Lychees: To eat or not to eat is the question?

Over more than 150 children have lost their lives in Muzaffarpur, Bihar and neighbouring districts over the past few days due to Acute Encephalitis Syndrome. Several reports have linked the deaths to eating lychees.

This has created fear among the people about the summer fruit. People on social media are circulating a message along with a video asking people, particularly children, to stop eating lychee. They claim eating the fruit might cause a life-threatening fever to children.

In a Facebook post by Live India 24x7, it said, "For your information: You are all advised to stop eating lychee for now. Never give lychee to your kids; else they will suffer from 'chamki' fever. The health ministry has declared it "incurable". Till the time the virus is in complete controlled, stay away from consuming lychee."

According to a report in India Today, it is a misleading claim. According to doctors and the Union health ministry, there could be many factors behind the deaths. There is neither any government advisory on lychee nor has it been declared hazardous or unsafe for human consumption by any credible organisation.

A short video attached with the viral post shows a worm inside a lychee. The post has been shared over 900 times.

Why lychee is an issue?

In Bihar, Muzaffarpur is said to be famous for its lychee orchards and this is the time of the year when the lush red fruits are being harvested in the area. And peculiarly, almost every year since 1995, encephalitis deaths are being reported from this area during the same time.

Soon after the deaths of children were reported this year from Muzaffarpur, various newspaper reports related the deaths to lychee.

Media houses have referred to a joint study by scientists from the US and India, published in international medical journal "The Lancet" in 2017.

According to the Lancet report "outbreak of acute encephalopathy in Muzaffarpur is associated with both hypoglycin A and MCPG toxicity". Both these elements are present naturally in lychee.

Since they cause reduction in blood sugar levels during the night, the report recommended "minimising litchi consumption, ensuring receipt of an evening meal and implementing rapid glucose correction for suspected illness" (sic).

Health ministry's stand on lychee

The Union ministry of health and family affairs has so far published three press releases on the recent AES/JE death in Muzaffarpur.

On June 18, 2019, the ministry said that they have discussed the socio-economic profile of the households which have reported the cases, "their nutrition profiles, issues such as the ongoing heatwave, reported high percentage of hypoglycemia in the children who have died" (sic)

But in none of the press releases or in press conferences addressed by the ministry, any advisory on lychee was issued.

What are the physicians saying about lychee?

There are news reports that Dr Gopal Shankar, the head of department, Sri Krishna Medical College and Hospital (SKMCH) in Bihar, where most deaths due to AES/JE have been reported this year, had discarded the lychee theory published by "The Lancet".

Dr KK Aggarwal, heart specialist is of the opinion that "malnutrition", coupled with eating lychee on an empty stomach and skipping evening meal, could be one of the factors behind the deaths. According to him, "there are chemicals in lychee that could affect the blood glucose level the next morning if consumed in empty stomach, skipping meals".

Eminent pediatrician Dr Sanjeev Bagai has outrightly discarded that consuming lychee could be the reason behind the deaths. "Eating lychee is not harmful at all, reports relating these deaths with lychee consumption are untrue," he says.

The worm inside the viral video is quite common in any fruit and can be avoided for other health hazards. But it has no relation to AES, doctors say.

Though doctors and researchers are yet to find the exact reason behind AES in Muzaffarpur around this time of the year and whether lychee plays a role or not, but pressing the panic button by social media users asking people to stop consuming the fruit is misleading.

What the Villagers have to say about it?

Villagers are surprised with the media focus on "lychee deaths".

"When we know that lychees could kill our children, why would we let them eat them? Would we not be extra cautious to ensure that our children don't eat them?" said Mohammed Zafrul, who sells chicken in Raksa village, reported Times of India. Another interjects that it was possible that if both parents worked as labourers, unsupervised children, especially of those living near or working on the lychee orchards might have eaten the fruit. They insist, however, that cases of AES from their own village do not fall into this category. Mohammed Sharif Alam, who sells cloth in the village, lost his two-and-a-half-year old son to AES. "Seeing all the news of deaths and AES over the years supposedly caused by lychee, why would any parent allow their children to eat lychee?" asks Alam. "Neither do we live near lychee farms, nor is he old enough to go by himself or with other kids to get them from orchards," he adds.