A further 20 children have died from acute encephalitis syndrome (AES) in just 24 hours, bringing the total number of child fatalities said to be caused by lychee fruit in the Bihar state of eastern India to 97.

“The government will leave no stone unturned to contain it at the earliest,” said Health Minister Harsh Vardhan during a four-hour visit to the Sri Krishna Medical College and Hospital (SLMCH) in Muzaffapur on Sunday. Three children reportedly died while he was there.

Union Health Minister @drharshvardhan visited SKMCH, #Muzaffarpur today to review the AES cases, with MOS Sh @AshwiniKChoubey. He spent approx 4 hrs,visiting all six wards where children are admitted. He conferred with the doctors and talked to attendants of the children. pic.twitter.com/cnMOF6Kems — Ministry of Health (@MoHFW_INDIA) June 16, 2019

Some 146 patients are still being treated in the district at the center of the outbreak. Encephalitis is a swelling of the brain often caused by viruses, with symptoms like high fever, convulsions and headaches.

Recent outbreaks of AES, also known as “brain fever,” have been linked to the lychee fruit, which contains an unusual combination of amino acids that disrupt glucose production leading to hypoglycemia which can, in turn, exacerbate the AES infection with fatal consequences.

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Health Secretary Sanjay Kumar told RFI that treatment of the encephalitis outbreak also has been hampered by the recent extreme heatwave in the region, which has so far claimed 56 lives.

The state health department has advised parents against letting their children play in the sun and against letting them go to bed on an empty stomach. Schools will reportedly remain closed until June 22 as a precautionary measure to help manage and contain the crisis.

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