The Muzaffarpur area produces 70% of India's lychee fruit. It's also the site of a mysterious and deadly illness plaguing children in May and June for each of the last 22 years. Researchers now say the two facts go hand in hand. In a Lancet study, they say children who filled up on lychee and skipped dinner ended up with dangerously low blood sugar and brain inflammation because of a toxin in the fruit, reports CNN. While bodies typically metabolize fatty acids to produce glucose, the hypoglycin toxin in lychee "severely impaired" a child's ability to do so, researchers say. As a result, children experienced fever, seizures and convulsions, and would slip in and out of consciousness. About 40% of patients died, per the New York Times.
"It was a very intense situation, because we witnessed children dying in front of our eyes every day," says a researcher. While investigating 400 cases of the illness, however, researchers realized sick children were 10 times more likely to have eaten lychee than healthy children, six times more likely to have visited an orchard recently, and twice as likely to have skipped dinner before becoming ill, reports Live Science. Then in 2014, lab tests revealed hypoglycin in lychee, and in unripe fruit in particular. Urine tests also showed high levels of hypoglycin in sick children. Experts now stress that kids should limit lychee consumption and eat an evening meal, though they add that a genetic component may also be at play in the deaths. (This mystery disease affects just one family.)