The highest number of 172 children died of the disease at Sri Krishna Medical College and Hospital (SKMCH) and Kejriwal Charitable Hospital in Muzaffarpur, Additional Secretary (Health) R P Ojha told reporters.
Another 63 children died at the Patna Medical College and Hospital (PMCH), while 11 others succumbed to encephalitis at the Anugrah Narayan Magadh Medical College and Hospital (ANMMCH) at Gaya.
The rest five children died under similar circumstances in Vaishali district, he said.
A total of 662 children showed symptoms of the disease following its outbreak in May this year, Ojha said.
The high casaulty figure was attributed to the heat wave conditions prevailing in past few months.