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<ul><li>Encephalitis syndrome death toll crossed 100 in Muzaffarpur, Bihar, on Monday.</li><li>CM <keyword id="6358190" type="PERSON" weightage="20" keywordseo="Nitish-Kumar">Nitish Kumar</keyword> has called an emergency meeting with senior health officers.</li><li>₹400,000 Ex-gratia announced for the families.</li></ul> Bihar is witnessing an outbreak of Acute Encephalitis Syndrome (AES) as the death toll crossed 100 on Monday. Ten more children died due the syndrome on Monday in <keyword id="527716" type="PERSON" weightage="20" keywordseo="Muzaffarpur-district">Muzaffarpur district</keyword>’s Sri Krishna Medical College and Hospital (SKMCH) in Bihar, medical superintendent of the hospital, Sunil Shahi, <a href="https://www.indiatoday.in/mail-today/story/encephalitis-deaths-lapses-behind-bihar-brain-fever-horror-1550908-2019-06-18">informed</a> media on Monday. Bihar Chief Minister Nitish Kumar has called in an urgent internal meeting to take stock of the situation. Senior officers of the Health ministry are expected to attend the meeting. Earlier, on Saturday, Bihar Health Minister Mangal Pandey had said that the state government is doing its best to save the children, <a href="https://www.thequint.com/news/india/muzaffarpur-deaths-hypogylcemia-bihar-brain-fever-outbreak?utm_campaign=fullarticle&amp;utm_medium=referral&amp;utm_source=inshorts">reported ANI</a>. “Everything is being made available, from medicines to doctors. We have even called doctors and nurses from AIIMS in Patna,” Pandey said, adding that protocol is being adhered to while monitoring things, <a href="https://www.thequint.com/news/india/muzaffarpur-deaths-hypogylcemia-bihar-brain-fever-outbreak?utm_campaign=fullarticle&amp;utm_medium=referral&amp;utm_source=inshorts">as per The Quint</a>. The minister also said that six ambulances will be operational at the hospital from Friday and a new ward with 100-bed capacity will be made operational soon, after holding a meeting with SKMCH staff. CM Kumar expressed grief over the unfortunate deaths and announced an ex-gratia of ₹400 ,000 for the families who have lost their children. Encephalitis and Bihar Bihar has been affected by the disease before. In 2014, encephalitis, caused 379 deaths in Bihar. It was said to be due to the delay in implementation of centre’s ambitious project to curb the disease. The then Health Minister, Dr Harsha Vardhan had then visited SKMCH and announced a 100-bed super-speciality facility which is still incomplete. On Sunday, Vardhan said it will be operational in six months. A 10-bed facility for treatment of children also awaits completion. Encephalitis deaths in Muzaffarpur, and adjoining places such as, Sitamarthi, Motihari, Sheohar and Vaishali have been an annual feature for the last three decades. Another lapse in this prevailing problem was a weak awareness campaign by the government. Director-in-Chief, Disease Control, Bihar, RD Ranjan, after his visit to Muzaffarpur on Friday, 14 June, said, “We can confirm the data as of 10 June.” Till then, 34 deaths had taken place and 109 cases of brain fever were reported. He reiterated that none of the deaths, till then, have been caused by AES. “The casualties were result of hypoglycaemia,” Ranjan <a href="https://www.thequint.com/news/india/encephalitis-bihar-muzzaffarpur-brain-fever-outbreak">told Quint</a>.

CM Nitish Kumar to hold internal meeting as Encephalitis death toll crosses 100

Around 19.26 per cent polling was recorded before noon on Tuesday in 94 <keyword id="30033" type="COMPANY" weightage="20" keywordseo="Bihar">Bihar</keyword> Assembly segments in 17 districts, though it was expected to pick up speed as the day progressed, an official said. Muzaffarpur district with 26.09 per cent polling led the table, followed by Gopalganj at 24.12 per cent. West Champaran district registered 21.99 per cent polling by 11 am. Polling percentage in Sheohar was 19.25, Sitamarhi 20.22, Madhubani 18.13, Vaishali 20.33, Samastipur 21.76, Begusarai 19.01, East Champaran 15.76, Darbhanga 15.65, Siwan 15.96, Saran 16.69, Khagaria 19.57, Bhagalpur 20.08, Nalanda 20.20, and Patna 18.16. Officials received a few complaints about non-functioning EVMs and VVPATs in six districts. A group of women in Gopalgang refused to vote at a polling booth after alleging that the EVM had been tampered with. An official at the election control room in Patna said booth number 89 in Darbhanga, 121 in Gopalgang, and 136 in Muzaffarpur reported technical glitches and errors in EVMs during mock polling in polling booth in Ugiyarpur constituency. During the second phase of polling, first-time voter Priyanka, 19, came on a bicycle to cast her vote along with her grandmother in the Raj Bhavan polling booth on Tuesday morning. "I am very happy to cast my vote for the first time. I pressed the EVM button while keeping the jobs issue in mind," she said. Deputy Chief Minister Sushil Kumar Modi cast his vote at Kumhrar's St Joseph High School in Patna district. "I appeal to the people of Bihar to come out and cast their votes by following Covid norms," he said. During the polling, some voters raised objections over the VIP treatment to Sushil Modi. Many voters claimed that they had been standing in queues for half an hour but he just arrived and cast his vote without standing in a queue. Chandrika Rai, Janata Dal-United candidate, also cast his vote in Vaishali. He lashed out at Lok Janshakti Party President Chirag Paswan and said that he did not know the ground realities in Bihar. "He lives in Delhi, wears branded clothes and follows 5-star culture. He doesn't know the ground situation in Bihar," he said. As per the Election Commission, Pirpainti in Bhagalpur district is the largest Assembly segment going to polls in the second phase, with 3.34 lakh voters, including 1.78 lakh males, 1.56 lakh females, and 12 transgenders. Cheria Bariyarpur is the smallest segment with 2.48 lakh voters, including 1.30 lakh males, 1.17 females, and 12 transgenders. Polling in 94 Assembly segments in 17 districts will be held from 7 am till 6 pm. The polling in some sensitive constituencies will end at 4 pm as per the Election Commission (EC) directions.

