SC Refrains from Continuing With Pleas on Encephalitis in Bihar, Says Steps Have Been Taken to Combat Menace


New Delhi: The Supreme Court Friday decided to refrain from hearing any further the petition relating to the outbreak of acute encephalitis syndrome (AES) in Bihar’s Muzaffarpur district saying steps have already been taken to combat the menace.

The apex court took on record the affidavits filed by state government and the Union Ministry of Health and Family Welfare in which the two said that they were cooperating and working together to combat the disease which has claimed more than 100 deaths.

The Bihar government had said that the state, in cooperation with the Centre, All India Institute of Medical Sciences and other agencies, has simultaneously provided all medical facilities to treat the affected children.

Similarly, the Centre had also said it was proactively providing all support to Bihar in containing the AES.

“Having perused the affidavit of Bihar and the Ministry of Health and Family Welfare, Government of India, we are not inclined to continue to entertain these writ petitions any further in view of the steps which are stated to have been taken to combat the menace of the encephalitis disease that has struck the different parts of Bihar.

“If the petitioners have any further grievance, they are free to move the High Court of Patna. The writ petitions are disposed of accordingly. Intervention application(s) and other pending interlocutory applications, if any, shall stand disposed of,” a bench comprising Chief Justice Ranjan Gogoi and Justice Deepak Gupta said.

During the hearing, the bench expressed displeasure that the petitioner has raised other issues like 57 per cent shortage of doctors etc.

“So you want us to exercise our jurisdiction for filling of vacancy of doctors. You go to Patna High Court.,” it said, adding that petitions would be filed relating to shortage of ministers, shortage of MPs in Rajya Sabha and shortage of water etc.

“We are not inclined to entertain,” the bench said.

The apex court on June 24 had taken note of the petition filed by an advocate, Manohar Pratap, who had said he was deeply “pained and saddened” by the deaths of more than 126 children, mostly in the age group of one to 10 years, in the past weeks.

It had asked the Centre and the state government to file their affidavits on the adequacy of medical facilities, nutrition and sanitation and the hygiene conditions in the state.

Litchi industry in Bihar faces huge loss after encephalitis outbreak


Unlike previous years, the summer this year initially brought wide smiles on the faces of farmers in Bihar’s Muzaffarpur district as the region witnessed a bumper crop of litchi, the luscious fruit grown abundantly here. The joy, however, was short lived as the crop once again came under the scanner of researchers and medical experts following the death of 204 children and 938 cases in hospitals across the state due to the Acute Encephalitis Syndrome (AES).

The deaths dealt a severe blow to the litchi industry which has resulted in huge losses for the farmers and traders involved in the seasonal business that is a major source of revenue for the local economy.

Bihar is the top litchi producing state in India and according to figures provided by the former union agriculture minister to Lok Sabha last year, the state accounts for 300,000 metric tonnes of litchi, which is produced on 32,000 hectare areas. Bihar’s contribution in the production of litchi is about 40 percent

Mohammed Nizamauddin, a prominent litchi farmer and trader from Muzaffarpur, is yet to come to terms to the enormous loss. Nizam, as he is fondly called, has been in the business for more than a decade now. This year he suffered losses to the tune of around Rs 1.5 million.

The loss has put all his plans to visit a tourist destination in a quandary.

“Negative propaganda about the fruit, which has high protein and nutritional value, took a toll on its demand and supply,” lamented Nizam.

Other litchi growers across Muzaffarpur are facing a similar situation due to the negative publicity of the fruit following the AES deaths.

Traders said that the industry has suffered losses to the tune of Rs 100 billion. Last year the litchi traders did a business to the tune of Rs 60 billion and due to bumper crop this year, they had expected the business to rise to Rs 100 billion. Besides, export, supply of the fruit to various processing plants has been adversely hit. The litchi farmers and traders are worried as their crop has been blamed for a disease that still remains a mystery and there is no authentic proof of its connection with AES.

Their concerns found support from BJP MLC Sanjay Paswan, who had raised the matter in Bihar assembly while MP Rajiv Pratap Rudy also raised the matter in Parliament.

