AN outbreak of "brain fever" in India has led to the deaths of 152 children, reports claim.

Youngsters in Bihar, India's poorest state, are believed to have died of Acute Encephalitis Syndrome, caused by dehydration and malnutrition.

India's top court ordered an investigation into the outbreak on Monday, after hearing a petition accusing the state and central governments of negligence.

The disease has reached endemic proportions in Muzaffarpur, a poor district of the eastern state of Bihar, which has some of the worst child health statistics anywhere in the world.

The fatalities have occurred in 20 of the state's 38 districts.

The outbreak has been exacerbated by a heatwave, with temperatures in Patna, Bihar's capital, reaching a high of 45.8C.

OVER 700 CASES IN JUNE

More than 700 cases of encephalitis have been registered since the outbreak began June 1, officials said.

Young children are particularly vulnerable to the illness, which can cause swelling of the brain, fever and vomiting.

A similar outbreak killed 350 children in Muzaffarpur in 2014, leading to questions about why the state and central governments had not done more to combat the disease.

Thousands of Indians suffer from encephalitis, malaria, typhoid and other mosquito-borne diseases each year during the summer monsoon season.

The Press Trust of India news agency on Monday reported that about 6,000 deaths from encephalitis occurred in India between 2008 and 2014.

Most of the deaths are occurring due to lack of medical facilities in the area of outbreak

Justice Sanjiv Khanna, a Supreme Court judge, said in response to a petition filed by activist lawyer Manohar Pratap: "We issue notice to the Bihar government seeking a detailed response."

The petitions, known as public interest litigations, are a common way for citizens to pressure state and national governments into action.

A copy of the petition said AES "is completely curable and lives of young children are being lost due to the inaction of the state machinery.

"Most of the deaths are occurring due to lack of medical facilities in the area of outbreak."

On Monday, India's health ministry reiterated a promise first made in 2014 that it would open a 100-bed children's ward in the district.

India's leaders are coming under fire for their lack of response.

ANGRY PARENTS PROTESTING

Bihars Chief Minister Nitish Kumar was accosted by angry parents when he visited the hospital for the first time last Tuesday, three weeks after the crisis began.

His health minister was criticised after he asked about the score in a cricket match between India and Pakistan during a televised meeting to discuss the outbreak.

On a visit to the district last week, several doctors said the deaths were preventable with basic treatment and education of those most at risk.

The outbreak has sparked a nationwide conversation about how the country treats its poorest.

What is Acute Encephalitis Syndrome?

Acute encephalitis syndrome (AES) is the onset of fever in the brain.

It causes mental confusion, disorientation, delirium, or coma.

The disease is mainly caused by viruses, but other sources such as bacteria, fungus, parasites, spirochetes, chemical, and toxins have been reported.

AES is particularly common in those below the age of 15.

Since the first case was reported in Bankura district, West Bengal, cases of AES and outbreaks have been the leading cause of premature deaths in India.

It is said to be triggered by dehydration and malnutrition and has also been linked to lychee fruit.

India's central government has sent medical experts to Bihar to help doctors treat the patients.

The Bihar authorities have been sharply criticized because patients were sharing beds in crowded hospital wards with too few doctors.

The families who could afford it transferred their children to private hospitals in Patna and other larger cities.

Prime Minister Narendra Modi has made no public statement on the crisis, though his health minister Harsh Varadhan said the Indian leader is monitoring the situation.

India, the worlds sixth largest economy, has its own space programme and major cities like New Delhi and Mumbai are home to world-class hospitals.

Those in Muzaffarpur, however, are in a poor condition, and experience frequent power cuts.

Varadhan said the central government was providing "all possible support" to Bihar, while the state government has also defended its response to the crisis.

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