A potential deadly brain disease prevalent in north-eastern regions of India could be linked to litchis, according to a report from the U.S. Center for Disease, Control and Prevention (CDC). 

The document entitled ‘Outbreak of Unexplained Neurologic Illness – Muzaffarpur, India, 2013-2014’ details the unexplained and sometimes fatal illness affecting young children reported in the Bihar state, as well as its possible connection to the exotic fruit.

The outbreaks generally peak in June and decline weeks later with the onset of monsoon rains.  Recurring isolated cases date back to 1995.

Although inconclusive, investigations have been carried out into the potential causes of the illness linked to low blood sugar levels, seizures and mysterious effects on the brain.

One possible cause could be toxins associated with litchi seeds, and as part of the investigations during 2013 and 2014, fruit samples from orchards close to the homes of ill children were collected and examined.

There is no definitive evidence to show the fruit or its seeds are behind the illness in children or that litchis from other regions inside or outside of India are harmful.

"There have been multiple epidemiologic and laboratory investigations of this syndrome, leading to a wide spectrum of proposed caused for the illness, including infectious encephalitis and exposure to pesticides,” the CDC report says.

"An association between illness and litchi fruit has been postulated because Muzaffarpur [in Bihar] is a litchi-fruit producing region. The outbreak period coincides with the month-long litchi harvesting season in Muzaffarpur.

"Although specific etiology has not yet been determined, the 2014 investigation has identified the illness as a hypoglycemic encephalopathy and confirmed the importance of ongoing laboratory evaluation of environmental toxins to identify a potential causative agent, including markers for methylenecyclopropylglycine (MCPG), a compound found in litchi seeds known to cause hypoglycemia in animal studies."

Current public health recommendations focus on reducing mortality rates by urging families to get medical attention quickly if they suspect a child is affected.

During the 2013 outbreak, between May and July, a total of 133 children were admitted to two Muzaffarpur hospitals showing systems of the mystery illness. During the same period in 2014 a total of 390 children were admitted.

"Analysis of epidemiologic data collected in the 2014 case-control study, including detailed histories regarding consumption of litchis or exposure to pesticides, might elucidate potential risk factors for illness among these children," the CDC report says.

"Although the underlying cause of this illness remains unknown, initial clinical and laboratory results of the 2014 investigation confirm the importance of systematically evaluating toxins and agents with the potential to cause acute encephalopathy.

"Furthermore, the consistent finding of hypoglycemia among affected children underscores the importance of examining the possible role of compounds that might acutely result in low blood sugar, seizures, and encephalopathy, including the possible role of MCPG in litchis."

Last June, www.freshfruitportal.com reported on the deaths of several young children in India, although scientists at that time did not believe there was a link to the fruit.

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