A small red fruit grown in Bihar’s Muzaffarpur and eaten widely across India is being linked to the deaths of at least 150 children in the north Indian state, triggering panic. According to reports, the presence of some toxins in the litchi, a fruit native to China, is believed to have caused encephalitis — inflammation of the brain — in around 200 children, 100 of whom are critical and are undergoing treatment. The outbreak of encephalitis takes place every year during the summer months in Bihar, the time the fruit is cultivated, but this year’s rising death toll has been alarming.
The deaths of children, almost all of them malnourished, have raised a larger question over how the fruit should be eaten and the ways in which it is harmful to the body.
The anatomy of the fruit
To understand the issue, one has to look at the composition of the fruit, which is divided into pulp and seed. The litchi seed was found to contain an unusual amino acid – called hypoglycin-A or methylene cyclopropyl glycine (MCPG) – which is a naturally-occurring fruit-based toxin, according to a 2017 study published in the Lancet Global Health medical journal conducted on the outbreak of acute toxic encephalopathy in Muzaffarpur.
Hypoglycin A or MCPG affects various processes of metabolism and the breakdown of glucose in the body, which may also lead to hypoglycemia, a condition where your blood sugar drops drastically, and encephalopathy.
The study also revealed that not just the seed, even the pulp was found to contain MCPG, which was later named hypoglycin-G.
What sometimes happens if you eat a litchi
The children in Muzaffarpur have been diagnosed with Acute Encephalitis Syndrome (AES), which is characterised by an acute onset of fever, inflammation of the brain and clinical neurological manifestation that includes mental confusion, disorientation, delirium, or coma, and predominantly affects children below 15 years.
Multiple studies conducted on the naturally-occurring toxins in litchi and the deaths in Muzaffarpur, India’s largest litchi cultivation region, over the years have suggested that the illness occurs when litchis are eaten if a long gap is taken after a meal or after a prolonged fast, especially by undernourished children.
The study found that children in Muzaffarpur ended up filling their stomachs with litchis grown in orchards and then returned home not wanting to have an evening meal. Skipping the evening meal caused their sugar levels to drop and their body began to metabolise fatty acids to produce glucose and energy.
However, the litchi toxins present in their bodies affected the metabolism of fatty acids and the breakdown of glucose, and in many cases, it led to the inflammation of the brain, which is called encephalitis.
Should we stop consuming litchis?
The side-effects of eating the fruit occur mostly in malnourished children, studies have shown. However, studies have also said that parents, in general, can minimise the consumption and making sure children do not fill their stomachs with only litchis. Experts have also recommended that parents ensure their children eat something after eating litchis and do not go to bed without eating an evening meal.
Though the fruit may have played a role in the deaths of children in Bihar this year, attention needs to be brought to the fact that these children were malnourished, making them vulnerable to the disease. This is not the first time children in Bihar have fallen victim to encephalitis - the state has seen an outbreak every summer since 2013. However, despite the prior warnings, the government remained under-prepared to tackle the crisis.