Muzaffarpur is facing a devastating outbreak of Acute Encephalitis Syndrome (AES) and the death toll has risen to a 100. The state government has attributed the rise in encephalitis cases to the heat wave in northern India. The city in Bihar has experienced similar encephalitis attacks in the past where they were said to be caused by litchis or lychees, seasonal fruit is grown in the region. Most of the victims of encephalitis were children in Muzaffarpur. Panic has spread in the region due to its high fatality and lack of understanding about encephalitis. Here’s everything about the symptoms, causes, treatment and prevention of encephalitis.

What is Encephalitis?

Encephalitis is the acute inflammation of the brain caused by either a direct infection to the organ or as an immune response to an infection.

Direct inflammation is when a virus, bacteria, fungus or protozoa attack the brain, causing an infection.

Indirect inflammation happens when the immune system mistakes the brain tissues for foreign invaders and attacks the organ, causing a flare-up. Encephalitis Death Toll: 100 Kids Confirmed Dead in Bihar; Schools, Colleges to Remain Closed Till June 19.

What are the Signs of Encephalitis?

Acute encephalitis can present a variety of symptoms starting with a change in the state consciousness. Other signs of encephalitis include:

  • Headache

  • Irritability

  • Disorientation or confusion

  • Fever 38C (100.4F) or above

  • Seizures

  • Drowsiness

  • Weakness

  • Personality changes

  • Slurring

  • Hearing problems

  • Loss of consciousness

  • Hallucinations

  • Paralysis in the face

  • Nausea

  • Vomiting

  • Involuntary eye movements

  • Stiffness

  • Bulging in an infant’s skull

  • Aching muscles and joints

Causes of Encephalitis

The causes of encephalitis could be a primary direct infection due to pathogens such as virus, bacteria, fungus or protozoans attacking the brain.

Sometimes, encephalitis is also caused due to immune system mistaking brain tissues for pathogens and attacking them. This happens two-three weeks after the initial infection takes place. Due to a fault in the immune system, the healthy cells of the body end up being attacked. Lychee Havoc in Bihar: Deaths Due to Encephalitis on The Rise in Muzaffarpur, Over a Dozen Admitted to Hospitals.

Causes of encephalitis include:

  • Herpes simplex virus

  • Varicella-zoster virus

  • Mumps, measles and rubella virus

  • Zika virus

  • Japanese encephalitis virus

  • Rabies virus

  • Non-cancerous or cancerous growth in the body

  • Certain vaccines (although very rare)

  • Previous infections

  • Autoimmune inflammation

  • Hypoglycaemia (low blood sugar)

How is Encephalitis Diagnosed?

Encephalitis is diagnosed with CT scans, MRI scans, lumbar puncture or ECG tests.

How is Encephalitis Treated?

Encephalitis requires immediate medical attention. Treatment of encephalitis includes arresting the underlying cause of the infection, treating the symptoms and giving supportive care.

People who suffer from encephalitis are kept in the intensive care unit to keep their health conditions monitored.

Treatment includes:

  • Antiviral medication, in case the encephalitis is caused by a virus.

  • The antibacterial medication of brain inflammation is caused by bacteria.

  • Steroid injections to stop the immune system from attacking itself.

  • Immunoglobin therapy if steroids don’t work.

  • Plasmapheresis, a procedure that removes the substances in the blood that are attacking the brain.

  • Surgery to remove tumours that are triggering the attack.

  • Supportive medication includes:

  • Fluids to treat dehydration

  • NSAIDS and other painkillers to reduce fever and pain

  • Seizure medications;

  • Oxygen to support lung functions

How is Encephalitis Prevented?

For viral and bacterial encephalitis, limiting contact with vectors such as mosquitoes is essential. Vaccines for mumps, rubella, (MMR) etc. should be administered to areas where it’s known to be endemic.

Zika and Japanese encephalitis are caused by mosquito bites. So special precautions should be taken to reduce the chances of getting bitten. Clearing garbage, stagnant water sources, etc. can prevent the vectors from breeding.

Wearing full-sleeved, ankle-length clothing can also protect the extremities from mosquito bites.

Previously, litchis or lychees were attributed to the large number of encephalitis deaths in Muzaffarpur. One study on the subject said that the presence of hypoglycin in lychees were the cause of encephalitis because it lowered blood sugar levels.

Another said that pesticides sprayed on litchi crops were the cause of poisoning and encephalitis.

To prevent any untoward consequences, health experts advise against eating litchis on an empty stomach. Others recommend washing the lychees thoroughly with water and removing the pink, leathery skin with the hand (as opposed to biting it off) before consuming.

(The above story first appeared on LatestLY on Jun 17, 2019 02:31 PM IST. For more news and updates on politics, world, sports, entertainment and lifestyle, log on to our website latestly.com).