“Wrong propaganda that litchi was behind the cause of AES deaths has led to the enormous losses. Nearly 100 tonnes of fruit pulp of Rs 6.5 million market value is still lying unused after the false propaganda that litchi was the culprit behind the AES deaths,” said K P Thakur, one of the leading litchi traders and owner of Litchica International.

Thakur exports litchi juice to USA, Australia, New Zealand besides supplying the same to Mumbai and Delhi. “No orders came this year either from USA, Australia or New Zealand causing a loss of Rs 3 million,” said Thakur, who has an annual turnover of Rs 30 million.

Thakur is not alone. “There are close to one lakh people including producers, businessmen and labourers who are directly or indirectly involved in this litchi business in four major litchi producing areas of Muzaffarpur, Vaishali, Samastipur and East Champaran,” said Bachcha Singh, president of Litchi Grower’s Association.

According to a report by the Bihar horticulture department, there are 45,000 litchi-growing farmers in Muzaffarpur alone.

“The AES false propaganda, though it came at later stages, must have caused a loss of more than Rs 1 billion alone in Muzaffarpur,” said Singh.

“Such was the impact that litchi, which usually disappears from the market by mid-june, had no takers till June 25 this year,” added Singh.

The Litchi Grower’s Association president cited that another reason for mounting loss has been the railway’s decision to discontinue the services of parcel van in Pawan Express for Mumbai forcing litchi traders to send their product by trucks. “We used to send 30 tonnes of litchis per day to Mumbai by Pawan Express. But after the railway’s withdrew the service in 2018, the fruit is sent by truck as a result of which, one-fourth of the total litchis get damaged and the fruit also doesn’t remain fresh, resulting in low price,” rued Singh.

Smelling a conspiracy, Thakur said that same litchis did not cause any problem in Uttar Pradesh.

“Litchis have high percentage of phosphorus and when poor kids eat rotten fruit empty stomach, it increases sugar levels and make kids vulnerable to sun stroke,” said Thakur.

Thakur and other traders have found support from BJP MP Rajiv Pratap Rudy and BJP Bihar MLC Sanjay Paswan, who alleged that a campaign was launched against litchi under a conspiracy.

India is the second largest producer of litchi in the World after China. Other major litchi producing countries are Thailand, Australia, South Africa, Madagascar and Florida in US.

Among fruit crops, litchi ranks seventh in area and ninth in production but is sixth in terms of value in India. The national average productivity of litchi is 6.1 t/ha, which is much lower than the realizable yield of the crop under well managed condition.

In the Saga of Bihar, Where to Start and Where to Conclude?


During the considerable time gap since then much water has flown down the rivers and many events, both pleasant and unpleasant — from abuse of girls in shelter-homes to Pulwama bombing to the Lok Sabha elections to the outbreak of encephalitis — have all filled the pages of newspapers, I spent a good hundred days in India, mostly at my ancestral home in the city of Darbhanga (24 Feb to 19 May, 2019). Away from India, I always had the urge to reach out to fellow Biharis through the PD columns; closer home, as if I was on an unexplained leave of absence!

Before arriving at Darbhanga, my wife, Reeta, and I had the opportunity to visit my alma mater JNU, present a talk arranged by Dr Mansi Mandal, a JNU alumni, at Amity University (Gurgaon), meet with a number of friends and relations in Delhi, and take a holy dip at the Prayag Kumbh while camping with my Lucknow-based cousin sister Madhu Di (originally from Patna).

At every stage of my travel, I thought I could have sent a short dispatch to PatnaDaily capturing my impressions or experience (as many competent writers do), but the procrastinator in me always came in my way. During my prolonged stay at Darbhanga, I always toyed with the idea of writing something and thought of a potential topic every day but, again, failed to get myself to doing that on one pretext or the other. The idea seemed to drown with the setting sun every night.

The thought of uselessness of writing, frankly, also crossed my mind. It possibly discouraged me from typing out my impressions. I was most likely overwhelmed by many things going on around me. I decided perhaps voluntarily to internalize the experiences and then set about expressing them. But then the question was where to start, which question to take up and where to go? Who will I be writing for? Who are the targeted readers? Is there anything new I’m going to say? Should I be recording things for myself and then share with interested friends and relations later? How is this going to be beneficial to the society? And so on.

