More than 100 children have died in Bihar recently. The children present themselves in the early hours of the morning with symptoms such as headache, fever, nausea, altered consciousness or unconsciousness. These symptoms are similar to those presented in cases of brain disorders such as inflammation or infection of the central nervous system (brain and/or the spinal cord) due to pathogens such as virus or bacteria. Clinical investigations have found that the deadly disease was falsely diagnosed as acute encephalitis syndrome (AES). The disease, in reality, is a metabolic disease called encephalopathy, occurring to due hypoglycaemia (dangerously low levels of glucose). First reported from Muzzafarpur in 1995, subsequent large outbreaks almost every year, with a timely precision of April-July months (period of litchi harvest), mostly affecting 3-7-year-olds. Mortality is 40-60% and the largest number of affected children are malnourished and from rural areas specifically those around the litchi farms. Clinicians have attributed encephalopathy and its related deaths in these children due to a combination of a malnourishment induced lowered glucose levels, and the consumption of litchi fruits on an empty stomach. The Head of the Department, Sri Krishna Medical College and Hospital (SKMCH) in Bihar, Dr Gopal Shankar, discredited the causes of death in children to due litchi consumption and blamed it on the heat and reduced rainfall in the season. Furthermore, news headlines of a story reporting this issue in the Times of India, was published with the title ““Litchi is not the culprit!” insists Muzaffarpur-based senior paediatrician”. As opposed to the clickbait title which could create confusion on the safety and toxicity of litchi consumption, the body of the article reflected the paediatrician’s evidence-based opinion. Alt News has studied the scientific literature on such deaths in India due to litchi consumption for a fact check on the possible causes of this specific metabolic disease. Several scientific studies have established the link of litchi consumption to a disease similar to brain inflammation in children during the litchi harvesting season (May-July) since the end of the 1990s. In the Bac Giang Province of Northern Vietnam, a clear link was established between the onset of this epidemic with the time period as well as the area of the litchi harvest. In Vietnam, the annual risk for these symptoms increased with the proportion of litchi-cultivated surface. In the districts that harvested litchis during May-June, the epidemic occurred earlier than those districts in which the litchis were harvested in the June-July period. (Paireau, Juliette et al. 2012). In India, the harvesting period of litchi in various parts of the country is also in the months of May and June with Muzaffarpur, East Champaran, Samastipur, Vaisali, and Bhagalpur districts of Bihar accounting for 31% of the annual production of litchis in India. Thus, it is evident that the link to the time period of litchi harvest as well as the specific region of litchi production is critical to the recent deadly encephalopathy epidemic in India. In 2013-2014, the National Centre for Disease Control, India (NCDC) and the US Centers for Disease Control and Prevention (US CDC) initiated an investigation to identify the potential causes of the disease. The aim was to eliminate any other known pathogens or infectious agents, heavy metals or pesticides associated with litchi fruits that may have triggered the disease. The laboratory investigation found no evidence of the aforementioned possible causative agents, and data indicated that the illness was consistent with a non-inflammatory encephalopathy. Notably, a common laboratory finding was low blood glucose (<70 mg/dL) on admission (Shrivastava, Akash et al. 2015). Thus, this study was another confirmation that low glucose due to malnourishment and/or skipping meals the night before the symptoms start, were the determining factors of the children that presented with the disease in Bihar. A case study in India (Singh et al. 2016), suggested the same pattern of encephalopathy symptoms and its deaths overlapped the harvest season of litchis. This study also found significant associations of the disease with literacy status and occupational status of parents, both suggesting lower economic class and thus, increased the likelihood of malnourishment among those children. The study also significantly correlated the presence of lychee orchard near the vicinity of households. Thus, by determining the economic status of the families close to the specific litchi producing orchards, it was determined that poverty and malnourishment was a key determinant of the encephalopathy disease.