Published on June 15th, 2019
Acute Encephalitis Syndrome (AES) claimed lives of 67 children in Bihar’s Muzaffarpur in the last two week. AES outbreaks are routine in areas in and around Muzaffarpur during summer. Children below 15 years of age mostly get affected by AES.
1. What Is AES?
2. What To Blame?
Viruses are the main causative agents in AES cases, although other sources such as bacteria, fungus, parasites, spirochetes, chemicals, toxins and noninfectious agents have also been reported over the past few decades.
Japanese encephalitis virus (JEV) is the major cause of AES in India (ranging from 5%-35%).Herpes simplex virus, Influenza A virus, West Nile virus, Chandipura virus, mumps, measles, dengue, Parvovirus B4, enteroviruses, Epstein-Barr virus and scrub typhus, S.pneumoniae are the other causes of AES in sporadic and outbreak form in India.
3. Who Is Affected?
- It predominantly affects population below 15 years.
- There is seasonal and geographical variation in the causative organism.
- JEV has its endemic zones running along the Gangetic plane including states of UP (east), Bihar, West Bengal and Assam, and parts of Tamil Nadu.
4. Signs And Symptoms
Acute encephalitis syndrome (AES) is characterized by an acute onset of fever and clinical neurological manifestation that includes mental confusion, disorientation, delirium, or coma. Apart from viral encephalitis, severe form of leptospirosis and toxoplasmosis can cause AES.
5. Relation Between Hypoglycaemia, Children and AES
Bihar government officials claim AES is a syndrome, not disease, and cause of death in these children was found to be prolonged hypoglycaemia that witnessed delayed treatment. In 2014 research paper titled ‘Epidemiology of Acute Encephalitis Syndrome in India: Changing Paradigm and Implication for Control’.pdf, coauthored by six researchers, a parallel was drawn between Muzaffarpur and Vietnam’s Bac Giang province where undernourished children were suffering from AES and hypoglycaemia that coincided with litchi orchards in neighbourhood.