The National Human Rights Commission (NHRC) of India has taken suo motu cognizance of media reports about the rising number of deaths of children due to acute encephalitis syndrome (AES) in Muzaffarpur district of Bihar since the second week of June.
The death toll from the suspected AES went up to 150 as of the last week of June. Apart from Muzaffarpur, some other districts of the northern Indian state were also affected by the malady.
NHRC issued a notice to the Chief Secretary, Government of Bihar and the Secretary, Union Ministry of Health & Family Welfare, calling for a detailed report in the matter, including the status of implementation of National Programme for Prevention and Control of Japanese Encephalitis Virus (JEV)/ Acute Encephalitis Syndrome (NPPCJA) and other steps taken to deal with the situation, reports said.
The commission wanted to know the status of the treatment being provided to the children who are presently hospitalised, and relief/rehabilitation provided by the state to the aggrieved families.
NHRC observed that in spite of reported measures taken by the government agencies, deaths of children in such a large number indicate a possible flaw in the proper implementation of vaccination and awareness programmes.
Under AES, children develop an acute fever with altered sensorium. According to the government manual, AES is a group of clinically similar neurologic manifestations caused by several different pathogens including JEV.
In Muzaffarpur, the encephalopathy is associated with hypoglycaemia, resulting from very low levels of blood sugar. There is a lack of clarity and research-based evidence about the disease.
Lancet, in a research paper published in 2017, had linked the outbreak to excessive consumption of lychees, a local fruit found abundantly in that region. However, the findings were refuted by researchers from Muzaffarpur-based National Research Centre based on toxicology tests.
AES outbreaks have been occurring almost every year between April and July since 1995 in Muzaffarpur. The extreme heat and humidity of the region and inadequate nutrition were linked to the outbreak.
Despite the fact that brain fever is endemic to the region, there have been no initiatives from health authorities to contain the disease or to prevent the children from dying.
Over 250 children were still in two hospitals — government-run Sri Krishna Medical College and Hospital (SKMCH) and the privately run Krishnadevi Deviprasad Kejriwal Maternity Hospital, as of 21 June.
The poor health infrastructure in Bihar and Uttar Pradesh makes handling such outbreak situations and disease epidemics more challenging.
The Union government sent a team to Muzaffarpur to assess the cause of the deaths and advised the hospital to set up a research wing and preserve serum samples for rechecking, following the visit of the health minister.
All precautionary measures, such as cleanliness and hygiene, are also required to be observed, along with vaccination, to ensure that the kids do not fall prey to the fatal disease. It is a case of violation of human rights of the victim children and their families, as the state appeared to have failed to protect the young innocent lives, NHRC noted.