Bihar had reported just seven AES deaths in 2018 and 11 in 2017 

156 deaths and counting! The tsunami of kids falling prey to what doctors call Acute Encephalitis Syndrome (AES) seems to have weakened now in Bihar, with few deaths reported since Sunday evening and arrival of new patients in hospitals becoming a trickle, but its ghost will haunt Bihar for some time to come.

It is not the first or second time that AES has struck in Bihar. Children have been dying of it for over a decade. Yet, the Bihar government – both the political leadership and ‘Iron frame’ (read babudom) – were caught napping. The high toll is proof, if any were needed, that they were not at all prepared with preventive and curative efforts to cope with the outbreak of this disease this year.

Here’s a look at the AES toll over the past decade: In 2009, 95 deaths had taken place. Next year, the figure came down to 24 deaths, but shot up to 197 in 2010. The death tolls were high between 2012 and 2014.

2012 recorded 275 deaths, 143 deaths in 2013 and a staggering 355 deaths in 2014.

Over the next four years, the deaths fell sharply to 35 in 2015, 4 in 2016, 11 in 2017 and 7 in 2018. Was it due to under reporting or was there better preparedness is something that requires to be probed.

Yet, the exact cause of this annual tragedy is yet to be ascertained. The most accepted hypothesis is that it is caused by malnourishment among children and compounded by severe heat wave and binge eating on empty stomach of litchis, grown widely in Muzaffarpur and surrounding districts. It is believed that a combination of these factors leads to hypoglycaemia among young kids, i.e. sharp drop in their glucose levels, leading to death if treatment gets delayed. The cure is said to be as simple as timely administration of glucose.

Dr CP Thakur, BJP leader and former Union health minister, said that since the timing of the outbreak of AES is fixed – mid-May to mid-June – the government should have chalked out a comprehensive plan to tackle it and save the children. Hospitals should have been kept in readiness to tackle the AES outbreak. Moreover, preventive steps through awareness campaigns should have been conducted in the region. But, the reality is that the state government (including health department bosses) and the Centre forget the dance of deaths once the menace dies down after the onset of monsoon, that lowers the severity of summer, and signals the end of the litchi season.

What should be done to prevent recurrence of this annual dance of death? Dr Harihar Dixit, vice-president of the Bihar chapter of Indian Medical Association, says, “Malnutrition, lower immunity, lack of awareness and poor hygiene are the factors contributing to this tragedy. So, awareness campaign through ground-level government machinery should be conducted, better nutrition supplement programme implemented under schemes like ICDS, and large-scale vaccination programme should be executed. On curative side, a targeted approach in the affected area is required. Better health infra at PHCs, with posting of doctors and paramedics, is needed.”