Bihar’s Muzaffarpur is going through yet another cycle of tragedy as an estimated 114 children have died from acute encephalitis syndrome in recent weeks. According to media reports on Thursday, more than 400 childen have been admitted to hospital to be treated for the condition.

The crisis is a replay of the summer months of 2012 to 2014, when experts studying the outbreak of acute encephalitis came to the conclusion that the victims were malnourished children who had suffered a toxic reaction to litchis. T Jacob John, the virologist from the Christian Medical College in Vellore who investigated the outbreak in 2012-2014, found that most of the children were from the families of labourers in the area’s litchi orchards.

After having eaten litchis through the day, the children went to bed hungry, without a nutritious dinner. The combination of malnutrition and toxins in the litchi fruit caused a condition called hypoglycaemic encephalopathy, which affects the brain, researchers said.

Given the experience of 2012-2014, the Bihar government does not have the luxury of claiming to be coping with a mysterious epidemic. The fresh cycle of deaths demonstrates the utter failure of governance in the state.

Though Bihar Chief Minister Nitish Kumar of the Janata Dal (United) projects himself as “Vikas Purush”, development man, it took him weeks to visit Muzaffarpur, only a two-hour drive from Patna. When he finally turned up on Wednesday, some parents of the sick children staged a protest, blaming the administration’s delayed response for the tragedy.

The apathy of those in power was on display through the week. On Sunday, Bihar Health Minister Mangal Pandey shocked reporters at a press conference about the tragedy by asking about India vs Pakistan cricket match scores.

It isn’t just encephalitis cases that have hit Bihar. The state is also dealing with a heat wave that has killed 90 people in the three days leading up to Tuesday. The Bihar government cannot absolve itself of blame by claiming that similar heatstroke deaths have occurred across the country. It has clearly failed to institute measures to deal with the scorching situation.

The current spate of deaths raises larger questions about the state of health and welfare delivery in Bihar. One thing is clear: natural conditions have been exacerbated by political negligence.

Sign up to The Political Fix, a newsletter that will guide you through India’s complex political landscape every Monday.