New research published in British medical journal The Lancet suggests that brain swelling and sudden seizures suffered by hundreds of children in northern India may be caused by lychee poisoning, BBC Newshas reported.

The mysterious deaths appear to have been caused by poor children eating fallen fruit from the ground in the lychee orchards of India’s main producing region, Bihar.

Lychees contain a toxin called hypoglycin, which inhibits glucose production and this affected the young children whose blood sugar levels were already low because they were not eating enough food.

Children are reported to have woken up screaming in the night as they suffered acute swelling of the brain, according to the BBC. This caused them to suffer convulsions and lost consciousness.

Researchers examining the sick children at Muzaffarpur hospital in Bihar in May and June 2014 discovered a link between the brain swelling suffered by the Indian children and a similar outbreak in the Caribbean.

The Caribbean children suffered convulsions after eating ackee fruit, which also contains hypoglycin and prevents the body from producing glucose, BBC News reported. So-called ‘Jamaican vomiting sickness’, linked to eating unripe ackee, most commonly causes sudden bouts of vomiting, but in severe cases it may lead to profound dehydration, seizures, coma and death.

Indian health officials have since advised parents to make sure children have an evening meal if possible and limit the number of lychees they eat.

Officials also said that children suffering symptoms of the outbreak should be tested for hypoglycaemia, or low blood sugar, without delay, according to the BBC.

Since the warnings were issued the number of reported cases of the illness has fallen from hundreds to about 50 a year, the New York Times reported.