As a Bihari settled in Canada, I thoroughly enjoyed being at my ancestral home place living in its own life-style; however, that didn’t prevent me from critically looking at my own surroundings in Darbhanga, most of the time through a foreigner’s pair of glasses. The contrasts between our two livings — and the mindset — were so stark that I feared if I said anything critical, I would be seen as attempting to force people into adopting certain attitudes and behavior that they considered “foreign.” But my anguish continued. I wished to engage everyone around me in a serious conversation: Please think long and hard about the future of Bihar.

If I were to frame one question, I would ask: “Are we trying to make Biharis, particularly the generation that is under ten, into the future aware Citizens?” What will happen when this huge chunk of the population grows up into adulthood not properly educated or trained; not seeing a clean or efficient administration or the rule of law in action; not realizing the dangers of lawless behavior on the road or in the over-populated neighborhoods; not understanding the consequences of environmental (including noise) pollution or not comprehending the superstitious-exploitative, ritualistic, self-destructive or political aspects of organized/ institutionalized religions?

It’s very easy to hold the government-that-be responsible for everything and it is to a large extent; but, what about the role of the people with whom lies the Sovereignty, who were part of the Civil Society? What when the government had all good intentions and a section of the people were hell bent on frustrating them? What when the people took laws into their own hands? So where to start and where to conclude?

162 children died of encephalitis in Bihar, 63 in seven other states: Govt


s many as 162 children died due to acute encephalitis syndrome (AES) in Bihar till July 2 this year, while 63 fatalities were reported from Assam, Jharkhand, Maharashtra, Manipur, Odisha, Uttar Pradesh and West Bengal till June 30, MoS Health Ashwini Choubey said on Tuesday.

Responding to a question over whether lychees were the cause of deaths, the minister, in his written reply in Rajya Sabha, said consumption of lychee was safe for healthy individuals, but in “malnourished children, it triggers hypoglycaemia and leads to seizures or AES”.

“A research study was conducted by the National Centre for Disease Control (NCDC), along with partner institutions, in the year 2013-14 wherein it has been found that when lychee is consumed by malnourished children, it triggers hypoglycaemia and leads to seizures or AES like picture,” Choubey said in his written reply.

On the basis of the study, an intervention strategy for awareness and nutritional supplementation was recommended to the state, the minister said.

A comprehensive study incorporating various other aspects of aetiology has been initiated by the Ministry of Health under Indian Council of Medical Research (ICMR).

“In 2019, a total of 162 deaths of children have been reported from Bihar till July 2 due to AES. As per information received from the National Vector Borne Disease Control Programme (NVBDCP), 63 deaths have been reported due to AES till June 30 from other seven states of the country — Assam (25), Jharkhand (2), Maharashtra (1), Manipur (1), Odisha (1), Uttar Pradesh (17) and West Bengal (16),” his reply stated.

He also elaborated on a number of measures that the Centre has initiated to support the Bihar government in the containment of AES, while adding that “as per constitutional provisions, health is a state subject”.

Choubey, in his reply, said Union Health Minister Harsh Vardhan had reviewed the situation with his counterpart in Bihar and also with officials from the ministry.

A team of experts, consisting of public health specialists from various central government institutes, was deputed to assist the Bihar government in taking immediate measures to contain AES, he said.

Vardhan had also visited Shri Krishna Medical College and Hospital (SKMCH) at Muzaffarpur in Bihar, Choubey said.

The Health Ministry had sent another high-level multi-disciplinary team, which included senior pediatricians from various central government institutes, to Muzaffarpur.

Epidemiologists from the National Centre for Disease Control (NCDC), senior pediatricians, laboratory technicians are in Muzaffarpur since June 12.

The NCDC’s Strategic Health Operations Centre (SHOC) was engaged to monitor the situation in Muzaffarpur and co-ordinate tasks at the field level, Choubey said.

He said the Health Ministry had deputed five teams of doctors, along with technicians from central government hospitals, to SKMCH to support clinical management.

