Scientists Solve Mysterious Outbreak in Muzaffarpur, India

Samantha Cirillo

As early as 1995, hundreds of children in the Indian town of Muzzaffarpur die each year from an unknown disease. [1] Every year the outbreak began in mid-May as the temperatures grew and ended during Monsoon season in late-July. [2] In 2014, 390 children were admitted into the hospital and 122 died. [3]

Researchers and medical experts were unable to pin the cause of the children’s illness until now. On Tuesday January 31, 2017, a study was published in the British Journal, The Lancet Global Health, conducted by India’s National Center for Disease Control and the India office of the Centers for Disease Control and Prevention in Atlanta. [4] The study found that the disease was caused by malnourished children eating Lychee Fruit. [5]

Dr. Rajesh Yadav, an investigator for India Epidemic Intelligence Service, was a leading researcher of the outbreak. Dr. Yadav collected over 300 biological samples and found that the infected children had dangerously low blood sugar levels. [6] Around the same time as Yadav’s study, a similar outbreak was occurring in the West Indies called the “Jamaican vomiting disease” that was linked to the high level of hypoglycin found in ackee fruit located in the area. [7] The hypoglycin inhibits the body’s ability to synthesize glucose which leads to extremely low blood sugar levels. [8] After comparing the outbreaks, Yadav conducted several laboratory tests that found similar levels of hypoglycin in the Lychee fruit. [9] Muzaffarpur grows 70% of India’s lychee harvest. [10]

In 2015, the Center for Disease Control was able to test the affected children’s urine to measure hypoglycin levels. [11] Nearly all of the children infected had consumed lychee within the past 24 hours and skipped an evening meal causing night-time hypoglycemia. [12] The lychee fruit that several children in the area consume contained seeds that lead to low blood sugar and brain inflammation. [13]

After the study was complete, the results pointed to the lychee fruit as the cause of the recent outbreak. Researchers instructed parents to limit children’s consumption of lychee fruit and to provide children with evening meals. [14] The study and outreach has reduced the level of cases significantly.


[1] Ellen Barry, Dangerous Fruit: Mystery of Deadly Outbreaks in India Is Solved, New York Times, (Jan. 31, 2017),
[2] Id.
[3] Juliet Perry, Killer Fruit? Lychee cause of mysterious disease that plagued Indian town, CNN (Feb. 1, 2017),
[4] Id.
[5] Id.
[6] Barry, supra note 1.
[7] Id.
[8] Id.
[9] Id.
[10] Id.
[11] Barry, supra note 1.
[12] Perry, supra note 3.
[13] Id.
[14] Barry, supra note 1.