A recurring disease outbreak following litchi fruit consumption among children in Muzaffarpur, Bihar—A comprehensive investigation on factors of toxicity

Litchi fruits are a nutritious and commercial crop in the Indian state of Bihar. Litchi fruit contains a toxin, methylene cyclopropyl-glycine (MCPG), which is known to be fatal by causing encephalitis-related deaths. This is especially harmful when consumed by malnourished children. The first case of litchi toxicity was reported in Bihar in 2011. A similar event was recorded in 2014 among children admitted to the Muzaffarpur government hospital, Bihar. Litchi samples sent to ICMR-NIN were analyzed and MCPG was found to be present in both the pulp and seed of the fruit. Diethyl phosphate (DEP) metabolites were found in the urine samples of children who had consumed litchi fruit from this area indicating exposure to pesticide. The presence of both MCPG in litchi and DEP metabolites in urine samples highlights the need to conduct a comprehensive investigation that examines all factors of toxicity.