Bihar Chief Minister Nitish Kumar on June 17 called an internal meeting of senior officials of the health department following reports of acute encephalitis syndrome (AES) claiming lives of over 100 children in Bihar's Muzaffarpur district.
According to reports, Bihar has recorded cases of the disease since January, but they have spiked in June.
While Chief Minister Nitish Kumar had earlier expressed grief over the deaths and announced Rs 4 lakh ex gratia to the next of the kin of the deceased, criticism against both the state and the central governments is mounting with the rising toll.
Here's what we know about the disease and the outbreak so far.
What is AES?
Acute encephalitis syndrome is a neurological disease affecting the central nervous system. The disease is mostly seen in children and young adults, and can cause delirium, coma, seizure and confusion.
According to the National Health Portal of India (NHP), it is "a serious public health problem" in the country. AES is characterised by onset of fever and change in mental status.
What causes AES?
The Japanese encephalitis virus (JEV) is a leading cause of acute encephalitis syndrome in India, according to the Union Health Ministry data. Over 15 percent of cases of AES were found positive for infection due to JEV.
That, however, is not the only cause. It can also be caused by Zika virus, Nipah virus, scrub typhus, measles, dengue and mumps among others.
What are the symptoms of AES?
According to the NHP, "a case of AES is defined as a person of any age, at any time of year with acute onset of fever and a change in mental status".
"Other early clinical findings may include an increase in irritability, somnolence or abnormal behavior greater than that seen with usual febrile illness," the NHP's page on the disease states.
Have AES outbreaks been reported earlier in India?
AES was diagnosed for the first time in India in 1955 in the then State of Madras (now Tamil Nadu). In Muzaffarpur, AES outbreaks have been reported since 1995, according to reports.
According to the National Vector Borne Diseases Control Programme (NVBDCP), in 2018, 10,485 AES cases and 632 deaths reported from 17 states across India. The cases were reported mainly from Assam, Bihar, Jharkhand, Karnataka, Manipur, Meghalaya, Tripura, Tamil Nadu and Uttar Pradesh.
How is the state and the central governments responding to the crisis?
Apart from the compensation offered by the state government, it has assured that it is making all the efforts to contain the disease. CM Nitish Kumar also called an internal meeting of senior officials of the health department on June 17.
State government officials continue to maintain that majority of the victims had died due to hypoglycemia, a condition caused by very low level of blood sugar and electrolyte imbalance and not due to AES.
Union Health Minister Harsh Vardhan visited the families of the children suspected to be suffering from AES in Muzaffarpur on June 16, assuring them of help from the Centre.
Vardhan held a meeting with senior health officials and doctors. He said the heat and humidity in Bihar— which has claimed over 44 lives in the state— as possible reason behind the disease.
Assuring that the Ministry of Earth Sciences would help formulate an action plan with the state government to deal with the situation, Vardhan said the IMD's observatory in Muzaffarpur will also be upgraded.
According to reports, Vardhan was confronted by the kin of the ailing children and by parents of a five-year-old child who died during the minister's visit. Black flags were also displayed at the health minister's cavalcade.
Meanwhile, the Jharkhand government has directed all the hospitals and medical colleges in the state to be on high alert.
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