"Fresh AES cases have been reported from all the 10 identified districts where the disease has spread," a health department official here said.

Additional Secretary (Health) R.P. Ojha said that of the 409 children detected with AES symptoms, 159 have died and 82 others have been admitted to various hospitals in the state. The rest have been discharged after treatment.

According to health officials, AES, a mosquito-borne disease, has claimed lives of 100 children in Muzaffarpur district alone - the highest figure in the state. Most of these children died at the Sri Krishna Memorial College and Hospital and the Kejriwal Charitable Hospital.

As many as 47 children have died at the Patna Medical College Hospital (PMCH) and 12 at Gaya's Anugrah Narain Medical College Hospital.

Alarmed by the situation, state Health Minister Ashwani Kumar Choubey has asked the striking junior doctors of the PMCH to resume work.

"We have cancelled leaves of doctors in the all the affected districts and alerted hospitals to provide prompt treatment," Choubey said.

A team from New Delhi is in Muzaffarpur, around 75 km from here, to help contain the fatal viral disease.

The worst affected districts include Patna, Gaya, Muzaffarpur, Sitamarhi, East Champaran and Vaishali.

"All medical colleges and hospitals have been directed to provide free medicines to patients having AES symptoms," said Health Secretary Vayasji.

Bihar is yet to officially declare AES an epidemic, which is mostly killing children from poor families.