The Supreme Court said the deaths of more than 100 children in Muzaffarpur due to an outbreak of acute encephalitis syndrome (AES) is a matter of “grave concern” and directed the Centre and the Bihar government to file their response on medical care facilities there within a week.

A bench of Justices Sanjiv Khanna and BR Gavai asked the Bihar government to file an affidavit on the adequacy of medical facilities, nutrition and sanitation and the hygiene conditions in the state.

“This Public Interest Litigation relates to outbreak of acute encephalitis syndrome virus that has caused deaths of about 150 children in different districts in the state of Bihar. The writ petition raises issues of grave concern and importance relating to public medical care facilities, nutrition and sanitation or hygiene. The respondents will file their response within seven days specifically dealing with the question of public medical care facilities, nutrition and sanitation or hygiene,” the bench said.

During the hearing, one of the lawyers informed the court that similar deaths had occurred earlier in Uttar Pradesh. The court took note of it and directed the state government to apprise it on the issue.

The matter has been posted for hearing after 10 days.

Direct result of negligence, says plea

The petition was filed by an advocate, Manohar Pratap, who said he was deeply “pained and saddened” by the deaths of more than 126 children, mostly in the age group of one to 10 years, in the past weeks. The figures were rising day by day, the petition stated.

“The deaths of children are a direct result of negligence and inaction on the part of the respective state governments of Bihar, Uttar Pradesh and Union of India in handling the epidemical situation which arises every year due to outbreak of AES, also called as Japanese encephalitis,” the plea said. It claimed that thousands of young children were losing their lives yearly from the disease, but the governments (states and Centre) had done nothing to prevent its spread.

“This year, the epicentre of the said disease is Muzaffarpur in Bihar where more than 126 children have lost their lives in the past one week. Media reports show that there is acute shortage of doctors, medical facilities, Intensive Care Units and other medical equipments in the hospitals in nearby areas and children are dying in hospitals due to lack of required facilities,” the petition said.

‘Stop the outbreak’

The petitioner also sought directions for all possible steps to stop the disease outbreak in the earlier epicentre, Gorakhpur in Uttar Pradesh, and to create awareness about preventive steps and first aid. He has asked for a compensation of Rs 10 lakh to members of the family of the deceased who have died due to negligence of the state machinery.

The petitioner sought a direction to the Centre for constituting a board of medical experts and immediately sending it to Muzaffarpur. He asked the apex court to direct the Centre and the Bihar government for immediately arranging 500 stationary and 100 mobile intensive care units with required medical professionals to deal with the patients from the remote areas and the emergency situation which occurred due to the AES outbreak.

Symptoms of AES include high fever, convulsions and extremely low blood sugar levels. Among the factors said to trigger the syndrome are malnutrition.

There were more than 44,000 cases and nearly 6,000 deaths from encephalitis in India between 2008 and 2014, said a 2017 study published in The Indian Journal of Medical Research (IJMR).

Researchers said the patients often report acute onset of fever and altered consciousness, with a rapidly deteriorating clinical course, leading to death within hours.

Litchis grown in Muzaffarpur, the country’s largest litchi cultivation region, are said to contain a toxin which can cause a drop in blood sugar levels if consumed by a malnourished child.