causing coma and, in some cases, death.
As it seemed to scientists, the answer to almost 20 years of death in the area was under their nose. In the area of Muzaffarpur, about 70% of all lychee fruit in India is mined, often they just lie on the streets, and hungry children eat breakfast or dinner. “This disease has remained unknown for so many years. This is a kind of symbol of why we are cooperating [with other countries] to create such a systematic approach, ” said Padmini Srikantiah , a senior epidemiologist at the US Centers for Disease Control and Prevention.
As a result of an investigation in 2015, the Ministry of Health of India called onparents in the area to be sure to feed young children with dinner and limit lychee consumption if they do not want them to get sick. Over the next few years, the number of reported diseases fell from hundreds to several dozen
At the end of May 2019, the disease returned – within a month, she suffered 719 children, of which 152 children died. As in the past, most of them come from poor families, but doctors believe that this time the use of lychee is not related to mass deaths.
Some researchers do not want to abandon the old version of the causes of the disease, although now it looks untenable
The reception center for sick children was organized in a medical college and hospital in Muzaffarpur, where, at the time of writing, 102 children died. There are so many sick that some are placed right on the mattresses in the corridors. The overwhelming number of people suffering from the disease is not older than five years, and many are about one or two years old. In the case of the latter, the version of the litchi fruit is almost excluded, because they feed on breast milk.
According to The New York Times, many doctors and authorities doubt that the current outbreak plays the role of litchi, as previously thought. “It must be some kind of virus or bacterium, we just haven’t found it yet,” says a pediatrician by the name of Mandal. “You have to transport the samples to the laboratory at -80, when the outside temperature reaches 45, it’s not surprising that we didn’t find anything.”
What exactly should the doctors find is one of the main questions. Researchers agree that the cause of the disease was encephalitis, but the authorities and scientists do not have a common opinion about what kind of ailment they encountered.
The lack of communication between the litchi fruits and diseases is also indicated by the fact that only the inhabitants of Muzaffarpur suffer from it. In other regions with litchi such flashes are not recorded. A second question appears – why even those who are too young to eat fruit become victims of the disease?
In one case, a five-year-old girl went to bed on an empty stomach, but did not eat fruit that day. The next day, she woke up in convulsions and soon passed away. According to the father of the family, the girl was the healthiest of four children.
According to Reuters, the authorities promise to take the outbreak under control, but the relatives of the sick complain of poor hospital conditions and go to rallies. At least two families petitioned the Indian Supreme Court, criticizing the government for failing to provide the right number of doctors and beds in medical facilities. A special team of pediatricians and medical assistants was sent to the area with the largest number of cases.
Scientist from the Indian National Center for Disease Control Akash Shrivastava (Aakash Shrivastava), who was the lead author of the report on the relationship of lychee fruit with the disease, complained that senior management had forbidden him to publicly discuss the new outbreak.
Arun Shah, a pediatrician from Muzaffarpur and one of the authors of an early scientific article on the disease, believes that a number of scientists are still convinced of the theory of the litchi fruit, even if now this version is much more doubtful.
“The government has not done anything that should have been. At first they paid attention, but in 2017-2018 only a few cases [of diseases] were recorded, last year only 25 cases, and the authorities were satisfied, ” Shah believes .
The Ministry of Health rejected the allegations of inadequate monitoring of the situation. A representative of the agency stressed that while the exact cause of the disease has not been identified, therefore it is impossible to blame the litchi fruits or other products for its outbreak.
In mid-June, the number of cases began to gradually subside, but this cannot be called a victory. None of the doctors still confidently knows what they have encountered. “I think we’ll find out that this is a multifactorial [disease], but for now it’s a mystery. The mystery we have to solve, ”says Dr. Mandal.