Patna: Some of the children in Bihar who recovered from chamki fever – the local name for acute encephalitis syndrome – have developed symptoms of ‘post-encephalitis syndrome’, the impact of which experts say could last a lifetime.Last year, 598 children in Bihar got chamki fever, of whom 130 passed away while the rest recovered. When this reporter contacted the families of some of these children, they said that after recovering from the fever, their children have developed problems indicative of mental and physical distress, including fatigue and weight loss.Sonam Kumari, a four-year-old resident of Kanti in Muzaffarpur district, had a fever last year and was diagnosed with AES, and then recovered. Uttam Giri, Sonam’s grandfather, said, “Earlier she was very smart. She used to play a lot and liked to study. But after recovering from the fever, she has became very lethargic. She talks less and stays at home instead of playing with other children. Her schoolwork has also suffered.”“We are concerned about the change in her behaviour and are planning to take her to a good paediatrician,” Giri added.Sonam fell ill on June 9, 2019. She had gone to sleep without eating dinner. In the morning, her body, according to her grandfather, suddenly started to ‘jerk’ and her temperature rose. According to Giri, “At first we took her to a local clinic, but there was no improvement. We then immediately admitted her to Shrikrishna Medical College & Hospital (SKMCH) in Muzaffarpur. She regained consciousness two hours after getting admitted, but remained hospitalised for two days and then she was discharged.”Most children in Bihar who suffer from chamki fever also have hypoglycaemia.If malnourished children skip dinner, the amount of glucose in their body decreases, which in turn can heighten the risk of severe conditions, including brain damage. When this happens, the body raises its temperature. Experts say poverty and malnutrition are the most important predictors for AES.Nine-year-old Radha Kumari from Musahari in Muzaffarpur district also recovered from the fever last year. She has now become lethargic, much like Sonam. “She has been feeling lethargic ever since she returned from the hospital after recovering from the fever. She doesn’t act like she used to. She had such little energy that we did not send her to school for 6-7 months,” says Rinku Devi, Radha’s mother.Her parents took her to the doctor again, and her condition has improved marginally. “There has been some improvement after taking the medicine. But I don’t know if this recovery is temporary or permanent,” Rinku Devi said.“We had a wedding at our house on June 11 last year, so everyone was busy. Radha did not eat food even in the morning and slept without eating at night,” Devi continued. “In front of and around our house are litchi orchards. She may have eaten a litchi in the afternoon.”“In the morning, her body started jerking and a thick, white substance started coming out from her mouth. We thought that a ghost might have overtaken her body, so first we took her to an ojha. The ojha said that she is ill and should be taken to the hospital. We took her to SKMCH. She was in the hospital for four days,” she said.Muzaffarpur, Samastipur, Vaishali and other adjoining districts of Tirhut division in Bihar are ostensible AES hotbeds. Between May and July, during the litchi season, the diseases wreaks havoc as children go to bed eating nothing else but litchis. In 2017, 11 children died of AES, while seven did in 2018. But in 2019 the number was much higher.One reason was the Lok Sabha elections, during which the public health and awareness programmes took a break. Another was the particularly hot summer, following which the government of Bihar imposed a public curfew to force people to stay at home.Fortunately the number of deaths dropped again this year – although the underlying issues continue to be a source of worry. According to accredited social health activists (ASHAs), awareness programmes kicked off in March this year even as the region received more rain than usual, keeping a hot summer at bay.As a result, the state has reported a little under 100 AES cases thus far, and 11 deaths, according to data from Bihar’s health department. But according to The Hindu, some of those who recovered also reported symptoms of brain damage.Dr Arun Shah, a paediatrician, said that if post-AES treatment is not good, the “effects can last a lifetime, and the brain of children may become weak permanently.” According to him, “The government should set up an AES Rehabilitation Centre, but nothing has been done.”