"According to our data, there have been four casualties till yesterday evening, while 16 others are undergoing treatment at Sri Krishna Medical College and Hospital. All the children are in the age group of two to five years," he said.
Outbreak of AES has been reported in the pre-monsoon summer season in Muzaffarpur for the last few years. It continues throughout the monsoon, at times peaking around July - August.
While doctors and researchers say heat and humidity provide ideal conditions for the spread of the disease, they have been unable to pinpoint the virus which causes it.
The symptoms vary from high fever, body ache, stiffness of limbs to meningitis and coma. Usually the syndrome affects malnourished kids.
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The civil surgeon said that the health department is trying to increase general awareness about the disease.
AES is reported mainly from Assam, Bihar, Karnataka, Uttar Pradesh and Tamil Nadu, which contribute around 80 per cent of AES cases in the country.