“A central team, consisting experts from Indian Council of Medical Research (ICMR), was also deployed at SKMCH. The team is also scrutinising and reviewing the case records of discharge and deceased patients using a standardised tool to know the reasons for mortality,” he added.

Free meals planned to fight ‘brain fever’ in India’s Bihar state


Patna: Alarmed at the large number of deaths in the state due to encephalitis, the Bihar government is working on a plan to start free evening meals for children vulnerable to the deadly virus.

The idea is based on reports by health experts that most of the children who fell victim to the illness had gone to bed on empty stomachs or had suffered from hypoglycemia or low blood sugar.

According to an official report, the disease has claimed close to 2,000 lives in the past nine years.

“The government is planning to start free evening meals for children on the pattern of the mid-day meal from the next season and also shifting them to temporary shelter homes during the peak summer when such cases register a huge jump,” federal minister of state for home and family welfare Ashwini Kumar Choubey told the media on Monday after holding a meeting with the experts.

However, the arrangement for free evening meal will be available only for two months during peak summer. Experts have found that the disease strikes the region once the summer starts and turns deadlier with the picking up of daytime temperatures.

Although some 20 districts are said to be in the grip of this disease, Muzaffarpur has been the worst-hit of all.

According to him, the government would also be making adequate arrangements of glucose, oral rehydration solution (ORS) and medicines.

“After meeting with the health experts, we have ordered the setting up of intensive care units (ICUs) in the affected areas from next year,” the minister said.

Bihar health minister Mangal Pandey on Monday said this year majority of children had died from hypoglycemia, which is one of the symptoms of Acute Encephalitis Syndrome (AES).

One of the main reasons behind disease outbreak this year was severe heat conditions and humidity. He advised the parents not to allow their children go out in the open sun.

“When the children play under the open sun, it causes dehydration and affects a child’s intake of food and water which leads to hypoglycemia,” the minister said.

In an official statement issued on Monday, the health minister said the disease has been occurring since 1995 after which various studies were conducted by the National Institute of Virology, Pune, National Centre for Disease Control, Delhi, All India Institute of Medical Sciences, Delhi, Rajendra Memorial Research Institute, Patna and Centre for Disease Control, Atlanta (USA) but no definitive causative agent has been found so far.

According to the minister, till June 28 this year a total of 720 cases of suspected encephalitis were reported of which 566 were cured whereas 154 children died.

100 Kids Have Died Due To Encephalitis In Bihar, Govt Seems Clueless About How To Save Them


The death toll due to the Acute Encephalitis Syndrome outbreak in Bihar has reached 100 and despite claims made by state government, the number of deaths are increasing with more and more infected children rushing to the hospitals.

Muzzafurpur district is mainly affected by the outbreak and 83 children have succumbed to Encephalitis at Sri Krishna Medical College while 17 died at Kejriwal hospital. The union health minister Harsh Vardhan visited the Muzaffarpur yesterday  and took stock of the situation. Different media reports said that the minister was shown black flags. However, the minister said he has spoken to  “every concerned individual about this issue”.

The situation turned grim when a five year od child while three minsiters around and this enraged the anger of the parents of the children and they confronted the ministers. Vardhan, however, later held a meeting and assured a research that would be undertaken to ascertain the cause of the disease to order any such outbreak in future. He was quoted News18. 

“I assure the people of the area, especially the affected families, that the government will extend all possible help and measures to the state government,” Vardhan said.

Despite all problems and considering the seriousness of this disease, I appreciate the efforts put in by the doctors to ensure efficient treatment to everyone,” he added.

Nitish Kumar, the CM had also expressed grief over the deaths of the children and announced “an ex gratia payment of Rs. 4 lakh to the next of the kin of those who have died”. The lack of awareness about his to tackle the decease is also the reason for outbreak, the CM said.

The health department of the state has cited hypoglycaemia in which the blood sugar level go down as the main reason behind the deaths of the children. Acute Encephalitis Syndrome is a viral diseases that has symptoms like high fever, convulsions and headaches.

