The toll in Bihar’s Acute Encephalitis Syndrome outbreak rose to 152 on Sunday as two children died in Muzaffarpur district, PTI reported. According to state health department officials, the deaths have occurred in 20 of the state’s 38 districts.

“AES has spread to 20 districts of Bihar but the total number of cases has come down,” Principal Secretary (Health) Sanjay Kumar told the Hindustan Times. “The death toll due to the disease has reached 152.”

Both the deaths on Sunday occurred in at the Sri Krishna Medical College and Hospital, where 431 children have been admitted for treatment since June 1, including two on Sunday, the district administration said. At the moment, 110 patients are being treated for Acute Encephalitis Syndrome. The Kejriwal hospital in Muzaffarpur town has so far seen 162 encephalitis cases, and 20 patients have died there.

“There is a perceptible decline in the number of children who are being admitted with brain fever as also the number of deaths,” said Sri Krishna Medical College and Hospital Superintendent Sunil Kumar Shahi. “It has always been observed that AES strikes at the peak of summer and the outbreak halts with the onset of rains.”

The state health department, meanwhile, suspended Bhimsen Kumar, a senior resident doctor posted at the Patna Medical College Hospital, for allegedly failing to comply with the direction to report for emergency duty in Muzaffarpur.

Meanwhile, former Union minister and Rashtriya Lok Samata Party chief Upendra Kushwaha said Chief Minister Nitish Kumar was responsible for the children’s deaths in Muzaffarpur district and demanded his resignation, PTI reported.

“Chief Minister Nitish Kumar is responsible for children’s deaths in large number in Muzaffarpur district...Despite so many deaths of children, the state government has not taken any concrete action to prevent it,” he told reporters in Patna. “The entire health services have been left at God’s mercy.”

On Sunday, residents of a village in Vaishali district, which has lost seven children to the disease, held their MLA hostage for more than an hour on Sunday, because they were angry at the government’s response to the outbreak, The Telegraph reported.

The villagers of Harvanshpur Banthu chased the car of Lalganj legislator Rajkumar Sah, a member of Ram Vilas Paswan’s Lok Janshakti Party that is part of the ruling alliance, and hurled stones at it after the police rescued him. They had earlier heckled Paswan’s younger brother and Hajipur MP Pashupati Kumar Paras.

Scare in Madhya Pradesh

Health officials in Madhya Pradesh are on alert after a man said doctors at a private hospital told him his eight-year-old son, who died on Sunday, was suffering from Acute Encephalitis Syndrome.

“The doctors at the community health centre at Khategoan told me that my son was suffering from brain fever,” the boy’s father Ibrahim Khan told the Hindustan Times. “I took him to a private hospital where a doctor said that he might be suffering from ‘Chamki Bukhar’ [as AES is known in the region]. I admitted him to hospital on Saturday and he died on Sunday.”

The doctors at the hospital did not confirm if the child was suffering from Acute Encephalitis Syndrome as they were still awaiting his reports. They said the boy had viral fever but was not malnourished, one of the syndrome’s causes.

The symptoms of Acute Encephalitis Syndrome, which causes fatal inflammation of the brain, include fever, mental confusion, disorientation, delirium, or coma, and onset of seizures. The Japanese encephalitis virus is the most common cause of the syndrome in the country, causing 5% to 35% of the cases. But the syndrome is also caused by scrub typhus, dengue, mumps, measles, and the Nipah and Zika viruses.