We would like to thank all the study participants for their contributions. We are grateful to the physicians of Dinajpur Medical College Hospital and Golam Dostogir Harun, Diana DiazGranados, and Meghan Scott deserve special thanks for their contributions in reviewing the manuscript. icddr,b acknowledges with gratitude the commitment of CDC and NIH to its research efforts. icddr,b is also grateful to the Governments of Bangladesh, Canada, Sweden and the UK for providing core/unrestricted support.
Jmor F, Emsley HC, Fischer M, Solomon T, Lewthwaite P, 2008. The incidence of acute encephalitis syndrome in western industrialised and tropical countries. Virol J 5: 134.
Tarantola A, Goutard F, Newton P, de Lamballerie X, Lortholary O, Cappelle J, Buchy P, 2014. Estimating the burden of Japanese encephalitis virus and other encephalitides in countries of the Mekong region. PLoS Negl Trop Dis 8: e2533.
Griffiths MJ, Lemon JV, Rayamajhi A, Poudel P, Shrestha P, Srivastav V, Kneen R, Medina-Lara A, Singh RR, Solomon T, 2013. The functional, social and economic impact of acute encephalitis syndrome in Nepal–a longitudinal follow-up study. PLoS Negl Trop Dis 7: e2383.
Government of India, 2009. Guidelines Clinical Management of Acute Encephalitis Syndrome Including Japaneese Encephalitis. Delhi, India: Directorate of National Vector Borne Disease Control Programme 22, Shamnath Marg, Delhi, Directorate General of Health Services, Ministry of Health and Family Welfare.
Chatterjee P, 2014. Two-Year Probe Finds No Infection, Hints at Litchi in AES Deaths. New Delhi, India: The Indian EXPRESS.
Shrivastava A, et al., 2015. Outbreaks of unexplained neurologic illness: Muzaffarpur, India, 2013–2014. MMWR Morb Mortal Wkly Rep 64: 49–53.
Rayamajhi A, Ansari I, Ledger E, Bista KP, Impoinvil DE, Nightingale S, Kumar R, Mahaseth C, Solomon T, Griffiths MJ, 2011. Clinical and prognostic features among children with acute encephalitis syndrome in Nepal: a retrospective study. BMC Infect Dis 11: 294.
Chokephaibulkit K, Kankirawatana P, Apintanapong S, Pongthapisit V, Yoksan S, Kositanont U, Puthavathana P, 2001. Viral etiologies of encephalitis in Thai children. Pediatr Infect Dis J 20: 216–218.
Lee TC, Tsai CP, Yuan CL, Wei CY, Tsao WL, Lee RJ, Cheih SY, Huang IT, Chen KT, 2003. Encephalitis in Taiwan: a prospective hospital-based study. Jpn J Infect Dis 56: 193–199.
Srey VH, Sadones H, Ong S, Mam M, Yim C, Sor S, Grosjean P, Reynes JM, Grosjean P, Reynes JM, 2002. Etiology of encephalitis syndrome among hospitalized children and adults in Takeo, Cambodia, 1999–2000. Am J Trop Med Hyg 66: 200–207.
Hossain MJ, et al., 2010. Hospital-based surveillance for Japanese encephalitis at four sites in Bangladesh, 2003–2005. Am J Trop Med Hyg 82: 344–349.
Paireau J, et al., 2012. Litchi-associated acute encephalitis in children, northern Vietnam, 2004–2009. Emerg Infect Dis 18: 1817–1824.
John TJ, Das M, 2014. Acute encephalitis syndrome in children in Muzaffarpur: hypothesis of toxic origin. Curr Sci 106: 1184–1185.
Shrivastava A, et al., 2017. Association of acute toxic encephalopathy with litchi consumption in an outbreak in Muzaffarpur, India, 2014: a case-control study. Lancet Glob Health 5: e458–e466.
Institute of Epidemiology Disease Control and Research, 2015 . Outbreak. Available at: http://www.iedcr.org/index.php?option=com_content&view=article&id=106. Accessed May 5, 2016.
McMichael AJ, 1999. Prisoners of the proximate: loosening the constraints on epidemiology in an age of change. Am J Epidemiol 149: 887–897.
Islam MS, Luby SP, Rahman M, Parveen S, Homaira N, Begum NH, Dawlat Khan AK, Sultana R, Akhter S, Gurley ES, 2011. Social ecological analysis of an outbreak of pufferfish egg poisoning in a coastal area of Bangladesh. Am J Trop Med Hyg 85: 498–503.
Luby SP, 2012. The cultural anthropological contribution to communicable disease epidemiology. Banwell C, Ulijaszek S, Dixon J, eds. When Culture Impacts Health: Global Lessons for Effective Health Research. Amsterdam, The Netherlands: Elsevier.
Bradley EH, Curry LA, Devers KJ, 2007. Qualitative data analysis for health services research: developing taxonomy, themes, and theory. Health Serv Res 42: 1758–1772.