Over 50 Children Have Died of Suspected Japanese Encephalitis in Bihar


Patna: In the last nine days, several children have died in North Bihar of suspected Acute Encephalitis Syndrome (AES). On Monday alone, about 20 children reportedly died, while three deaths were reported early Tuesday in Muzaffarpur town hospitals. As per reports, five five children died in two villages — Harvanshpur Paschim and Khirkhaua under Bhagwanpur police station in Vaishali district — in last the 24 hours due to symptoms similar to AES after being admitted to hospital.

As helpless parents look on, dozens of children are still battling for their lives with symptoms similar to AES and are undergoing treatment at two hospitals in Muzaffarpur. So far, the disease has already claimed the lives of 53 children, but the state government is playing these deaths down by claiming that these were due to hypoglycaemia.

In Muzaffarpur, the state government-owned Sri Krishna Medical College and Hospital (SKMCH) and private Kejriwal Hospital, where most of deaths took, have names and address of the victims. But state government, particularly the health department, is not prepared to accept this reality.

Meanwhile, Bihar Health Minister Mangal Pandey has denied that these deaths were due to AES. Pandey, a senior Bharatiya Janata Party (BJP) leader, said that only 11 children had died since June 2 and most of the deaths were due to hypoglycaemia, adding that only one child died due to Japanese encephalitis. “There is a situation of misconception in connection with deaths of children in Muzaffarpur. We have got information of deaths due to hypoglycaemia, except one death due to JE,” he was reported as saying.

AES cases have surfaced in Bihar in such a large number after a gap of three years. Last year, a total 40 cases of AES were reported in which seven deaths occurred.

But this year, the situation is alarming, said sources. This can be gauged from the fact that the two paediatric intensive care units at SKMCH are full and the hospital authorities were forced to open a third PICU to accommodate fresh cases. Ironically, with heavy rush of seriously ill children on Monday, there were no bed available to admit new suspected AES cases in the PICU the hospital and officials had to get the general ICU vacated by shifting patients to other wards.

“We have been admitting seriously ill children in PICU and the general ICU to provide treatment in view of the situation and regular arrival of new patients” SKMCH’s chief medical officer, S P Singh, said.

SKMCH superintendent Sunil Kumar Shahi said “It took us by surprise. We hardly expected such a bounce back this year”.

Helpless parents, after failing to get their seriously ill children admitted in SKMCH, are left with no option but to rush to privately run Kejriwal Hospital in Muzaffarpur.

Most of the children with suspected AES belonging to the rural poor section (dalit, other backward classes and extremely backward classes) of the population in Muzaffarpur and the neighbouring districts of Vaishali, Sitamarhi, Samastipur, Sheohar, East and West Champaran.

Locally known as Chamki Bukhar or Mastishk Bukhar, AES is widely seen as a deadly disease for children in flood-prone North Bihar districts. While the cause of deaths of children may be AES or any other, Sanjay Kumar, the principal secretary in the health department, reiterated that the deaths this year had occurred due to hypoglycaemia, resulting from high heat and humidity.

Kumar explained that when children play in the open under the scorching sun, it leads to dehydration and affects their intake of food and water, leading to hypoglycaemia.

According to him, Bihar had reported 34 cases of hypoglycaemia, resulting in 10 deaths till date this year, while one death was due to dyselectrolytemia (electrolyte imbalance).

However, with increasing cases of suspected AES, the state government has introduced a verbal autopsy form to fix responsibility for any lapses in treatment and referral. “We have a standard operating procedure for treatment of AES”, he added.

The health department has also issued an advisory urging parents to prevent their children from playing in the open under the sun at a time when the temperature was hovering between 42 to 43 degrees Celsius.

Interestingly, contrary to the denial of children deaths due to AES by a top health department officer, chief minister Nitish Kumar on Monday at a press conference, in reply to question on child deaths due to AES in Muzaffarpur, said the health department had been keeping a close watch on the situation. “Ahead of the rains (monsoon) ,every year this disease (yeh bimari) creates havoc. It is a matter of concern that every year children are dying due to it”, he said.

The chief minister said the health department had taken steps to contain the disease and was sensitising the people about measures to prevent it.

According to doctors, AES is a severe stage of encephalitis characterised by inflammation of the brain. The disease is transmitted through mosquito bites, leading to infection that causes high fever.

