Acute Encephalitis Syndrome: Are litchis really the culprit?

Doctors have blamed the litchi fruit for the spread of Acute Encephalitis Syndrome. But is the fruit really the villain here as everybody seems to think? Dr. Pradeep Gadge, leading Diabetologist, Gadge Diabetes Centre, shares his views

Editorial Team | Published: June 25, 2019 7:05 pm

As a recent outbreak of encephalitis in Bihar has so far claimed 110 lives, here we tell you all about this serious condition. © Shutterstock

Acute encephalitis syndrome is a serious health problem in India and it has assumed epidemic proportions in Bihar. This disease causes inflammation of the brain. Symptoms range from high fever, confusion, disorientation and delirium. It can induce coma if left untreated. Most of the victims are children.

The recent outbreak of the disease in Bihar has so far claimed 110 lives. This has spread fear among many patients. Everybody wants to know if it is safe to eat litchis. Encephalitis is spreading in litchi growing areas of Bihar, including Muzaffarpur district, besides making an appearance in other parts of the country. Many experts have also confirmed that eating the fruit can spread the disease.

But it was seen, that in Muzaffarpur, many of the victims also had very low sugar levels. They were also from the poorer section of society. So, maybe litchi is not the only contributing factor and there are other reasons behind this epidemic.

Causes of Acute Encephalitis Syndrome

Acute encephalitis syndrome (AES) affects the central nervous system, mostly in children and young adults. It is a viral disease. Symptoms include high fever, convulsions and headache.

AES is complex and can be caused by either a virus or bacteria or fungi or a range of other agents. Scrub typhus, dengue, mumps, measles, Nipah and Zika virus can also cause this disease. Thus, many cases of AES remain clinically unidentified.

According to a study published in the journal Annals of Neusrosciences in 2016, apart from viral encephalitis, a severe form of leptospirosis and toxoplasmosis can also cause AES. The causative agent of AES varies with season and geographical location. It predominantly affects children below 15 years of age.

Litchis do not cause Acute Encephalitis Syndrome

Sleeping on an empty stomach at night, dehydration due to humidity and eating litchi on an empty stomach can cause AES. Blood sugar goes down in the early mornings after several hours of fasting. Undernourished children who sleep without eating a meal at night develop hypoglycemia (a condition that occurs when a person’s blood glucose level drops too low). The brain needs normal levels of glucose in the blood. The liver is unable to supply the need. The body then turns on the alternate pathway of glucose synthesis for fatty acid oxidation. Methyl Carboxy Phenyl Glycine (MCPG), found in litchis, blocks this pathway. Thus, litchi does not cause any harm in well-nourished children, but only in undernourished children who had consumed the fruit on an empty stomach.

Effects of the toxin on undernourished children

The liver of a well-nourished child stores glycogen (glucose polysaccharide). When the glucose level goes down, this glycogen breaks down into glucose and circulates in the blood to regularise blood sugar. But undernourished children (who belong to poor families) don’t have an adequate glycogen reserve to convert into glucose. Hence, the natural mechanism in undernourished children cannot correct the low glucose level in their blood and this causes hypoglycemia.Generally, when the glycogen reserve in liver is exhausted or is insufficient, the body tends to convert the fatty acid (non-carbohydrate energy source) into glucose.

Unripe litchis contain high levels of a naturally occurring amino acid derivative called hypoglycin. This inhibits the body’s ability to produce glucose, causing hypoglycemia. But the litchi toxin blocks the the conversion process midway. Therefore, the body is unable to generate glucose and, as a result, does not correct the low blood glucose level.

Don’t say no to litchi

Litchi is a good source of vitamin C, vitamin B2 (riboflavin), potassium and copper. It contains antioxidants and has anti-cancer, anti-inflammatory, anti-microbial and anti-viral properties. Furthermore, it keeps blood sugar in check, reduces weight, protects the liver and boosts the immune system. It is a rich source of polyphenols (plant-based antioxidants) and proanthocyanidins. This prevents cardiovascular problems and even cancer.

Published: June 25, 2019 7:05 pm

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