Dinesh DS, Pandey K, Das VNR, Topno RK, Kesari S, Kumar VAR, Sinha PK, Das P, 2013. Possible factors causing acute encephalitis syndrome outbreak in Bihar, India. Int J Curr Microbiol Applied Sci 2: 531.
Das M, Asthana S, Singh SP, Dixit S, Tripathi A, John TJ, 2015. Litchi fruit contains methylene cyclopropyl-glycine. Curr Sci 109: 2195–2196.
Papademetriou MK Dent FJ, 2002. Lychee Production in the Asia-Pacific Region. Bangkok, Thailand. Food and Agriculture Organization of the United Nations, Regional Office for Asia and the Pacific.
Shakerkhatibi M, Mosaferi M, Asghari Jafarabadi M, Lotfi E, Belvasi M, 2014. Pesticides residue in drinking groundwater resources of rural areas in the northwest of Iran. Health Promot Perspect 4: 195–205.
Khan BA, 2005. Studies on the Residues of Commonly Used Insecticides on Fruits and Vegetables Grown in NWFP-Pakistan. Nwfp Agricultural University/Agricultural Chemistry, Pakistan Research Repository Peshawar.
Harikrishnan VR, Usha S, 2004. Endosulfan: A Fact Sheet and Answers to Common Questions. Kerala, India: Thanal.
Caton P, Lopez B, 2012. Revealed: The Child Victims of Pesticide Poisoning in India. Available at: http://www.theecologist.org/News/news_analysis/1189820/revealed_the_child_victims_of_pesticide_poisoning_in_india.html. Accessed December 7, 2014.
Satar S, Sebe A, Alpay NR, Gumusay U, Guneysel O, 2009. Unintentional endosulfan poisoning. Bratisl Lek Listy (Tlacene Vyd) 110: 301–303.
Mnif W, Hassine AI, Bouaziz A, Bartegi A, Thomas O, Roig B, 2011. Effect of endocrine disruptor pesticides: a review. Int J Environ Res Public Health 8: 2265–2303.
Jha PN, 2014. 11 New Acute Encephalitis Syndrome Cases, Only One Death. The Times of India, India.
Coronado GD, Vigoren EM, Thompson B, Griffith WC, Faustman EM, 2006. Organophosphate pesticide exposure and work in pome fruit: evidence for the take-home pesticide pathway. Environ Health Perspect 114: 999–1006.
Eskenazi B, Marks AR, Bradman A, Harley K, Barr DB, Johnson C, Morga N, Jewell NP, 2007. Organophosphate pesticide exposure and neurodevelopment in young Mexican-American children. Environ Health Perspect 115: 792–798.
Xue J, Zartarian V, Moya J, Freeman N, Beamer P, Black K, Tulve N, Shalat S, 2007. A meta-analysis of children’s hand-to-mouth frequency data for estimating nondietary ingestion exposure. Risk Anal 27: 411–420.
Martin CA, et al., 2011. Investigation of an outbreak of unintentional acute pesticide poisoning: assessment of exposure to carbamate and organophosphate insecticides, rural Bangladesh, 2009. Epidemiology 22: S115.
Levy-Khademi F, Tenenbaum AN, Wexler ID, Amitai Y, 2007. Unintentional organophosphate intoxication in children. Pediatr Emerg Care 23: 716–718.
Moffatt A, Mohammed F, Eddleston M, Azher S, Eyer P, Buckley NA, 2010. Hypothermia and fever after organophosphorus poisoning in humans–a prospective case series. J Med Toxicol 6: 379–385.
Peter JV, Sudarsan TI, Moran JL, 2014. Clinical features of organophosphate poisoning: a review of different classification systems and approaches. Indian J Crit Care Med 18:735–745.
Eisenstein EM, Amitai Y, 2000. Index of suspicion. Case 1. Organophosphate intoxication. Pediatr Rev 21: 205–206.
Lifshitz M, Shahak E, Bolotin A, Sofer S, 1997. Carbamate poisoning in early childhood and in adults. J Toxicol Clin Toxicol 35: 25–27.
Kumar A, 2004 . Environmental Contamination and Bioreclamation. New Delhi, India: APH publishing Corporation.
Eskenazi B, Bradman A, Castorina R, 1999. Exposures of children to organophosphate pesticides and their potential adverse health effects. Environ Health Perspect 107 (Suppl 3): 409–419.
Pulla P, 2015. A child-killing toxin emerges from shadows: scientists link mystery deaths in India to consumptions of lychees. Science 348: 15–16.
Food and Agricultural Organization of the United Nations, 2005. International Code of Conduct on the Distribution and Use of Pesticides. Proceedings of the Asia Regional July 26–28, 2005, Workshop on the Implementation, Monitoring and Observance. Bangkok, Thailand, FAO, Regional office for Asia and the Pacific.