Thus, eating a lot of litchi at night and sleeping on an empty stomach resulted in hypoglycaemia in malnourished children. They further experienced brain dysfunction and feverish symptoms. Poor brain function can lead to drowsiness, disorientation, and even unconsciousness.

Furthermore, hampered biochemical processes result in toxic amino acids that cause brain cells to swell. As a result, children may suffer from convulsions, deepening coma and even death. Hypoglycaemic encephalopathy, the condition that the malnourished children in Bihar faced is distinct from encephalitis. In the case of encephalitis, there is brain inflammation due to a viral infection.

EAre healthy, well-nourished children at the risk of AES if they eat litchis?

Healthy children can eat litchis without any fear. They have sufficient glucose reserve in their liver. Thus, when they experience low blood sugar levels in the morning, they have a reserve that manages the deficit. Their bodies do not have to resort to another pathway to create glucose, which is blocked by the toxin in litchi.

What are the signs and symptoms of encephalitis in infants & children?

The signs and symptoms of encephalitis are similar for everyone. They experience flu-like signs and symptoms, which may progressively worsen and continue for a period of time. These are:

• fever
• Headache
• Dizziness
• Poor appetite
• Photophobia – sensitivity to light

Can litchi cause encephalitis in children?

No, eating litchi does not cause encephalitis in children. Recently, in India, acute encephalitis syndrome (AES) led to the deaths of more than 100 children. These deaths were caused due to hypoglycemia or low blood sugar levels that were triggered and aggravated by the consumption of litchi and sleeping in empty stomach. Litchi contains the toxin methylene cyclopropyl glycine (MCPG), which blocks the production of glucose by the liver. Therefore, its consumption on an empty stomach by malnourished children leads to fatal hypoglycemia. Litchi by itself does not cause encephalitis or death.

In encephalitis, the child is already low on glucose and depends on the emergency reserve which is further limited due to the consumption of litchi. Inadequate glucose in the brain impairs function and causes drowsiness, disorientation and even unconsciousness. Furthermore, hampered biochemical processes result in toxic amino acids that cause brain cells to swell. As a result, children may suffer from convulsions, deepening coma and even death.