Bihar health officials on Monday said 103 children have lost their lives after contracting acute encephalitis syndrome in Muzaffarpur district, reported the Hindustan Times. About 300 children have been admitted to the intensive care unit of the two local hospitals, NDTV reported.

Sunil Kumar Shahi, the superintendent of Sri Krishna Medical College and Hospital, confirmed the deaths of the 85 children while Dr SP Singh confirmed 18 other deaths at the Kejriwal Maternity Clinic.

Manoj Kumar, the executive director of Bihar’s State Health Society said 11 children, suffering from acute encephalitis syndrome, have so far been admitted at the health facilities in Samastipur and Vaishali each. “Another six cases have so far been admitted in East Champaran this year,” he added. Shahi said that only monsoon can bring relief from the disease.

On Monday, a case was filed against Union Minister of Health and Family Welfare Harsh Vardhan and Bihar Health Minister Mangal Pandey in a Muzaffarpur court on charges of negligence leading to the deaths of the children. Activist Tamanna Hashmi filed the case that will be heard on June 24, according to India Today.

The petition said that Vardhan and Pandey had failed to fulfill their duties to control the outbreak of the disease. It alleged that both the ministers had done nothing to raise awareness and sensitise people in the affected areas even though the disease had been killing children for years.

Vardhan visited Muzaffarpur on Sunday to take stock of the situation. Families of patients, especially at Sri Krishna Medical College and Hospital, protested when Vardhan arrived at the hospital. People demonstrated against the inadequate facilities at the hospital and alleged negligence on the part of hospital staff. They waved black flags at Vardhan’s convoy.

Acute Encephalitis Syndrome causes fatal inflammation of the brain, along with fever, mental confusion, disorientation, delirium, or coma, and cause onset of seizures.

The Japanese encephalitis virus is the most common cause of Acute Encephalitis Syndrome in the country, causing 5% to 35% of the cases. But the syndrome is also caused by scrub typhus, dengue, mumps, measles, and Nipah and Zika viruses. However, the cause remains clinically unidentified in several cases.

Treatment for the disease has been affected as Bihar’s health authorities have also been tackling a severe heatwave that has killed over 60 people. This year has seen the worst outbreak of encephalitis in Bihar due to the long spell of high temperatures and excess humidity, The Hindustan Times quoted Sahni as saying.

Muzaffarpur MP Ajay Nishad said that the cause of the outbreak is still uncertain as several reasons could contribute to it. “There’s a rise in the number of patients this year compared to last year,” Nishad told ANI. “Biggest reason can be very high temperatures this year. Some say it happened after eating lychee, some say it happened due to malnutrition.”

The Rashtriya Janata Dal will hold protests across Bihar on June 24 over the deaths due to acute encephalitis syndrome in Muzaffarpur, ANI reported.

On Sunday, Bihar Chief Minister Nitish Kumar had announced compensation of Rs 4 lakh each to families of the children who died. He had also instructed the health department, district administration and doctors to take necessary measures to fight the disease. The state health department had cited hypoglycaemia, a condition caused by very low levels of blood sugar and electrolyte imbalance, as the main reason for the deaths.