More than 150 children have died in eastern India from a “brain fever” believed to be linked to a toxic substance found in lychee fruit, officials have reported.

The outbreak has swept across in Muzaffarpur, in the north-eastern state of Bihar, as children fall victim to encephalitis, which occurs when the brain becomes inflamed, says Brinkwire.

The publication notes the disease is believed to be triggered by dehydration and malnutrition.

It is 'completely curable'. However, it can be especially harmful in malnourished children under the age of 10, according to experts.

Different reports vary in their death tolls, with mortality rates coming in at 152, 129 and 122.

Public anger over the crisis has been growing, with nationals accusing both the state and the federal government of "negligence and inaction" in a petition, says Deutsche Welle.

In response, India’s highest court has ordered an investigation into the central and state governments, notes Brinkwire.

‘Most of the deaths are occurring due to lack of medical facilities in the area of outbreak’, Reuters quotes the petition saying.

While Bihar is home to 100 million people, it is one of India’s poorest states.

Lychees' link to encephalitis

Bihar is responsible for as much as 74% of India’s lychee production due to its ideal growing conditions, according to the Fruit Crops, a book concerning farming in Asia.

Similar outbreaks are also occuring in lychee-growing regions of Bangladesh and Vietnam, says Brinkwire.

It explains that the link between lychees and encephalitis starts with the fruit putting people at risk of hypoglycaemic encephalopathy.

This occurs when someone’s blood sugar drops so low they slip into a coma, have seizures or even suffer irreversible brain damage.

A dangerous lack of energy stops cells in the brain from working properly. This causes the cells to swell, putting them at risk of the inflammation that causes encephalitis.

Yet some are pointing to other possible causes of the rising death toll.

Dr. Mala Kaneria told BBC Hindi: ‘It is difficult to say with certainty if children are dying due to encephalitis because there could be a number of reasons behind these deaths.

‘It could also be due to malnutrition, insufficient levels of sugar and sodium or electrolyte imbalances.’

Poor medical treatment for sufferers

The city's Sri Krishna Medical College and Hospital has been trying to treat patients but is reportedly struggling to cope with the high number of sufferers, says Brinkwire.

According to the publication, most patients are semi-conscious by the time they reach the hospital.

Health official Ashok Kumar Singh claimed most victims are suffering from sudden and fatal drops in their blood-sugar levels.

Unfortunately, the facility is ‘ill-equipped’ to handle so many of them.

The publication explains that treatment centers in Muzzafarpur are in poor condition and frequently experience power cuts.

Reuters has said that one of its journalists visited an area hospital, which reportedly smelt of urine in its corridors and had stray goats roaming its grounds.

India’s health ministry has reiterated that it will open a 100-bed children’s ward in Muzaffarpur.

However, it first made this promise in 2014 after a similar outbreak in the area killed 350 children, points out Brinkwire.

It comments that the country’s leaders have come under fire for failing to respond to the tragedy.

Angry parents accosted Nitish Kumar, chief minister of Bihar, when he visited a hospital for the first time last Tuesday – three weeks after the crisis began, notes the publication.

Meanwhile, the state’s health minister also came under fire when he asked about the score of a cricket match during a televised meeting to discuss the outbreak.