Acute Encephalitis Syndrome (Chamki Fever) causes, symptoms and prevention

Patna: People perform "yagna" to get rid of heat and Japanese encephalitis that claimed lives of around 100 children in Bihar; in Patna on June 17, 2019. (Photo: IANS)
Encephalitis, also known as Chamki fever has claimed a lot of lives in Bihar and hence the topic has become hotter today. A lot of people are now wondering what causes this fever and how to prevent it. Here is an account of the causes of Chamki fever, its symptoms, and prevention methods.

The cases reported

Encephalitis or Acute Encephalitis Syndrome (AES) or Chamki fever can be explained to an extent as the inflammatory condition in the brain. The most common targets of Chamki fever are children and young adults. Chamki fever is noted to cause a huge amount of mortality and morbidity. The recent outbreak of Chamki fever in Bihar has resulted in over a hundred deaths in the districts of Muzaffarpur and the surrounding districts. More than 200 children have been admitted in hospitals in the state of Bihar diagnosed with high fever and a number of severe viral infection symptoms. Earlier during a similar outbreak of chamki fever in 2014, as many as 700 deaths were reported.

Investigations into the causes of chamki fever

Few of the terms that describe chamki fever are Litchi Havoc, Killer Encephalitis, Chamki Bhukar, and Deadly Litchi Toxin. Mangal Pandey, the health minister of Bihar had set up a team of medical industry professionals to investigate into the causes of chamki fever. The list of causes identified by this team includes consuming lychee on an empty stomach, going to bed with an empty stomach, and humid conditions resulting in dehydration in addition to some others. The recent reports have confirmed that the highest number of mortality on account of chamki fever is noted in the age group of 1 to 10.

The number of cases diagnosed with chamki fever has peaked in the months of April, May and June with the disease-focused mainly in the regions in and around Muzaffarpur in Bihar. The predominant cases of chamki fever are noted in the children who were undernourished and visited the litchi farms as observed by a report published in the National Health Portal of India.

Do litchi fruits cause chamki fever?

Two commissions set up by the government to investigate into the causes of chamki fever had concluded that malnourished children who consumed litchis and slept without food were affected with chamki fever in the pre-monsoon season in the early mornings. Their studies tried to establish a relationship between low blood glucose levels noticed in poor and malnourished children who slept with an empty stomach and a toxic chemical known as methylene cyclopropyl-glycine (MCPG) found in litchis that affects the brain during undernourished conditions. However, this theory has been discredited recently and the recent claims point out to the environmental factors like heat waves and the poor rainfall in these regions as the causes for chamki fever. During earlier outbreaks of chamki fever in 2005, 2011, 2013, and 2014, the temperature was more than 38 degrees and humidity was more than 50 percent. In Muzaffarpur, the sharp rise of humidity in nights make the condition worse for young children.

Understanding Acute Encephalitis Syndrome (AES)?

CDC describes acute encephalitis syndrome as a clinical condition predominantly caused due to infection by Japanese encephalitis virus (JEV) or due to some other infectious and non-infectious reasons.

Symptoms of chamki fever (Encephalitis or Acute Encephalitis)

The symptoms and signs of AES are an acute beginning of fever associated with headache. This will be accompanied by a range of clinical neurological symptoms like mental confusion, delirium, disorientation, and even coma.

Who are at the highest risk of chamki fever?

The chamki fever causing virus is very commonly present in the rural areas. Hence the children living in these regions are noted with the highest risk of chamki fever. The incidence of chamki fever was the highest among the children between 0 to 6 years with the other possible ager group targeted by this illness being 7 to 10 years. The most common targets of chamki fever are people with a weak immune system who already have HIV/AIDS, those that take immunity suppressing drugs and those that are undernourished.

The spread of Encephalitis or Chamki fever

While viruses are said to be the most common causes for chamki fever (AES) in India, some other sources like bacteria, fungus, spirochetes, parasites, some toxins and chemicals were also said to cause this condition. Severe kinds of leptospirosis and toxoplasmosis are also found to be causing AES. Scientists have a notion that the toxin known as methylene cyclopropyl-glycine (MCPG) present in litchi fruit could be related to the inflammation of the brain.

AES and chamki fever

Any brain disease or AES cannot be termed as chamki fever. AES can be of different types including brain inflammation due to virus known as encephalitis, swelling of the protective membranes of the spinal cord and brain known as meningitis, any brain disease that can alter the brain structure and function like encephalopathy, and many kinds of neurological complications or malarial infections like cerebral malaria. The two important theories connected to the causes of chamki fever include the heat wave stroke and the toxins found in the locally grown litchi fruits. However, the recent views state that the main causes of chamki fever is the lack of acclimatization in children, heat wave and poor rainfall.

Treating Encephalitis or Chamki fever

The subjects reporting encephalitis must be treated urgently. The treatment plan for chamki fever will include antiviral medication, and steroid injections besides many others in order to support the body and relieve the subjects of the symptoms. During recent days, the PHCs have been instructed to provide an intravenous glucose infusion during the attacks of chamki fever. The subjects are also given a lot of rest, fruits and anti-inflammatory medicines to relieve the headache and fever. Though there is no cure noted for this disease, there are safer and effective vaccines available today to prevent chamki fever.

How to prevent chamki fever or encephalitis

Vaccination is advised as the most dependable preventive measure for encephalitis. In addition, using repellants, wearing long-sleeved clothes, maintaining hygienic conditions, washing hands with soap and water after using the toilet and before taking meals can help prevent the encephalitis that is caused due to the virus.
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