As death toll rises, AIIMS to begin study on cause of AES
The All India Institute of Medical Sciences (AIIMS), Delhi, is set to begin a comprehensive study into the actual cause of acute encephalitis syndrome (AES) that is annually killing thousands of children under the age of 15 in the country.
The study, which is scheduled to begin next month, is not outbreak-related and will only focus on causes that trigger the syndrome in children admitted at AIIMS. Over 113 children have died of AES in Bihar hospitals since June 5.
Experts say that in nearly 40% AES cases, the cause remains unknown because of inadequate etiological (to know the cause of the disease) studies in the field.
“The cases are put under the ‘unknown cause’ category, and there’s no way to know what caused AES. The reasons could be many, this is probably the first time a single project is including viruses, bacteria, fungi, parasites and auto-immune disorders,” said Dr Sheffali Gulati, chief of child neurology division in department of paediatrics at AIIMS, Delhi.
“The project needs special equipment that we recently procured, and work is going to start next month. We will collect blood and cerebro-spinal fluid samples to know the actual cause.”
As part of the study that will target multiple conditions in one experiment, the researchers will cover a wide spectrum of infections, including dengue, chikungunya, malaria, herpes, Japanese B encephalitis, meningitis, E coli, H influenza, pneumonia etc.
AIIMS’ Centre for Advanced Research and Excellence will be handling the project that is being jointly funded by the Union ministry of health and family welfare and India Infrastructure Finance Company Limited (IIFCL), as a part of its corporate social responsibility.
“The AES study is one of 11 projects that the centre will be working on. Since litchi fruit is a known cause, I am looking for collaborators to include environmental toxins to make the study comprehensive,” Gulati said.
The research will study acute, subacute and chronic encephalopathy/ encephalitis syndrome affecting infants, children and adolescents admitted at AIIMS. Experts from the hospital’s microbiology department will also be a part of the project.
Though there is no formal registry in place, the hospital on average gets 15-20 cases of children with AES in a month, with the number going up during monsoon. Apart from Delhi-National Capital Region, cases come from Uttar Pradesh, Bihar, West Bengal, Gujarat, Rajasthan, Punjab, Haryana, and even countries like Bangladesh.
As part of the project, there is a plan to put in place a national registry for AES cases so that exact numbers can be documented.
Experts in the field say studies involving multiple conditions have been done in the past to know the cause of AES. According to a former National Centre for Disease Control official, “There have happened some such studies in the past, which is why in about 50% of the cases we do know what’s causing the syndrome. However, we need more research in the area and the AIIMS study will surely help.”