(CNN)Scores of parents and locals gathered outside a hospital in the eastern Indian state of Bihar on Tuesday to protest the death of more than 100 children over the past three weeks.
Child death toll from brain disease crosses 100 in India as parents protest
Health authorities have confirmed that at least 109 children have died in the city of Muzaffarpur due to inflammation or infection in the brain. The fatal diagnosis is acute encephalitis, a neurological disease caused by either a virus or environmental toxins connected to the lychee fruit.
Protestors were yelling for government officials, who have been trickling in to assess the situation, to leave the hospital premises.
Local media showed mothers sobbing, parents running alongside gurneys transporting their babies, and droves of parents entering the hospital premises with children in their arms, asking for help.
Official responses -- both medical and administrative -- have been weak and delayed, some politicians say. In just two hospitals in the region, more than 400 children complaining of fever, dizziness and delirium have been admitted since the start of the year.
Acute encephalitis syndrome has spread across a few districts in India, focused in pockets in the poorer states of Uttar Pradesh, Bihar and West Bengal, which also have some of the country's hottest summers.
In 2014, nearly 117 deaths were reported in Muzaffarpur. But the death toll had dipped over the past few years.
"This year, the number [of cases] has gone up a bit," said Sanjay Kumar, a senior state health official. "The heat wave has been too intense, and it has gone on for too long."
Indian health officials and experts have been unable to accurately point to the cause of certain types of acute encephalitis syndrome and whether, as in the case of the latest India outbreak, it is viral or caused by the consumption of a toxin.
Vietnam and Malaysia have also had outbreaks, according to a study published in 2012. Both countries have tried for years to contain the spread or eliminate the cause of the condition. Experts have tried to narrow it to a virus, certain mosquito species and finally the lychee fruit.
Research papers and local officials point to the presence of lychee as a factor that may have significance in understanding the cause behind the outbreak. The fruit is widely grown in and around Muzaffarpur.