Kathmandu, June 17

The recent news about litchi causing sudden death of more than 50 children in India has created fear among Nepalis. However, health practitioners and the Department of Food Technology and Quality Control Division say consumption of litchi is safe as no case of illness due to consumption of litchi has been reported in the country till date.

“No illness triggered by eating litchi has been reported till date. We are alert and prepared to tackle the problem,” said Purna Chandra Wasti, spokesperson for the Department of Food Technology and Quality Control.

According to a research article ‘The enigma of litchi toxicity: An emerging health concern in southern Asia’ published in The Lancet by Peter S Spencer and his team in 2017, says litchi contains unusual amino acids that disrupt gluconeogenesis — a metabolic pathway that results in the generation of glucose from non-carbohydrate precursors and beta-oxidation of fatty acids. The unripe litchi fruit has higher concentration of hypoglycin A — a naturally occurring amino acid derivative.

As per media reports, Indian children succumbed to encephalopathy, which can present a very broad spectrum of symptoms that range from mild, such as some memory loss or subtle personality changes, to severe, such as dementia, seizures, coma, or death. “Researchers are trying to find out cause of death of children. The question is: why only some children in a village were affected and not others. It could be related to the genetic factor,” said Anup Bastola, consultant tropical medicine physician at Sukraraj Tropical and Infectious Disease Hospital.

We cannot relate cases of Nepal with India. An extended investigation should be carried out to determine the cause/s. There aren’t any cases yet in the country. But there are chances of people suffering due to toxins if there is use of insecticides and pesticides in the fruit, said the doctor.

To prevent any kind of illness from litchi consumption, it is recommended that consumption be minimised, take evening meal without fail and implement rapid glucose correction for suspected illness. Skipping an evening meal is likely to result in night-time hypoglycaemia, particularly in young children, with limited hepatic glycogen reserves, added the doctor.

According to Spencer’s report, toxic hypoglycaemic encephalopathy can be mistaken for a viral disorder, especially Japanese B encephalitis. Litchi production is increasing and poorly nourished children have access to dropped, damaged or unripe fruit that cannot be sold. Consumption of such litchis makes them susceptible to viral infections. Areas of concern include the Tarai region of Nepal’s central and eastern districts, north-western Bangladesh, southern China and northern India.

The combination of litchi consumption, a missed evening meal, and other potential factors such as poor nutritional status, eating more litchis, and unidentified genetic differences might be needed to produce this illness, explains a research article published in The Lancet by Aakash Shrivanastava and his team on Association of acute toxic encephalopathy with litchi consumption in an outbreak in Muzaffarpur, India, 2014: A case control study.

There should be detailed study to determine how levels of hypoglycaemic acids vary across cultivars, soil, climate and harvest conditions. Guidance should be developed for the consumer, especially children, but also adults who have a susceptible metabolic profile or who eat fruit after fasting, reveals Spencer’s research.