NEW DELHI: A high-level team sent by the Centre to study Acute Encephalitis Syndrome (AES) deaths in Bihar’s Muzaffarpur, has for the first time established a co-relation with day temperature exceeding 40 degree Celsius over three days at a stretch, coupled with constant high night temperatures with a spike in cases of the disease.
A total of 441 AES admissions were recorded from three districts of Bihar earlier this year and around 135 of the patients, all children from very poor families, succumbed to the disease.
The report, accessed by this newspaper, has shown that whenever there has been a spike in temperature for a long period in between the months of May-June, since 2012, more children — who come from disadvantaged families — have been admitted with AES.
AES is an umbrella diagnosis, under which a child experiences unconsciousness and convulsions with or without fever. The peculiarity of AES in Muzaffarpur includes the fact that it involves young children, mainly between 18 months to 10 years of age with a mean age of 3 to 4 years.
A clustering of cases in the month of mid-May and June was noticed, with an acute decline in a number of new cases with the first spell of rain.
In most cases, the children were active and played out in the sun. After returning home they showed signs of extreme exhaustion and went to sleep early without having any food. They would then wake up with convulsions the next morning.
The team, led by Dr Arun Singh, an advisor with the Union Ministry of Health and Family Welfare on Rashtriya Bal Swasthya Karyakram, concluded that the years with the highest number of days with temperatures over 40 degrees, registered the highest number of AES cases.
These years include 2012, 2014 and 2019. The highest numbers of mortalities were also recorded in these years. In 2018, when the day temperature never crossed 40 in the period, there were just 15 hospital admissions.
In 2019, on the other hand, when the day temperature was over 40 for about two weeks in a row, the highest numbers of cases were reported.
“These children are acutely malnourished and cannot cope up with the heat that tires down their mitochondria,” Singh who spent a month in Muzaffarpur to study the disease pattern told this newspaper.
The team conducted extensive sampling of some of the affected children in laboratories of Pune, Bengaluru and Bombay and found that mitochondria in these children were swollen. Due to high temperatures and the absence of essential micronutrients in the bodies, the children were affected by AES either due to infective or metabolic reasons.
“In states where day temperatures are high, people adapt to it by avoiding outdoor activities or covering themselves up. That is not happening in the affected region,” said Singh.
The team also dismissed the Litchi connection with the disease.