Acute encephalitis syndrome, including Japanese encephalitis, is caused by numerous different viruses, bacteria, fungi, parasites, spirochetes, chemical and toxins. The epidemic coincides with the June-October monsoon season and post-monsoon period as the density of mosquitoes increases. It usually spreads from pigs to people via mosquitoes, and is easily identified through testing. Approximately 25,000 children in India had died from encephalitis since 1978.

Seven-year-old Aryan Singh could have met the same outcome as his cousin, who had died seven years ago because the nearest hospital was very far. When Aryan got low-grade fever in mid-September, his mother firstlyignored and then rushed to the hospital only when his temperature shot up overnight.

Doctors hospitalized Aryan after he was diagnosed with scrub typhus, a bacterial infection spread by rats and mites that accounts for almost 40% of identifiable causes of encephalitis - a potentially deadly brain swelling which is predominant in parts of South Asia and sub-Saharan Africa.

A vaccine for one strain, Japanese encephalitis, is available, but there is does notsafeguard against the strains caused by bacteria. The survival rateJapanese encephalitis is high if it is treated early.

Dr K P Yadav, in charge of primary health at the centre said that the boy is recovering. Doctors and state government officials said that eastern UP had experienced Indias worst encephalitis outbreak in 2005, with above 1,500 deaths reported at state-run BRD Medical College. But things are been changing in UP and encephalitis cases have reduced sharply because of a new network of rural clinics.

CM Yogi Adityanath said that a massive immunization and cleanliness drive in 2017 has sharply brought down the fatality rate. Small hospitals are being set up within 10km of the most disease-prone villages and over 40 lakh children were vaccinated against Japanese encephalitis between January and March. In 2018, 35 lakh children were vaccinated.

The state has claimed a steady decline in encephalitis fatalities in the last two years. In 2017, encephalitis has almost taken 748 lives. The toll dropped to 278 in 2018 and till August 31stonly 38 children had died of the disease. Dr R N Singh said there was no specificapproach to verify the governments claims, but a decline was definitely noticeable.