Despite recurring annual outbreaks of AES in Bihar, its exact cause is not yet confirmed medically.

Bihar has been in the grip of chamki fever, afflicting more than 600 children of which 136 have lost lives, according to statistics released by the district administration. But this isn’t the first time chamki or Acute Encephalitis outbreak has happened in the state.

It is a regular phenomenon since 2009. The vector-borne disease affects children below age 5 every year during peak summer months. And, it’s only after the onset of monsoon the symptoms of AES start subsiding drastically. According to the latest report by Oxfam India, Muzaffarpur district, with a population of nearly 5 million people, is the epicentre of the crisis. Based on the report’s assessment, the first case reported by the State Health Society was on January 3, 2019, and till June 19, 2019, the epidemic had spread across 10 districts claiming as many as 129 lives, of which, 75 deaths happened in Muzaffarpur district.

AES is a viral disease that causes flu-like symptoms such as high fever (at night), vomiting, pain in stomach and in extreme cases, brain dysfunction, seizure, and inflammation of heart and kidney. With its origin still unknown, the report provides potential causes, including Lychee (Litchi Chinensis) which is at the centre-stage of this debate. However, due to the lack of any conclusive evidence, the Bihar government is creating awareness among villagers to keep their surroundings clean and take care of personal hygiene and sanitation.

Meanwhile, the Oxfam report reveals that none of the hospitals, leaving Community Health Centres (CHC) and Primary Health Centres (PHC) are maintaining cleanliness. What causes AES is still not known. Like many researchers and Bihar health authorities, MD (Pediatrics) Dr Niraj Srivastav from Krishnadevi Deviprasad Kejriwal Maternity Hospital, Muzaffarpur is in a state of complete denial.

Despite working on the viral disease for the last nine years, he still has no answers. “Every year there are so many deaths owing to this mysterious fever that now, it seems to be a regular phenomenon which lasts for about two-and-a-half months — like the annual Sonepur Cattle Fair of Bihar.” But, are the Lychees, a fruit grown in abundance in orchards around Muzaffarpur to be blamed for this wreaked havoc? “It might be an infection from Lychees, heatwave and malnutrition,” he quips with uncertainty in his voice.

To prevent this cyclic outbreak of AES in the coming years, Bihar needs a dedicated research institute specifically on AES in Muzaffarpur. The onset of rains may subside the number of AES cases, but the problem of water-logging will bring other diseases along. However, Union Health Minister Dr Harsh Vardhan has ordered to set up an expert committee comprising of a virologist, nutritionist, paediatrician and scientists to unravel the mystery around the ‘mysterious fever’ that kills several children every year in Bihar.