Heat, humidity and malnutrition contributed to children's death due to AES in Bihar: IMA

New Delhi: Prevailing heat and humidity conditions coupled with malnutrition has "contributed substantially" to the deaths of hundreds of children due to acute encephalitis syndrome in Bihar's Muzaffarpur, an IMA team has said.

The team, which analysed the fatalities there, said consumption of 'litchi' cannot be attributed as the major factor as even infants have been affected. Dehydration, hypoglycaemia and the heat syndrome have played a significant part, the IMA said adding reduction in body temperature with tepid sponging, increased fluid intake and adequate food intake may prevent this syndrome. "Tepid sponging, correction of dehydration and hypoglycaemia can start right from home.

"A package programme focussed on health awareness, free meals to children especially at night and public availability of ORS (oral rehydration solution) may be simple interventions which may prevent further catastrophes," the four-member doctors team said. Two more children died in Bihar's Muzaffarpur district on Sunday due to acute encephalitis syndrome (AES). The state Health Department put the total number of AES casualties across 20 districts at 152. In its observations, the IMA team said that no definite conclusions can be made about the aetiology of the syndrome as of now, but "high atmospheric temperature, humidity and malnutrition appear to play a role in the causation of this encphalopathy." According to the doctors, acute encephalitis syndrome is unlikely to be an infectious cause with the present evidence.

"Litchi consumption cannot be attributed as the major factor as even infants have been affected. Persistence of very high atmospheric with temperature humidity through out the day and night without fluctuations might be causing a heat syndrome in children," they said. The doctors body recommended that affected children have to be given IV dextrose for correction of hypoglycaemia to prevent significant brain injury.

Foolproof scientific, epidemiological study and follow up of children who survived in previous episodes (2014, 2015) should be done systematically, they said. Follow up of these children for assessment of sequlae and MRI brain imaging for changes in brain should be evaluated, they stated. They pointed out that an awareness campaign about the preventive measures is essential especially among the rural population and measures to uplift the living conditions of the affected population should be undertaken as an immediate package programme. "Reduction in number of cases when the atmospheric temperature has fallen down indicates a possible causal relationship between the high temperature, humidity and the present syndrome," the team added.



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