The outbreaks of the unexplained acute neurological illness with high mortality among children were mainly due to toxicity. This toxicity in litchi can arise due to several factors such as humidity, heat, pesticides, etc. According to a research study done by a team of researchers from US and India, and published in the medical journal The Lancet, it stated, "Our investigation suggests an outbreak of acute encephalopathy in Muzaffarpur associated with both hypoglycin A and MCPG toxicity."
The amino acid, which is believed to be the culprit, is found in the fruit of many members of the Soapberry family, which also includes the litchis, rambutan, longan and ackee. During the study, urine samples showed that two-thirds of the ill children showed evidence of exposure to toxins found in lychee seeds, found in higher levels in unripe fruits. Due to these toxins glucose synthesis is severely impaired, leading to dangerously low blood sugar and brain inflammation in the children.
"To prevent illness and reduce mortality in the region, we recommended minimising litchi consumption, ensuring receipt of an evening meal and implementing rapid glucose correction for suspected illness," advised the researchers. If a child did become ill, the researchers said they should be treated quickly to correct their glucose levels to prevent lasting damage such as mental impairment, muscle weakness and movement disorders.