Bihar elections 2020: 19.26% polling recorded before noon

What Is Chamki Fever/Acute Encephalitis Syndrome Chamki fever or encephalitis is an inflammatory condition of the brain resulting in a variety of associated symptoms. Acute Encephalitis Syndrome (AES) causes an acute-onset of fever associated with headache and most commonly reported in children and young adults. This illness brings about an alarming rate of morbidity and mortality. The recent outbreak of chamki fever in Bihar resulted in over 100 deaths in Muzaffarpur and its adjoining regions in the state of Bihar, India. Most notably, the similar outbreak of chamki fever resulted in about 700 deaths in 2014. Predominantly, chamki fever affects children and young adults in the age group of 1 to 10. The name chamki bukhar means fever condition associated with a seizure. Reports say that chamki fever or AES has spread in over 12 districts of Bihar including Muzaffarpur, Vaishali and East Champaran with Muzaffarpur declared as the worst hit zone. What is Chamki Fever or Acute Encephalitis Syndrome Acute encephalitis syndrome (AES) or chamki fever is a highly serious public health problem in India. It manifests as an acute onset of fever and a seriously affected mental condition resulting in confusion, disorientation, delirium, or coma. The affected individual may experience seizures. Chamki fever can happen in any age and at any time of the year. Muzaffarpur, Bihar and adjoining areas in Bihar are litchi producing districts. This disease mostly spreads far and wide in the months between April and June especially in children who are undernourished with a history of consuming litchis from the neighboring orchards. Causes of Chamki fever or Acute Encephalitis Syndrome Viruses are said to be the main agents causing AES. However, other sources like bacteria, fungus, chemicals, parasites, spirochetes, toxins, and some noninfectious agents have also been noted to cause chamki fever as studied over the past few decades. Japanese encephalitis virus (JEV) is identified as the major cause of AES in India. The percentage of this agent ranges from 5-35 percent. Nipah virus and Zika virus are also said to be AES causing agents. In some cases. The other agents causing chamki fever include Influenza A virus, simplex virus, mumps, dengue, West Parvovirus B4, Nile virus, Epstein-Barr virus Chandipura virus, measles, enteroviruses, scrub typhus, and S pneumonia. Symptoms of chamki fever or Encephalitis Some of the prominent and most common symptoms of chamki fever include High temperature, Headache, extreme sensitivity to light, stiff neck and back, nausea, and mental confusion. In severe cases of chamki fever, seizures and paralysis can result. Japanese encephalitis virus (JEV) As discussed so far, JEV is identified as the major cause of AES in India. This virus is spread by mosquitos and it is a kind of flavivirus. This virus belongs to the same genus like dengue, yellow fever, and West Nile viruses. So far no cure has been discovered for chamki fever. The treatment available now focuses mainly on relieving the severe clinical symptoms found in the affected persons and supporting the patients to overcome the infective condition. Treatment for chamki fever or Encephalitis The affected persons must be treated immediately to avoid severe complications. The patients must be admitted to the Intensive Care unit or ICU to prevent any kinds of major mishaps. Chamki fever can be treated with anti-inflammatory drugs including Acetaminophen, Ibuprofen and Naproxen Sodium which can bring down the temperature and headache. Majority of cases reported with chamki fever can get resolved in a matter of a few days. However, some severe cases can take about a few weeks to recover.

