While some say the death took place due to heat-stroke, others say it was sun-stroke. Yet another section of doctors led by former Union health minister Dr C P Thakur argue that it could be because of the white small germ found in litchi fruit, which is mostly cultivated near Muzaffarpur.
When the situation became alarming, a central medical team was rushed there to stem the mystery disease. The central team comprised Dr B B Tandla and Dr C P Rawat of National Institute of Virology (NIV) Pune, Dr S K Jain of National Vector Brone Disease Control Programme, New Delhi, and an eminent paediatrician of Safdarjung Hospital Dr IP Choudhary.
Even though the team members collected samples of cerebrospinal fluids and blood serum, experts differ whether the killer disease is indeed encephalitis. The team from NIV, Pune, which conducted tests on four samples drawn from children affected by a mystery disease, has, on the basis of the samples received, ruled out Japanese encephalitis (JE).
“The NIV report which we have received, categorically says that no trace of JE was found in any of the samples,” said the director of the Rajendra Memorial Research Institute (RMRI) Dr Pradeep Das. However, experts argue that the report was based on blood serum samples and cerebrospinal fluids, which were inadequate to prove encephalitis.
Diagnosis of infection
One week after the outbreak of the mysterious disease, RMRI authorities had collected cerebrospinal fluids (CSF) and blood serum from the afflicted children and sent it to the NIV for diagnosis of the infection.
The doctors say that brain tissues were needed for examination to ascertain encephalitis. The only positive thing in the NIV report is that it has ruled out the possibility of the disease being caused by fruits like litchi, as no strain of the Nipah virus was seen in the samples.
It may be mentioned here that fruit bats of pteropodidae family are the natural host of the Nipah virus, which causes severe illness, characterised by inflammation of the brain (encephalitis) or respiratory diseases.
According to the report, the Chandipura virus, which shows symptoms similar to those of acute encephalitis was also not detected either in the cerebro-spinal fluids or the serum. Then what is the disease that took the lives of 42 children in the last few days? National Institute of Virology director Dr A C Mishra says that to identify the exact virus, the laboratory needed brain autopsy material of the patients affected, which was not made available by the Bihar government.
“Since the disease relates to the brain, we need brain tissues to arrive at any conclusion,” he said and added that cerebro-spinal fluids and blood serum samples would not suffice for diagnosing the disease.
Rise in death toll
It all began in the third week of June when nearly two dozen children were admitted to different hospitals in Muzaffarpur with symptoms of high temperature and convulsion. Initially, seven children died within a couple of days. But the death toll kept on rising with three-four children reportedly dying due to mysterious disease every day.
It was then that the central medical team was pressed into service. Intensive spraying of DDT was carried out. Affected villages were cordoned off and special immunisation drive launched by fogging mosquitoes and viral insects.
Even then, 29 children are still admitted in two hospitals including 21 in Kejriwal Hospital and eight in Sri Krishan Medical College and Hospital (SKMCH). Health minister Ashwini Choubey, who made an on-the-spot inspection, said Bihar government won’t leave the children in the lurch and would bear the expenses incurred by even those undergoing treatment in private hospitals.
Ashwini Choubey ruled out encephalitis but at the same time he was not sure what the mysterious disease actually is.
