Infected patients were sharing beds in crowded hospital wards with too few doctors, while families who could afford it transferred their children to private hospitals in Patna and other larger cities. Manager of SKMCH, Sanjay Kumar Shah, told ANI.
Despite the deaths, Kumar said the mortality rate among children from encephalitis, which can cause swelling of the brain, a burning fever and vomiting, had dropped to 26.5% from 34% a year ago.
Scores of people gathered outside the hospital and started shouting slogans like "Nitish Kumar go back", as they vented their anger over the chief minister for visiting the area after the number of casualties had crossed the three-digit mark.
The National Human Rights Commission (NHRC) on Monday issued a notice to the Bihar government and the Union Health Ministry calling for a detailed report on the growing number child deaths caused by the encephalitis virus in the state's Muzaffarpur district.
Media have been barred from entering the facility and the families of sick children asked not to crowd the premises.
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The disease sets in rapidly and is characterised by plummeting blood sugar, high fever, convulsions and paralysis.
Outbreaks have occurred annually during summer months in the same districts since 1995, typically coinciding with the lychee season.
Apart from 2014 when a record 150 children died, the annual death toll is usually much lower.
A plea was also filed in the Supreme Court seeking direction to the Centre to urgently constitute a team of medical experts for treatment of the children.
"State government should ensure that Bihar-like situation should not arise in Odisha". It has also been hit by a heatwave in recent weeks with temperatures of 45 degrees Celsius (113 Fahrenheit).