An Indo-US collaborative study published in the Lancet in the year 2017 covering deaths of 125 children in orchards of Muzaffarpur in Bihar during May-July 2014. Another story covered by the famous medical journal ‘American Journal of Tropical Medicine and Hygiene’, described the story of death of more than 12 children in the year 2012 working in litchi orchards in Bangladesh.
Different news published in different media for a couple of years about children death episodes due to brain fever, convulsion, vomiting and other complications in Muzaffarpur district of Bihar.
The extensive research done by Indo-US team has claimed that the mystery has been solved which continued since 2012. The collaborative study was performed by scientists of ‘National Center for Disease Control’, Delhi and the ‘US Center for Disease Control and Prevention’ (CDC), Atlanta, USA. They researched on around 390 patients admitted to the two specific hospitals at Muzaffarpur within 26th May and 17th July, 2014 all of them having symptoms of acute encephalitis.
They observed that the disease was not Encephalitis but Encephalopathy. They described the difference that Encephalitis occurs from a viral infection, but Encephalopathy is a biochemical disease. Specific treatment for Encephalitis is insufficient, but Encephalopathy is mostly treatable.
Their observation revealed that the disease broke out in a certain season when fruit litchi was harvested – nearly on April, May and June. Muzaffarpur in Bihar is full of litchi orchards and many people work in that area from harvesting to delivery, and mostly they reside with their family and children. Most of the time it was found that the illness started suddenly – children found vomiting, fallen semi-conscious, they were found convulsing. Within a few days, they went into coma and died.
After testing sick children, it was always found that their blood glucose level remained below normal. Whatever information collected from the local people was that – majority of the children were from families camped inside orchards for the cause of fruit harvesting. Children from well-to-do families never fell ill by this acute encephalitis.
During litchi harvesting, families inside the orchard areas used to go to sleep early. Many of their children used to go to sleep without having their dinner. Generally, waking up in the morning, children used to collect stray litchis (half-ripe or unripe) fallen on the ground from bunches of collection.
After a night-long fasting, malnourished children went into hypoglycaemia in the morning; their body became unable to mobilize glucose from liver glycogen. Human brain needs glucose to produce energy. So, lack of liver glycogen, gluceogenesis used to turn on. Since, litchi has a chemical compound called ‘methylene cyclopropyl glycine’(MCPG). Researchers found that skipping the dinner and habit of consuming huge quantity of litchi fruit on an empty stomach led to a sudden decrease in blood glucose level, causing convulsion, vomiting and other complications, then coma and ultimately death.
So it is confirmed, the potential chemical, ‘methylene cyclopropylglycine’ (MCPG), a similar of ‘hypoglycin A’ and a component naturally found in the litchi fruit and seed known to create ‘hypoglycaemia’ by β-oxidation of fatty acids and ‘gluconeogenesis’. The government needs to take stringent steps to control consuming litchi in empty stomach and after prolonged fasting by malnourished children of litchi harvesters.