Contributed by – Dr Deepak Parasher

Around the months of June and July, most of us heard about an illness called Acute Encephalitis Syndrome (AES). The illness started in Muzaffarpur in Bihar and within a short period claimed the lives of almost 162 children. Most people haven’t even heard of this illness and thus it was natural that this outbreak caused a furore. Additionally, a lot of information and consequently misinformation related to the risk, spread and causes of this disease started doing the rounds. Today in this blog we tell you all about what Acute Encephalitis Syndrome (AES) is, what its symptoms are, how you can prevent and treat it and why you should take encephalitis seriously.


What is encephalitis syndrome?

Commonly known as Chamki fever, Acute Encephalitis syndrome is a serious health issue which affects the brain. The illness causes acute onset of fever and a change in mental status. There is inflammation in the brain due to viral infection. This affects the central nervous system and hampers the neurological functions.

There are two types of encephalitis syndrome – primary and secondary. In primary encephalitis syndrome, virus or other agents directly infects the brain. Secondary encephalitis syndrome is the result of a weak immune system’s reacting to the infection anywhere in the body.



What are the symptoms of encephalitis syndrome?

Symptoms of encephalitis syndrome depend upon the part of the brain affected. However, some of the most common symptoms are:

  • Headache
  • Severe fever
  • Sleepiness
  • Mental confusion
  • Personality changes
  • Weakness
  • Disorientation
  • Delirium
  • Seizures
  • Hallucinations
  • Partial coma
  • Speech impairment
  • Coma



What are the causes of encephalitis syndrome?

Viruses are the most common cause of most encephalitis syndrome cases. Bacteria, fungi, parasites, spirochetes, chemicals and toxins can also cause it. Moreover, Herpes simplex virus, Nipah virus, Zika virus, Influenza A virus, West Nile virus, Chandipura virus, mumps, measles, dengue, scrub typhus, S. pneumoniae can also cause encephalitis syndrome. In India, Japanese encephalitis is the most common cause of it. In fact, the Ministry of Health attributes 5-35% cases of encephalitis syndrome to it.

The cause of the spread of Chamki fever in Bihar, however, is not clear yet. Although, unripe litchis that the children consumed seem to be linked. Unripe litchis contain the toxins hypoglycin A (naturally occurring amino acid) and methylenecyclopropyl-glycine (MCPG) which can cause hypoglycemia. A diet of unripe litchis not supplemented by a nutritious meal would put a malnourished child at risk. Immediate treatment and hospitalization is required especially in malnourished children as their bodies are not equipped to fight the illness.


How to prevent encephalitis syndrome?

Prevention of encephalitis syndrome is absolutely necessary to avoid severe conditions. To avoid contact with the viruses that cause it, the following pointers can help.

  • Practice good hygiene – Frequently wash your hands with soap especially before and after you eat food or after you use toilet or touch surfaces which are dirty and full of germs.
  • Stay safe against mosquitoes – Do everything possible to avoid mosquitoes. Apply mosquito repellent on your exposed body parts when going out, use insecticide, do not let water collect in any kind of container, and if possible, avoid going out when mosquitoes are the most active.
  • Get vaccinations – Get all the recommended vaccinations on time, particularly when travelling to different destinations. Also, make sure that vaccination of your child is up to date.


Government of India has approved 2 doses of Japanese Encephalitis vaccine. These are included in UIP and the first dose has to be given along with measles dose at the age of 9 months, whereas, the second dose has to be given with DPT booster at the age of 16-24 months.



How to treat encephalitis syndrome?

Most of the cases of encephalitis syndrome get resolved on their own in a few days. However, severe cases may take more time. Children suffering from encephalitis syndrome need immediate care. They need to be admitted in ICU to avoid any mishap. The doctor may do the following:

  • The doctor may keep a check on heart rate, blood pressure, breathing and other body fluids.
  • Test like MRI, CT scan, blood test, urine test, stool test and various others might be asked.
  • Various anti-viral and anti-inflammatory drugs might be given to them to control the inflammation of the brain.
  • Over the counter medicines may also help to bring down fever and control headache.