“Every year, encephalitis hits Muzaffarpur, Gaya and other neighbouring districts in May or June. But this year it seems to have affected a large number of children,” a health department official said.

Bihar: 14 kids die in Muzaffarpur due to Encephalitis, over dozen admitted to hospitals


At least 14 children have died in Bihar’s Muzaffarpur due to Acute Encephalitis Syndrome (AES) and over a dozen have been admitted to different city hospitals with high fever and other symptoms of the disease, news agency ANI reported. Sunil Shahi, Superintendent of Shri Krishna Medical College and Hospital (SKMCH), Muzaffarpur, confirmed the death toll and number of children admitted to the hospital with symptoms of encephalitis this year.

“We have received 38 patients so far, most of them have a deficiency of glucose in their blood. The overall casualty till now is 14,” he said. Encephalitis is a viral infection which causes fever and headache. It causes a sudden loss in the level of sugar in the body and affects the life-supporting function in a minor’s body. This time, the outbreak has gone beyond the limits of Muzzaffarpur with many children being diagnosed with the syndrome in Vaishali, Sheohar as well as the East and West Champaran districts.

State Health minister Mangal Pandey said that all efforts are underway to bring the situation under control. “All arrangements have been made to check the outbreak of the disease,” he said.

Dr Gopal Sahni, head of Critical Care Unit at SKMCH said that the outbreak is mostly reported just ahead of the arrival of Monsoon when heat and the humidity rise. The humidity level has hovered around 50% in Muzaffarpur for the last few days while thge tempertaure stayed around the 40-degree mark.

Muzaffarpur Civil Surgeon Dr SP Singh said that a team of health department recently visited the SKMCH and held a high-level meeting with doctors on the outbreak.

The epidemic impacts children every year in the north Bihar and eastern Uttar Pradesh regions. According to UP government’s claim, 187 deaths were reported due to encephalitis in 2018 against 553 such deaths in 2017. In Bihar, it claimed over a dozen lives.

Suspected outbreak of encephalitis claims lives of 21 children in Patna this year


PATNA: The outbreak of suspected encephalitis in North Bihar’s Muzaffarpur and its some adjoining districts included Vaishali has reportedly claimed the lives of around 21 children from January to May 9. As many as 18 children, diagnosed with the syndrome of encephalitis, have been admitted in Muzaffarpur based SKMCH and other private clinics.

The outbreak has gone beyond the Muzaffarpur and many children belonging to extremely poor families, have also been diagnosed with the syndrome of acute encephalitis  in neighbouring Vaishali, Sheohar, East and West Champaran districts. On Sunday alone, 4 new suspected cases of encephalitis diagnosed with four children were brought and admitted at SKMCH in Muzaffarpur.

“This time again after a gap of the last three years, the outbreak of syndrome of encephalitis has been reported. It occurs only when heat coupled with extreme humidity rises to an extreme level. It is contained as soon s Monsoon arrives”, Dr M Singh said, adding that sudden loss in the level of sugar in the body leads to collapse of life support functioning in the body of a minor.

Meanwhile, Reena Devi of Muzaffarpur said her 6-year-old son Raghu developed a symptom of high fever with breathing problem suddenly after returning from a nearby mango orchard in Motipur.

“Now, he has been admitted at SKMCH  under critical condition”, she said, adding that fearing further casualties in many remote areas of Muzaffarpur like Saraiya, Sherpur and others, many families have left the villages.

On Saturday, Prince Kumar of Vaishali and Chanda Kumari of Sheohar died while on Friday and other past few days, Madhu Kumari, Pawan Kumar, Sonu Kumar and many other minors had died in Muzaffarpur and other private clinics during treatments.

State health minister Mangal Panday claimed that all efforts are on to save the lives of children, who are being diagnosed with symptoms of encephalitis. Dr S K Shahi, superintendent of SKMCH, told the media that all arrangements have been made to check the outbreak of this disease.

He admitted that nearly 38 kids with symptoms of encephalitis were admitted between January and June this year. According to Muzaffarpur civil surgeon Dr SP Singh, a team of health department had recently visited the SKMCH and held a high-level meeting with doctors on the outbreak.