In the last one month, at least 14 children under the age of 15 have died in hospitals in Nagpur, Maharashtra, and Chhindwara in Madhya Pradesh. Doctors say that cases appear to be acute encephalitis syndrome (AES), a word is often used when the brain suddenly becomes swollen or stops functioning, but without a confirmation.

According to doctors from both the districts, the affected children came to hospitals with high high fever. Within hours, many deteriorated rapidly. Some fainted within 24 hours of entry.

Most of these children also went into acute kidney failure, which means their kidneys stopped working and they did not make any urine. Many were placed on dialysis and ventilator support in an attempt to save their lives.

In Chhindwara, six deaths came from Parasia block, a rural pocket where all children were between 3 and 10 years old. The block has now been declared a high-alert zone.

Cerebrospinal fluid (CSF) and blood tests have rejected the bacterial and viral infections known so far. This means that common defects behind brain fever, such as common viruses and bacteria, have not been found in these cases.

Due to the mysterious nature of the outbreak, both the National Institute of Virology (Pune) and the National Center for Disease Control (NCDC) have sent teams for investigation. Monitoring is also being stepped into rural Vidarbha and nearby districts, as more children are admitted to Nagpur hospitals with similar symptoms.

Some recent cases are now being classified as acute encephalopathy rather than encephalitis. This is an important difference, as encephalitis usually indicates a viral infection that causes brain inflammation, encephalopathy may result in toxins, toxicity, or environmental factors.

Doctors are not yet sure that this outbreak is due to a new infectious agent, toxicity or some environmental trigger.

Despite the severity of the situation, experts say that there is very little public communication from the national health agencies.

What is acute encephalitis syndrome?

AES is not the same disease. It is a umbrella word for a group of conditions where the brain becomes inflamed. One of the most famous causes of AE in India is Japanese Encephalitis (JE), a viral disease that spreads from animals to humans through mosquito bites.

The JE virus is mainly transmitted by Culex mosquitoes of the Vishnu Group. These mosquitoes raise viruses from birds (such as ponds Herons and Cattle Agrates) and pigs, and then infect humans.

“Humans are casual hosts, meaning that they do not play a major role in spreading the virus further. The virus usually affects people living or traveling in rural areas where mosquitoes breed in rice paddeds, marshes or other stable water bodies,” Dr. Vibhu Kavatra, Pulmonologist and allergic specialist, said.

Symptoms for viewing

According to the National Center for Vector Born Disease Control (NCVBDC), JE infection shares symptoms with other viral encephalitis cases, making it difficult to differentiate without tests.

The disease often starts with fever and neurological problems. Common symptoms include:

• Fever and headache
• Stupa
• Shocks and seizures
• Paralysis
• Loss of coordination
• Symptoms of meningitis (neck hardness, vomiting, sensitivity to light)

“The disease progresses rapidly. Brain inflammation can cause severe neurological complications such as paralysis, memory loss, and cognitive loss. In severe cases the mortality rate can be 20% to 30%, and even the survivors are often left with long -term disabled,” Dr. Kavatra said.

No specific treatment

Currently there is no specific antiviral drug that can kill the JE virus. Doctors focus on supporting treatment to help patients cure. Acetaminophen (paracetamol) is given for fever, headache and body pain.

Adequate hydration is ensured if the patient has high fever, vomiting, or diarrhea. Giving intravenous fluid if necessary. Dialysis in ventilator support or serious cases, as seen in Nagpur and Chhindwara.

Is there any vaccine?

Due to the severity of Japanese encephalitis, the central government included it in the Universal Vaccination Program (UIP) in 2013.

Two doses of JE vaccine are given to children: at the age of 9 with measles vaccine at the age of 9, and the second with DPT booster in 16–24 months.

Currently, 334 districts are vaccinated in 24 states which are considered spatial for JE.

For more than 15 years of adults and adolescents, Genwak vaccines have also been introduced in high -burden states.

For now, doctors and scientists are waiting for the test results and field reports to confirm whether Nagpur and Chhindwara outbreaks are associated with Japanese encephalitis, or are completely different reasons such as toxins or environmental risk.

It is clear that deaths have killed young children in rural, high -risk areas, very population is weaker for most encephalitis.