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Indian Journal of Emergency Medicine

Volume  3, Issue 1, January - June 2017, Pages 121-125
 

Review Article

Epidemics of Acute Encephalitis in Young Children: Lychee the Sweet Hypoglycemic or a Silent Killer

Shahid Mustafa Khan, Kishalay Datta, Indranil Das, Deepika Mittal

1Resident 2Principal Consultant, 3Attending Consultant, Department of Emergency Medicine, Max Hospital, Shalimarbagh, New Delhi, India.

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DOI: http://dx.doi.org/10.21088/ijem.2395.311X.3117.19

Abstract

Epidemics of acute encephalitis In young children: Lychee the sweet hypoglycemic or a silent killer a review of the literature. There have been reports of children presenting with acute neurological illness from Bihar India dating back to 1995, with recent ones being reported from China and Vietnam in 2012 and the latest ones being reported from Muzaffar India in 2014. The fact that is common to all these reports has been the association with lychee (lichi chinensis) a juicy sweet fruit grown in the summer months from May till June. Not surprisingly the cases coincide with the harvesting season of the fruit. The presentation is with varied neurological symptoms ranging from acute onset of behavioral disturbance to seizures accompanied by marked hypoglycemia with radiological evidence of cerebral edema and features suggestive of inflammation. Epidemiological and laboratory evaluations has postulated a spectrum of causes for this illness, including infectious encephalitis, exposure to pesticides, and Methylenecyclopropylglycine (MCPG) a compound found in litchi seeds known to cause hypoglycemia in animal studies. Current approach to the illness is focused on reducing the mortality by prompting the affected families to seek immediate medical attention and to ensure rapid correction of hypoglycemia. The varied presentation, absence of conclusive evidence to suggest a causative pathological agent warrant need for greater research to identify the culprit pathogen. Till such time lychee continues to be a sweet hypoglycemic, a silent killer.US researchers commented that a mysterious and sometimes fatal brain disease that has afflicted children in northeastern India for years could be linked to a toxic substance in litchi fruits, -Published in Leading Newspaper. The US Centers for Disease Control and Prevention have said that more research is needed to uncover the cause of the illness, which leads to seizures, altered mental state, and death in more than a third of cases. In the meantime, doctors who encounter sick children should takes steps to rapidly correct low blood sugar, which can make the disease more likely to be fatal, said the report.The outbreaks have coincided with the month-long litchi harvesting season in and around the Muzaffarpur district of Bihar state since 1995,- Published in CDC’s Morbidity and Mortality Weekly Report. In 2013, some 133 children were admitted to local hospitals in Bihar with seizures and neurological symptoms. Most were aged one to five, and nearly half (44 percent) of them died. Those who died were more than twice as likely as other patients to have been admitted to the hospital with low blood sugar.
 


Keywords : Lychee; Hypoglycemia; Epidemics.
Corresponding Author : Shahid Mustafa Khan, Resident, Department of Emergency Medicine, Max Hospital, Shalimarbagh, New Delhi - 110088, India.