What Is Acute Encephalitis Syndrome (Chamki Fever) - All you need to know

<ul><li>There have been 129 deaths due to the Acute <keyword id="6382102" type="UNKNOWN" weightage="20" keywordseo="encephalitis">Encephalitis</keyword> Syndrome (AES) in <keyword id="30033" type="LOCATION" weightage="20" keywordseo="Bihar">Bihar</keyword> so far. </li><li>The National Research Centre on Litchi has denied speculations linking litchi to causing the syndrome. </li><li>The state-run All India Institute of Medical Sciences (<keyword id="40458" type="COMPANY" weightage="20" keywordseo="AIIMS">AIIMS</keyword>), Delhi, will soon study the actual cause behind the AES syndrome, which is listed under 'unknown category'. </li></ul>129 children have died so far in the Indian state of Bihar due to the latest outbreak of the acute encephalitis syndrome (AES). While poverty and lack of access to healthcare failed the children and their families, a humble fruit, litchi or <keyword id="1168849" type="PERSON" weightage="20" keywordseo="lychee">lychee</keyword>, is taking the fall for the epidemic. The common ground between litchi and encephalitis is <keyword id="6374885" type="LOCATION" weightage="20" keywordseo="Muzaffarpur">Muzaffarpur</keyword>, the centre of the outbreak and the country’s biggest litchi producing district. “We have witnessed around 20% decline in litchi sales in last one week after AES connection with this fruit,” <a href="https://timesofindia.indiatimes.com/city/patna/bihar-aes-outbreak-brings-litchi-sales-down-by-15-20/articleshow/69935680.cms">KP Thakur, managing director of a litchi processing and exporting firm, told the Times of India</a>. The fall in demand occurred after the state government of Bihar issued an advisory for parents to not allow their children to eat the fruit. The advisory was based on a speculation that litchi may be the major cause for the encephalitis syndrome, that affects children under the age of 10. "The cases of AES might be linked to litchi but the disease can be caused by a whole plethora of infections and encephalopathy situations," Professor Sheffali Gulati, Chief of Child Neurology Division, Department of Paediatrics AIIMS <a href="https://www.livemint.com/news/india/aiims-delhi-to-find-out-cause-of-aes-listed-in-unknown-category-1561276211601.html">reportedly said</a>. The speculations regarding litchi being the cause for encephalitis gets validity from <a href="https://www.scmp.com/news/asia/south-asia/article/3014212/encephalitis-lychees-kills-31-children-india-say-health">a research done by the United States in 2005</a>, stating that a toxic substance in the fruit may be the reason. On the other hand, Vishal Nath, Director of National Research Centre on Litchi, has denied the charge that litchi has any link to the cause of the disease. Litchi is sold in many other countries but we don’t hear such epidemics elsewhere, he argued in an interview with IANS, adding that the fruit was a rich source of vitamin B, Calcium, Potassium, Sodium and phosphorus. From pride to panic in six months India exports a part of its litchi produce every year. The government of India wanted to promote the fruit earlier this year by giving it a ‘Geographical Indicator’ (GI) tag. “We have been waiting for GI tag for shahi litchi for a long time. The move has come as a boon for litchi cultivators of the region,” <a href="https://timesofindia.indiatimes.com/city/patna/muzaffarpur-shahi-litchi-gets-gi-tag/articleshow/66297801.cms">Nath had earlier said</a> adding that the GI tag will fetch them “good money.” <div type="javascript" title="Custom" contenttype="Video"><cdata><![CDATA[
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 Six months later, the same country is debating whether fruit is lethal for young children. The real reason The debate over the dangers of litchi may distract from the actual reason where the national anger must pour over -- poverty and lack of access to basic healthcare, which millions suffer from 70 years after independence. It’s not just the poor children of Muzaffarpur who ate the fruit, but the ones who died were mostly poor. The United Nations’ Global Hunger Report for 2018 placed India at 103rd spot out of 119 countries. The National Family Health Survey says almost half of the children under five in Muzaffarpur are stunted, almost 60% were anaemic, and more than 40% were underweight. A health ministry survey found that none of Muzaffarpur's 103 primary health centres - and its only community health centre - were even considered fit for evaluation, <a href="https://economictimes.indiatimes.com/news/politics-and-nation/poverty-not-lychees-the-real-culprit-in-indian-brain-fever-outbreak/malnourishment-is-the-underlying-cause/slideshow/69888516.cms">the Economic Times reported</a>. The state-run All India Institute of Medical Sciences (AIIMS), Delhi, will soon study <a href="https://www.livemint.com/news/india/aiims-delhi-to-find-out-cause-of-aes-listed-in-unknown-category-1561276211601.html">the actual cause behind the AES syndrome</a>, which is listed under 'unknown category'. The anxiety of the litchi farmers of Muzaffarpur will continue until the final results of the study are out.

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CM Nitish Kumar to hold internal meeting as Encephalitis death toll crosses 100

BI India Bureau

Bihar elections 2020: 19.26% polling recorded before noon

IANS

What Is Acute Encephalitis Syndrome (Chamki Fever) - All you need to know

BI India Bureau

India's tragic encephalitis epidemic has hit a humble fruit, Lychee, and its farmers

Sriram Iyer

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