After extreme anxiety and chaos was witnessed at several hospitals in Muzaffarpur, the Health Department had immediately issued an advisory urging parents to prevent their children from playing under the sun when temperature is hovering between 42 to 43 degree Celsius.
Why the proper case management is very important in AES is the disease is caused by 100 different pathogens ranging from virus, bacteria to fungi and parasites. "Then urban kids too should have fallen to the disease", he said. Poverty and malnutrition may hold the answer. Numerous children were squatting on the floor as the availability of beds is less than the number of patients approaching there for treatment.
The state's central districts of Muzaffarpur, Vaishali, Sheohar and East Champaran are worst affected.
"In the last two days, no child from this hospital has recovered", she told the BBC.
Earlier in the day, Bihar Health Minister Mangal Pandey's convoy was shown black flags by the Hindustani Awam Morcha and Jan Adhikar Party Loktantrik supporters in Aurangabad.
One doctor said most patients are already semi-conscious by the time they reach the hospital which is "ill-equipped" to handle so many of them.
"Infrastructure is not adequate to deal with the influx of patients", he said.
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Union Health Minister Harsh Vardhan and Bihar Health Minister Mangal Pandey have been named in a case filed in a court in Muzaffarpur district on charges of negligence leading to the death of 100 children due to Acute Encephalitis Syndrome (AES).
Bihar health secretary Sanjay Kumar said 106 children had died and more than 430 others between the ages of 4 and 10 were being treated at hospitals in Muzaffarpur district, 80 kilometres (50 miles) north of Patna, the state capital.
That's not all; the SKMCH has been grappling with shortage of doctors as well as nurses. It observed that despite reported measures taken by the government agencies, deaths of children in such large number indicated a possible flaw in the implementation of vaccination and awareness programmes.
Anyone can be affected, but the very young and very old are most at risk.
Past research has suggested the illness, which is not contagious, could be linked to toxins in lychees which are known to stop the body from producing glucose. Malnourished children have no such reserve. Thus, those given artificial sugar can be saved. A delay of even half an hour can be fatal. If an improper case management is undertaken here, then Odisha is also vulnerable to record high case fatality rate as the State topped the country in AES cases till April 2019.
"Sometimes their households have nothing to eat but litchis are in abundance in the summer. It is a matter of concern that every year children die due to it".
Experts have also connected intense heatwave in the country to the disease, although what role it plays is not clear.