Acute Encephalitis Syndrome (AES)
- While the causes of AES are still researched, the association with hypoglycaemia and litchi fruit has drawn attention.
About AES:
- Acute encephalitis syndrome is a basket term used for referring to hospitals, children with clinical neurological manifestation that includes mental confusion, disorientation, convulsion, delirium, or
- Meningitis caused by virus or bacteria, encephalitis (mostly Japanese encephalitis) caused by virus, encephalopathy, cerebral malaria, and scrub typhus caused by bacteria are collectively called acute encephalitis
- The disease most commonly affects children and young adults and can lead to considerable morbidity and
Symptoms:
It is characterized as acute-onset of fever and a change in mental status (mental confusion, disorientation, delirium, or coma) and/or new-onset of seizures in a person of any age at any time of the year.
Cause of the disease:
- Acute Encephalitis Syndrome (AES) is considered a very complex disease as it can be caused by various agents including bacteria, fungi, virus and many other agents.
- Viruses are the main causative agents in AES cases, although other sources such as bacteria, fungus, parasites, spirochetes, chemicals, toxins and non-infectious agents have also been reported over the past few decades.
- Japanese encephalitis virus (JEV) is the major cause of AES in India (ranging from 5%-35%)
- Nipah virus, Zika virus are also found as causative agents for AES.
How is it related to litchi fruits? How it affects?
- In India, AES outbreaks in north and eastern India have been linked to children
eating unripe litchi fruit on empty stomachs.
- Unripe fruit contain the toxins hypoglycin A and methylenecyclopropylglycine (MCPG), which cause vomiting if ingested in large quantities. Hypoglycin A is a naturally occurring amino acid found in the unripened litchi that causes severe vomiting (Jamaican vomiting sickness), while MCPG is a poisonous compound found in litchi seeds.
Why it affects undernourished children?
- Blood glucose falls sharply causing severe brain malfunction (encephalopathy), leading to seizures and coma, and death in many
- This is because under-nourished children lack sufficient glucose reserve in the form of glycogen and the production of glucose from non-carbohydrate source is blocked midway leading to low blood sugar
- This causes serious brain function derangement and
Measures needed:
- Increase access to safe drinking water and proper sanitation
- Improve nutritional status of children at risk of JE/AES.
- Preparative measures to be in place before the possible
- Vector
- Better awareness generation among children, parents through Anganwadi workers, ANMs