More than 50 children have passed away in the last ten days from a life-threatening brain disease after eating lychee fruit, according to health officials.

The deaths in northern India were reported from two hospitals in Bihar state’s Muzaffarpur district, officials reported.

The children showed signs and symptoms of Acute Encephalitis Syndrome (AES), said senior health official Ashok Kumar Singh. Most of them had suffered a sudden drop in glucose in their blood.

“The health department has already issued an advisory for people to take care of their children during the hot summer when day temperature is above 40 degrees Celsius (104 Fahrenheit),” Singh said.

More than 40 other children experiencing the same symptoms were being cared at intensive care units.

S.P. Singh, the chief medical officer of Sri Krishna Medical College and Hospital, said “they are trying our best to save them.”

The outbreaks have occurred yearly during summer months not only in Muzaffarpur but also in neighboring districts for over 20 years.

Also known as Chamki Bukhar, the deadly brain disease had already claimed 150 lives in 2014.

US researchers had said the condition could be linked to a toxic substance found in lychee. Last year, the death toll from the illness was 40.

Officials also said more research was required to know the underlying cause of the disease which alters mental state and leads to seizures and deaths.

Cases of brain disease have also been observed in Vietnam, Bangladesh, and other lychee-growing countries.

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